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Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
Published on: July 2, 2013
Acute aphasia after right hemisphere stroke.
Géraldine Maillard Dewarrat1, Jean-Marie Annoni, Eleonora Fornari
1Department of Neurology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, 1011 Lausanne, Switzerland. geraldine.maillard-dewarrat@chuv.ch
Journal of Neurology
|April 14, 2009
Summary
Right hemispheric stroke aphasia (RHSA) is uncommon, but this study found comprehension and repetition impairments were less frequent than in left hemispheric stroke aphasia (LHSA). Non-right-handed patients showed fewer comprehension issues in RHSA.
Area of Science:
- Neurology
- Neuroscience
- Linguistics
Background:
- Right hemispheric stroke aphasia (RHSA) is rare, with language representation typically in the right hemisphere (RH).
- Crossed aphasia, occurring in right-handers with RH language representation, suggests variable anatomo-clinical correlations.
- Existing literature indicates a need for further investigation into RHSA and its relationship with handedness.
Purpose of the Study:
- To investigate language function and lesion correlates in patients with RHSA.
- To compare language impairments in RHSA with those in left hemispheric stroke aphasia (LHSA).
- To explore the influence of handedness on language deficits in RHSA.
Main Methods:
- Retrospective analysis of 16 patients with first-ever ischemic RH stroke and aphasia.
- Inclusion of 25 LHSA patients as a control group.
- Assessment of four language modalities (fluency, naming, repetition, comprehension) in hyperacute and acute phases.
- Analysis of lesion location and volume using CT and MRI, transformed into stereotaxic space.
- Nonparametric statistical comparisons between patient groups.
Main Results:
- Comprehension and repetition impairments were less frequent in RHSA (56%, 50%) than LHSA (84%, 80%) during the hyperacute phase (P=0.05, P=0.04).
- Non-right-handed RHSA patients had fewer comprehension disorders than right-handed RHSA patients in the acute phase (P=0.013).
- RHSA lesions were less posterior, and comprehension/repetition deficits correlated with anterior lesions (P<0.05).
Conclusions:
- Findings suggest atypical anatomo-functional correlations for RH language representation.
- Handedness plays a significant role in language representation and susceptibility to aphasia after RH stroke.
- Further research is warranted to elucidate the complexities of RH language networks, especially in non-right-handed individuals.
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