The effects of low-frequency transcranial magnetic stimulation combined with hyperbaric oxygen in the treatment of non-fluent aphasia

Abstract

Objective To investigate the effect of repeated application of low-frequency transcranial magne-tic stimulation (rTMS) when combined with hyperbaric oxygen (HBO) in the treatment non-fluent aphasia after a stroke. Methods Forty-eight stroke survivors with non-fluent aphasia were randomly assigned to a control group, an HBO group or an observation group, each of 16. All received conventional rehabilitation therapy consisting of drug therapy, speech training and conventional physical exercises, while the HBO and observation groups were additionally given HBO and rTMS combined with HBO respectively. The 1 Hz rTMS was applied over the Broca′s homologues of the unaffected hemisphere. Before and after 4 weeks of treatment, the Western Aphasia Battery (WAB) was used to evaluate the subjects′ language function and the Modified Barthel Index (MBI) was used to assess their ability in the activities of daily living. Results There was no significant difference in the average WAB scores among the three groups before the treatment. After 4 weeks of treatment the average WAB and MBI scores of the HBO group and the observation group had improved significantly, and there was then a significant difference among the three groups. The observation group was performing significantly better than the HBO group and the control group in spontaneous speech, auditory comprehension, repetition, naming, AQ score and MBI score. Pairwise comparisons showed that the observation group′s average WAB score, spontaneous speech, auditory comprehension, repetition, naming, AQ score and MBI score were the best, followed by those of the HBO group and then those of the control group. All of the differences were statistically significant. Conclusions Low-frequency rTMS combined with HBO can significantly improve the language function and the quality of life of patients with non-fluent aphasia. Such combined therapy is worthy of clinical promotion and application. Key words: Transcranial magnetic stimulation; Hyperbaric oxygen; Stroke; Non-fluent aphasia