FV 13. The combination of repetitive transcranial magnetic stimulation (rTMS) and language therapy enhances improvement of functional communication and linguistic skills in patients with subacute aphasia

Abstract

Background and Objective Repetitive transcranial magnetic stimulation (rTMS) has shown encouraging effects on naming performance in the treatment of persons with chronic aphasia by means of inhibiting homologous language areas and reactivating perilesional tissue ( Naeser et al., 2005 ). However, there are heterogeneous results about the combined impact of speech and language therapy (SLT) and rTMS in the subacute stage of aphasia and its effect on linguistic performance in language assessments and functional communication ( Thiel et al., 2013 , Seniow et al., 2013 ). As few studies have dealt with the effect of rTMS on functional communication, the study aimed to determine to which extent rTMS combined with SLT improves functional communication and linguistic skills in patients with subacute aphasia. Methods Design and Participants: The randomized, blinded, sham-controlled study investigated the effect of a 10-day treatment period with inhibitory rTMS over the right inferior frontal gyrus versus sham stimulation in conjunction with SLT on language recovery in 30 participants with subacute aphasia after stroke. Intervention: During treatment period, half of the participants received 10 sessions of 20 min 1 Hz-rTMS over the right inferior frontal gyrus (BA 45) and the other half was subjected to sham stimulation. Directly thereafter all the participants underwent 45 min of SLT. SLT aimed at recruiting left hemisphere perilesional areas by using tasks and therapy methods which had been shown to activate predominantly left hemisphere structures in imaging studies ( Heim et al., 2008 ). Outcome Measures: Aachen Aphasia Test (AAT), Amsterdam-Nijmegen Everyday Language Test (ANELT), a naming screening and subscales of the Functional Independence Measure (FIM), all assessed the day before and the day after treatment period. Results The participants who received real rTMS significantly improved in all 10 measures of language skills and functional communication whereas sham treated participants significantly improved only regarding 6/10 measures (P Conclusion The results show for the first time that linguistic skills as well as functional communication are bolstered by combining rTMS and behavioral language therapy in patients with subacute aphasia.