Non-invasive repeated therapeutic stimulation for aphasia recovery: a multilingual, multicenter aphasia trial.

Abstract

Noninvasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) has been used in case series and small randomized controlled trials to improve recovery from poststroke aphasia in combination with speech and language therapy. Results of these studies suggest possible clinical efficacy and an excellent safety profile. Therefore, a larger international multicenter proof-of-concept trial was launched, to directly compare the safety and efficacy of rTMS, tDCS, and sham stimulation as adjuvant therapy to speech and language therapy in subacute poststroke aphasia. In the 4 participating centers, subacute stroke patients with aphasia are randomized between 5 and 30 days after ischemic stroke to either receive rTMS, tDCS, or sham stimulation in combination with a daily 45 minutes speech and language therapy session for 10 days. Efficacy is evaluated at 1 and 30 days after the last of the 10 treatment sessions using 3 outcome measures, validated in all participating languages: Boston naming test, Token test, and verbal fluency test. Additionally, adverse events are recorded to prove safety. In this study, a total of 90 patients will be recruited, and data analysis will be completed in 2016. This is the first multilingual and multinational randomized and controlled trial in poststroke aphasia and if positive, will add an effective new strategy for early stage poststroke aphasia rehabilitation.

• Authors: Alexander Thiel, Sandra E Black, Elizabeth A Rochon, Sylvain Lanthier, Alexander Hartmann, Joyce L Chen, George Mochizuki, Anna Zumbansen, Wolf-Dieter Heiss, NORTHSTAR study group
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) Vol. 24 Issue 4 Pg. 751-8 (Apr 2015) ISSN: 1532-8511 [Electronic] United States
• PMID: 25735707 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Aphasia (therapy)
• Canada
• Female
• Germany
• Humans
• Male
• Middle Aged
• Multilingualism
• Outcome Assessment, Health Care
• Recovery of Function (physiology)
• Time Factors
• Transcranial Direct Current Stimulation (methods)
• Transcranial Magnetic Stimulation (methods)
• Treatment Outcome