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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
Epidural cortical stimulation and aphasia therapy
Leora R Cherney1, Richard L Harvey, Edna M Babbitt
1Rehabilitation Institute of Chicago, Chicago, IL, USA.
Aphasiology
|May 14, 2013
Summary
Epidural cortical stimulation combined with language therapy (CS/LT) shows promise for improving aphasia after stroke. This approach may augment speech-language therapy, with lasting benefits observed post-treatment.
Area of Science:
- Neuroscience
- Neurology
- Speech and Language Pathology
Background:
- Cortical brain stimulation is increasingly explored for aphasia rehabilitation post-stroke.
- Epidural cortical stimulation offers high-frequency, spatially specific stimulation of targeted neuronal populations.
Purpose of the Study:
- Review evidence for epidural cortical stimulation in upper limb recovery and aphasia.
- Summarize procedures and outcomes of a safety and feasibility study on epidural cortical stimulation for aphasia.
Main Methods:
- A controlled study compared epidural cortical stimulation plus language treatment (CS/LT) to language treatment alone (LT) in eight stroke survivors with nonfluent aphasia.
- Surgical implantation of an epidural stimulation device was performed in four participants, activated during therapy sessions.
Main Results:
- CS/LT demonstrated moderate effect sizes for the Western Aphasia Battery Aphasia Quotient from baseline to post-treatment, and large effects at 12-week follow-up.
- Significant improvements were noted at 12-week follow-up for naming, communicative effectiveness, and discourse measures in the CS/LT group compared to LT alone.
- Effect sizes for discourse measures were typically larger for subjects receiving CS/LT.
Conclusions:
- Epidural cortical stimulation may augment behavioral speech-language therapy for post-stroke aphasia.
- Further investigation of CS/LT in post-stroke aphasia warrants cautious, individualized study designs.
- Insights from non-invasive CS/LT research may inform future epidural stimulation studies.
