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Published on: July 2, 2013
Long-Term Therapy With Transcranial Magnetic Stimulation in Primary Progressive Aphasia: A Randomized Clinical Trial
Lucía Fernández-Romero1, María Nieves Cabrera-Martin2, Cristina Delgado-Alonso1
1Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute, Universidad Complutense de Madrid, Madrid, Spain.
Transcranial magnetic stimulation (TMS) combined with language therapy improved brain metabolism and language function in primary progressive aphasia (PPA) patients over six months. This approach offers a promising treatment for PPA, enhancing outcomes and slowing disease progression.
Area of Science:
- Neuroscience
- Neurology
- Clinical Trials
Background:
- Primary progressive aphasia (PPA) is a debilitating neurodegenerative syndrome with no current effective treatments.
- Existing therapies offer limited efficacy, highlighting the need for novel therapeutic strategies.
Purpose of the Study:
- To investigate the efficacy, safety, and adherence of transcranial magnetic stimulation (TMS) combined with language therapy in PPA patients over a 6-month period.
- To evaluate the impact of TMS on regional brain metabolism and various language and cognitive functions.
Main Methods:
- A prospective, double-blind, parallel-design randomized clinical trial involving 63 PPA participants (aged 71.8 ± 8.4 years).
- Participants received either active intermittent theta-burst TMS or sham TMS for 6 months, followed by evidence-based language intervention, stratified by PPA variant.
- Primary outcome: standardized uptake value ratio (SUVR) measured by FDG-PET; Secondary outcomes: Mini Linguistic State Examination, confrontation naming, spontaneous speech, daily living activities, and neuropsychiatric inventory.
Main Results:
- Active TMS demonstrated a statistically significant positive effect on the primary outcome (SUVR) compared to sham TMS (P=.046).
- Significant improvements were observed in secondary outcomes including language abilities (Mini Linguistic State Examination, confrontation naming), functional independence, and neuropsychiatric symptoms at 6 months.
- No significant differences in adverse events were noted between groups, and adherence was high (92.1%).
Conclusions:
- Intermittent theta-burst TMS combined with language therapy shows potential for slowing neurodegenerative decline in PPA.
- This combined approach offers a promising therapeutic strategy to improve functional outcomes and slow disease progression in individuals with PPA.
- Further research is warranted to explore long-term effects and optimize TMS protocols for PPA treatment.
