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Language improvements after TMS plus modified CILT: Pilot, open-protocol study with two, chronic nonfluent aphasia cases.

AbstractPURPOSE:
The purpose of this study was to investigate: 1) the feasibilty of administering a modified CILT (mCILT) treatment session immediately after TMS; and 2) if this combined therapy could improve naming and elicited propositional speech in chronic, nonfluent aphasia.
METHODS:
Two chronic stroke patients with nonfluent aphasia (mild-moderate and severe) each received twenty minutes of rTMS to suppress the right pars triangularis, followed immediately by three hours of mCILT (5 days/week, 2 weeks). (Each patient had received TMS alone, 2-6 years prior.) Language evaluations were performed pre- TMS+mCILT, and post- at 1-2 months, and 6 or 16 months.
RESULTS:
Both patients showed significant improvements in naming pictures, and elicited propositional speech at 1-2 months post- TMS+mCILT. The improved naming was still present at 6 months post- TMS+mCILT for P2; but not at 16 months post- TMS+mCILT for P1.
CONCLUSIONS:
It is feasible to administer mCILT for three hours immediately after a TMS session. It is unknown if the significant improvements in naming pictures, and elicited propositional speech were associated with the second series of TMS, or this first series of mCILT, or a combination of both. A larger, sham controlled clinical trial is warranted.
AuthorsPaula I Martin, Ethan Treglia, Margaret A Naeser, Michael D Ho, Errol H Baker, Elizabeth G Martin, Shahid Bashir, Alvaro Pascual-Leone
JournalRestorative neurology and neuroscience (Restor Neurol Neurosci) Vol. 32 Issue 4 Pg. 483-505 ( 2014) ISSN: 1878-3627 [Electronic] Netherlands
PMID25015701 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
Topics
  • Adult
  • Aphasia, Broca (etiology, therapy)
  • Female
  • Humans
  • Language Therapy (methods)
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Stroke (complications)
  • Transcranial Magnetic Stimulation

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