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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
[Improving the effectiveness of treatment of patients with post-stroke aphasia]
S V Kotov1, M M Shcherbakova1, V A Zenina1,2
1Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia.
Objective:
To evaluate the efficacy of speech therapy in patients with acute ischemic stroke (AIS) who received comprehensive treatment, including speech therapy and Cytoflavin infusions.
Material And Methods:
46 right-handed patients who were hospitalized during the acute phase of AIS in the left middle cerebral artery were included in the study. Patients received comprehensive speech therapy and were randomly assigned to one of two groups. The first group consisted of 25 patients whose treatment regimen included infusions of the Cytoflavin solution, while the second group (n=21) received only basic therapy for the secondary prevention of AIS. To assess the patients' condition, the following scales were used: the National Institutes of Health Stroke Scale (NIHSS), the Modified Rankin Scale, a screening tool for aphasia, and the Goodglass-Kaplan Scale (GKS).
Results:
After the completion of the treatment course, statistically significant improvements were noted in patients from both groups. However, the degree of disability and dependence on others for daily activities in patients receiving infusions of Cytoflavin solution was significantly lower in group 1 compared to group 2 (p=0.015). After the treatment, there was a regression of aphasia to moderate compensation in patients from group 1 (mean score 3 [3-4] points) and group 2 (mean 2 [2-2] points), with p=0.007 significance. As a result, patients from group 1 were able to communicate verbally on everyday topics (mean GKS score 3), while patients from group 2 also improved their communication, but still required significant assistance from an interlocutor (mean GKS 2). A clinical example is provided.
Conclusion:
A positive result was observed from the inclusion of Cytoflavin in the treatment of patients with aphasic disorders in AIS. There was a significant decrease in disability levels, an improvement in speech communication abilities, and a regression of aphasia following the use of the combination of drug therapy, speech therapy, and physical rehabilitation methods. Additionally, patients who received drug support with Cytoflavin showed an increased tolerance to treatment loads during therapy.
