Effects of rTMS Based on Brain Activation During Language Performance in Stroke Patients With Non-fluent Aphasia

Seoul National University

Status: Completed

Conditions: Stroke; Aphasia

Treatments: Device: High frequency rTMS; Device: Low frequency rTMS

Study type: Interventional

Funder types: Other

Identifiers

NCT02556385

B-1507-308-006

Details and patient eligibility

About

The aim of this study is to assess the safety and clinical efficacy of high or low-frequency repetitive transcranial magnetic stimulation based on brain activation with functional near infrared spectroscopy in poststroke nonfluent aphasia patients.

Full description

In poststsroke aphasia rehabilitation, repetitive transcranial stimulation (rTMS) studies aimed to reinforce the activity of the brain regions in the left hemisphere. This goal can be achieved by using an excitatory protocol to reactivate the perilesional area or inhibitory protocol to reduce activities in the contralesional area. However, most conventional rTMS studies employed an inhibitory low frequency protocol for the contralesional homologs of Broca's area.

In the present pilot study, investigators will perform functional near-infrared spectroscopy (fNIRS) prior to rTMS treatment for selection of the most appropriate application of stimulation. Stimulation site and protocol (high frequency or low frequency rTMS) will be determined by activation pattern from the fNIRS findings with language task in individual patients.

Enrollment: 5 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18-80 yrs old
• Right-handed
• Radiologically confirmed left hemisphere stroke
• Fluent in Korean
• First ever stroke
• More than 1 year from stroke onset
• Non-fluent (motor-dominant) aphasia
• Written informed consent

Exclusion criteria

• Previous medical histories of stroke, cerebral vascular operation, seizure
• Patients with traumatic brain injury
• Unable to perform the language task
• Severe cognitive impairment (MMSE less than 16)
• Skin lesion in the stimulation site of scalp
• Metal implants in the body (cardiac pacemaker or aneurysm clip)
• Pregnancy, Breastfeeding

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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5 participants in 2 patient groups

High frequency rTMS

Experimental group

Description:

Most activated area from fNIRS with language task: Perileisional Broca's area

Treatment:

Device: High frequency rTMS

Low Frequency rTMS

Active Comparator group

Description:

Most activated area from fNIRS with language task: Contralesional homologs of Broca's area

Treatment:

Device: Low frequency rTMS