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Treatment of dysphasia with rTMS and language therapy after childhood stroke: Multimodal imaging of plastic change.
- Source :
-
Brain and language [Brain Lang] 2016 Aug; Vol. 159, pp. 23-34. Date of Electronic Publication: 2016 Jun 02. - Publication Year :
- 2016
-
Abstract
- Expressive dysphasia accompanies left inferior frontal gyrus (IFG/Broca) injury. Recovery may relate to interhemispheric balance with homologous, contralesional IFG but is unexplored in children. We evaluated effects of inhibitory rTMS to contralesional IFG combined with intensive speech therapy (SLT). A 15year-old, right-handed male incurred a left middle cerebral artery stroke. After 30months, severe non-fluent dysphasia impacted quality of life. Language networks, neuronal metabolism and white matter pathways were explored using MRI. Language function was measured longitudinally. An intensive SLT program was combined with contralesional inhibitory rTMS of right pars triangularis. Procedures were well tolerated. Language function improved persisting to four months. Post-treatment fMRI demonstrated increased left perilesional IFG activations and connectivity at rest. Bilateral changes in inositol and glutamate metabolism were observed. Contralesional, inhibitory rTMS appears safe in childhood stroke-induced dysphasia. We observed clinically significant improvements after SLT coupled with rTMS. Advanced neuroimaging can evaluate intervention-induced plasticity.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Aphasia, Broca etiology
Aphasia, Broca pathology
Aphasia, Broca physiopathology
Broca Area pathology
Broca Area physiopathology
Functional Laterality
Glutamic Acid metabolism
Humans
Infarction, Middle Cerebral Artery physiopathology
Infarction, Middle Cerebral Artery therapy
Inositol metabolism
Magnetic Resonance Imaging
Male
Neurons metabolism
Quality of Life
Rest
Speech Therapy
Stroke pathology
Stroke physiopathology
Stroke therapy
White Matter pathology
White Matter physiopathology
Aphasia, Broca therapy
Brain Mapping
Language Therapy
Multimodal Imaging
Neuronal Plasticity
Stroke complications
Transcranial Magnetic Stimulation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1090-2155
- Volume :
- 159
- Database :
- MEDLINE
- Journal :
- Brain and language
- Publication Type :
- Academic Journal
- Accession number :
- 27262774
- Full Text :
- https://doi.org/10.1016/j.bandl.2016.05.008