重复经颅磁刺激(rTMS)有望改善中风后失语症的言语能力。有限的证据表明,将rTMS与言语治疗配对可能会带来更大的改善。20名卒中幸存者(卒中后>6个月)随机接受假rTMS加多模态失语症治疗(M-MAT)或rTMS加M-MAT。第一次,我们证明rTMS结合M-MAT是可行的,零不良事件和最小减员。随着时间的推移,两组在所有语音和语言结果上都有显着改善。然而,rTMS或假手术之间的改善没有差异。我们发现rTMS和假手术组的病变位置不同,这可以解释语音和语言结果以及每个组内BOLD信号变化的独特模式。我们为未来的研究提供了实际考虑,并得出结论,虽然rTMS加M-MAT联合治疗慢性卒中后失语症是安全可行的,个性化干预可能是必要的。
Repetitive transcranial magnetic stimulation (rTMS) shows promise in improving speech production in post-stroke aphasia. Limited evidence suggests pairing rTMS with speech therapy may result in greater improvements. Twenty stroke survivors (>6 months post-stroke) were randomized to receive either sham rTMS plus multi-modality aphasia therapy (M-MAT) or rTMS plus M-MAT. For the first time, we demonstrate that rTMS combined with M-MAT is feasible, with zero adverse events and minimal attrition. Both groups improved significantly over time on all speech and language outcomes. However, improvements did not differ between rTMS or sham. We found that rTMS and sham groups differed in lesion location, which may explain speech and language outcomes as well as unique patterns of BOLD signal change within each group. We offer practical considerations for future studies and conclude that while combination therapy of rTMS plus M-MAT in chronic post-stroke aphasia is safe and feasible, personalized intervention may be necessary.