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Burile GC, Seth NH, Raghuveer R. Exploring the Impact of Neurophysiotherapy in Managing Leukoencephalopathy Challenges: A Case Report. Cureus 2024; 16:e56452. [PMID: 38638743 PMCID: PMC11025020 DOI: 10.7759/cureus.56452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Leukoencephalopathy (LE), characterized by structural changes affecting cerebral white matter, presents a complex clinical picture with diverse etiologies. This case report details the presentation, clinical findings, and physiotherapy management of a 32-year-old female with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy and a history of diabetes and hypertension. She suddenly stopped her medications, which led to the worsening of her condition. She presented with symptoms of headache, slurred speech, visual disturbances, cognitive impairment, and impaired balance and coordination, due to which her activities of daily living were affected. The symptoms highlighted the challenges and multidisciplinary approach required for its management. The patient exhibited neurological deficits, cognitive decline, and abnormal reflexes, with magnetic resonance imaging (MRI) revealing white matter abnormalities. Outcome measures demonstrated significant improvements in cognitive and functional abilities, emphasizing the effectiveness of tailored rehabilitation in managing the complexities of colony-stimulating factor 1 receptor-related leukoencephalopathy. A six-week physiotherapy rehabilitation program addressed various domains, including strength training, task-specific exercises, errorless learning, facial muscle retraining, balance exercises, visual restoration therapy, and mobility training. All these interventions effectively improved her functional capacity and made the patient independent in performing activities of daily living.
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Affiliation(s)
- Ghanishtha C Burile
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikita H Seth
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Raghumahanti Raghuveer
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Burile GC, Harjpal P, Arya NP, Seth NH. The Role of Early Rehabilitation in Better Outcomes in a Rare Presentation of Tuberculous Meningitis With Broca's Aphasia. Cureus 2024; 16:e53793. [PMID: 38465188 PMCID: PMC10923730 DOI: 10.7759/cureus.53793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
There is a complex link between tuberculous meningitis (TBM) and aphasia, in which a language impairment is caused by an injury to the cortical language centre. The parts of the brain that function for speech and language production are the Wernicke's, Broca's, and arcuate fasciculus regions. This case report mainly highlights the neurological consequences of TBM, and how it affects language and speech functioning. It outlines a comprehensive physiotherapy rehabilitation program that targets a range of issues for the patient, such as verbal output, weakness, motor deficits, articulation issues in speech, and coordination issues. Various treatment modalities can help correct weakness, improve balance and coordination, increase flexibility and range of motion (ROM), and make speech more fluent. The case report emphasizes the necessity of using an integrated approach that combines speech-language therapy (SLT), melodic intonation therapy (MIT), constraint-induced aphasia therapy (CIAT), medication treatments, and physical therapy to address the multifaceted impacts of TBM-induced aphasia on a patient's quality of life (QOL).
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Affiliation(s)
- Ghanishtha C Burile
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Harjpal
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neha P Arya
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nikita H Seth
- Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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3
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Audio-video database from subacute stroke patients for dysarthric speech intelligence assessment and preliminary analysis. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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4
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Feng S, Tang M, Huang G, Wang J, Lv Y, He S, Liu D, Gu L. Comparison of the efficacy of acupuncture-related Therapies for post-stroke motor aphasia: A Bayesian network meta-analysis. Front Neurol 2022; 13:992079. [PMID: 36619913 PMCID: PMC9810494 DOI: 10.3389/fneur.2022.992079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Motor aphasia, which can affect the communication ability of patients and even triggers severe psychological disorders, is one of the most common sequelae after stroke. Acupuncture (a typical complementary alternative therapy) is frequently combined with speech training (ST) to treat post-stroke motor aphasia (PSMA) and presents significant efficacy. However, the most effective acupuncture intervention is still unknown. This study aims to analyze the efficacy of several acupuncture approaches combined with ST for PSMA to identify the best intervention for clinical decision-making by using network meta-analysis (NMA). Methods Eight major databases were searched from the time of their establishment to March 2022. Clinical efficacy rate (CER) was used as the primary outcome indicator. R software (version 4.13.0) and STATA software (version 16.0) were used to analyze the data. Results A total of 29 randomized controlled trials (RCTs) and six treatment regimens were included in this study. In the pair-wise meta-analysis, we found that the efficacy of scalp-tongue acupuncture (STA) combined with ST [OR = 8.30; 95% Credible interval (CrI): 3.87, 17.33], tongue acupuncture (TA) combined with ST (OR = 3.95; 95% CrI: 2.27, 6.89), scalp-body acupuncture (SBA) combined with ST (OR = 3.75; 95% CrI: 2.26, 6.22), scalp acupuncture (SA) combined with ST (OR = 2.95; 95% CrI: 1.74, 5.0), and body acupuncture (BA) combined with ST (OR = 2.30; 95% CrI: 1.26, 4.19) were significantly superior to that of ST. In addition, the efficacy of STA + ST was significantly superior to that of SA +ST (OR = 2. 82; 95% CrI: 1.24, 6.38) and BA + ST (OR = 3.61; 95% CrI: 1.40, 9.29). According to the surface under the cumulative ranking curve (SUCRA), STA + ST (SUCRA = 97.9%) may be the best treatment regimen to improve the clinical outcome in patients with PSMA. Conclusion The NMA showed that STA combined with ST may be the best treatment to improve CER, compared with other combination treatments. However, since the overall quality and number of studies are limited, further RCTs with a large sample and multicenter are needed for further validation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=316081, identifier CRD42022316081.
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Affiliation(s)
- Sisi Feng
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Mingzhi Tang
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Gan Huang
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Jumei Wang
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yulan Lv
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Sijin He
- Kunming Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Duo Liu
- Kunming Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Lihua Gu
- Kunming Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China,*Correspondence: Lihua Gu ✉
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5
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Chen Q, Shen W, Sun H, Zhang H, Liu C, Chen Z, Yu L, Cai X, Ke J, Li L, Zhang L, Fang Q. The effect of coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation on shaping early reorganization of the motor network after stroke. Brain Res 2022; 1790:147959. [PMID: 35654120 DOI: 10.1016/j.brainres.2022.147959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022]
Abstract
Neural plasticity is a major factor driving cortical reorganization after stroke. This study aimed to evaluate functional connectivity (FC) changes in the cortical motor network after coupled inhibitory-facilitatory repetitive transcranial magnetic stimulation (rTMS) treatment and to assess the correlation between FC changes and functional recovery, further characterizing the neural mechanisms underlying the beneficial effects of rTMS. We randomly divided 63 patients with acute stroke into four groups: (1) Group A received coupled inhibitory-facilitatory rTMS [1 Hz over the contralesional primary motor cortex (M1) and 10 Hz over ipsilesional M1]; (2) Group B received a contralesional sham stimulation and ipsilesional 10 Hz stimulation; (3) Group C received a contralesional 1 Hz rTMS and ipsilesional sham stimulation; and (4) Group D received bilateral sham stimulation only. Standardized rehabilitation therapy was performed immediately after rTMS, and each group was treated with their respective treatment modalities for 4 weeks. Twenty-four hours before and after the intervention, participants underwent resting-state functional magnetic resonance imaging. Additional functional assessments were conducted at baseline, after treatment, and at the 3 month follow-up. The rTMS treatment significantly changed the FCs of intra- and inter-hemispheric cortical motor networks in the rTMS groups (A and B) compared with the sham group (Group D). This effect was more pronounced in Group A, which displayed a changed FC between the contralesional postcentral gyrus and contralesional superior parietal gyrus, between the contralesional precentral gyrus and contralesional postcentral gyrus, and between the ipsilesional postcentral gyrus and contralesional superior parietal gyrus, when compared with Groups B and C. Importantly, FC changes were significantly correlated with improvement of motor function. In the early stages of ischemic stroke, coupled rTMS was more conducive to motor recovery by modulating the FCs of intra-hemispheric and inter-hemispheric motor networks. Our results suggested that FC changes were related to motor function recovery for early-stage cerebral stroke patients treated with coupled rTMS. These findings could help to understand the mechanism of coupled rTMS and further the use of this therapy as an adjunct rehabilitation technique in motor recovery.
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Affiliation(s)
- Qingmei Chen
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China; Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Wenjun Shen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Haiwei Sun
- Department of Emergency Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Hanjun Zhang
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Chuandao Liu
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Zhiguo Chen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Liqiang Yu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Xiuying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Jun Ke
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China
| | - Li Li
- Department of Physical Medicine &Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.
| | - Lichi Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China.
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Sheppard SM, Meier EL, Kim KT, Breining BL, Keator LM, Tang B, Caffo BS, Hillis AE. Neural correlates of syntactic comprehension: A longitudinal study. BRAIN AND LANGUAGE 2022; 225:105068. [PMID: 34979477 PMCID: PMC9232253 DOI: 10.1016/j.bandl.2021.105068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Broca's area is frequently implicated in sentence comprehension but its specific role is debated. Most lesion studies have investigated deficits at the chronic stage. We aimed (1) to use acute imaging to predict which left hemisphere stroke patients will recover sentence comprehension; and (2) to better understand the role of Broca's area in sentence comprehension by investigating acute deficits prior to functional reorganization. We assessed comprehension of canonical and noncanonical sentences in 15 patients with left hemisphere stroke at acute and chronic stages. LASSO regression was used to conduct lesion symptom mapping analyses. Patients with more severe word-level comprehension deficits and a greater proportion of damage to supramarginal gyrus and superior longitudinal fasciculus were likely to experience acute deficits prior to functional reorganization. Broca's area was only implicated in chronic deficits. We propose that when temporoparietal regions are damaged, intact Broca's area can support syntactic processing after functional reorganization occurs.
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Affiliation(s)
- Shannon M Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Communication Sciences & Disorders, Chapman University, Irvine, CA 92618, United States.
| | - Erin L Meier
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Kevin T Kim
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bonnie L Breining
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Lynsey M Keator
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Bohao Tang
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Brian S Caffo
- Department of Biostatics, Johns Hopkins School of Public Health, Baltimore, MD 21287, United States
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, United States
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7
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Chen Q, Shen W, Sun H, Shen D, Cai X, Ke J, Zhang L, Fang Q. Effects of mirror therapy on motor aphasia after acute cerebral infarction: A randomized controlled trial. NeuroRehabilitation 2021; 49:103-117. [PMID: 34180428 DOI: 10.3233/nre-210125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mirror therapy (MT) has proven to be beneficial for treating patients suffering from motor aphasia after stroke. However, the impacts of MT on neuroplasticity remain unexplored. OBJECTIVE In this paper we conducted a randomized controlled trial to evaluate the treatment using the MT on motor aphasia following acute cerebral infarction. METHODS We randomly assigned 30 patients into test and control groups, with test group patients treated with MT, whereas control group patients were treated with sham MT. At 24 hours prior to and after the intervention, we obtained functional magnetic resonance imaging (fMRI) data from study subjects. At baseline, after treatment and 12-week follow-up, we additionally evaluated patients with the Modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), and the aphasia quotient (AQ) in the western aphasia test. RESULTS After 2 weeks of treatment, the test group demonstrated significant improvements in AQ values, naming, repetition, spontaneous speech, and mRS scores compared to the control group (P < 0.05). Furthermore, in the follow-up time point (12 weeks), we found that the test group exhibited significantly better NIHSS scores and AQ evaluation indicators than the control group (P < 0.05). Specifically, the fMRI study shows that functional connectivity significantly improved in test group patients mainly among frontal, temporal, and parietal lobes of the left hemisphere with each other than controls group. Meanwhile, we found significantly enhanced functional connectivity with the hippocampus (P < 0.01). CONCLUSIONS Our results indicate that the MT can expedite the recovery of language function during the early phases of stroke recovery. These findings may elucidate the underlying mechanism of MT and the application of this therapy as an adjunct rehabilitation technique in language recovery.
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Affiliation(s)
- Qingmei Chen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Wenjun Shen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Haiwei Sun
- Department of Emergency Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Dan Shen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xiuying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Jun Ke
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Lichi Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Chen Q, Shen D, Sun H, Ke J, Wang H, Pan S, Liu H, Wang D, Su M, Fang Q. Effects of coupling inhibitory and facilitatory repetitive transcranial magnetic stimulation on motor recovery in patients following acute cerebral infarction. NeuroRehabilitation 2021; 48:83-96. [PMID: 33361618 DOI: 10.3233/nre-201606] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The treatment for patients suffering from motor dysfunction following stroke using continuous repetitive transcranial magnetic stimulation (rTMS) has the potential to be beneficial for recovery. However, the impact of explicit results on the coupling of various rTMS protocols on motor treatment in patients following acute cerebral infarction remain unexplored. OBJECTIVE The current study aims to design a sham-controlled randomized report to explore the capability of consecutive suppressive-facilitatory rTMS method to increase the motor results following acute stroke. METHODS A hundred ischemic stroke patients suffering from motor disorder were randomly assigned to obtain 4 week sessions of (1)10 Hz over the ipsilesional primary motor cortex (M1) and next 1 Hz over the contralesional M1; (2) contralesional sham stimulation and next ipsilesional real 10 Hz; (3) contralesional real 1 Hz rTMS and next ipsilesional sham stimulation; or (4) bilateral sham-control procedures. At 24 hours before and after the intervention, we obtained cortical excitability data from study subjects. At baseline, after treatment and 3 months follow up, we additionally evaluated patients with the clinical assessments. RESULTS At post-intervention, group A showed greater motor improvements in FMA, FMA-UL, NIHSS, ADL and mRS values than group B, group C and group D, that were continued for at least 3 months after the completion of the treatment time. Specifically, it is shown in the cortical excitability study that the motor-evoked potential (MEP) amplitude and resting motor threshold (rMT) more significantly improved in group A than other groups. The improvement in motor function and change in motor cortex excitability exhibit a significant correlation in the affected hemisphere. The combined 1 Hz and 10 Hz stimulation treatment showed a synergistic effect. CONCLUSIONS Facilitatory rTMS and coupling inhibitory produced extra satisfactory results in facilitating the motor's recovery in the subacute and acute phase following stroke compared to that acquired from alone single-course modulation.
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Affiliation(s)
- Qingmei Chen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.,Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Dan Shen
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Haiwei Sun
- Department of Emergency Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Jun Ke
- Department of Medical Imaging, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Hongxia Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Shenjie Pan
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Haoyu Liu
- Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Dapeng Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Min Su
- Department of Physical Medicine & Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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9
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Zhao Q, Wang J, Li Z, Song L, Li X. Effect of Anodic Transcranial Direct Current Stimulation Combined With Speech Language Therapy on Nonfluent Poststroke Aphasia. Neuromodulation 2021; 24:923-929. [PMID: 33624330 DOI: 10.1111/ner.13337] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/01/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Transcranial direct current stimulation (tDCS) facilitates or inhibits spontaneous neuronal activity by low-intensity current. In this study, we evaluated the effects of tDCS and sham stimulation combined with speech language therapy (SLT) on nonfluent poststroke aphasia (PSA) patients. MATERIALS AND METHODS Patients with PSA were randomly divided into the anode tDCS (A-tDCS) group (n = 8) and sham tDCS (S-tDCS) group (n = 10). The anodes and cathodes were fixed over left inferior gyrus frontalis (L-IFG) and the deltoid muscle of the right shoulder. A-tDCS consisted of 2 mA for 20 min, while S-tDCS current started at 2 mA but automatically decreased to 0 mA after 30 sec. Stimulation was concurrent with 30 min of SLT. Stimulation + SLT sessions occurred five times a week for four weeks. The Western Aphasia Battery (WAB) was given before treatment to obtain the baseline score and once more after all sessions were completed, and the Aphasia Quotient (AQ) was calculated. RESULTS After tDCS treatment, the AQ mean(SD) in both groups was significantly higher than before treatment (p < 0.001) and the AQ of the A-tDCS group 72.99 (21.91) was significantly higher than that of the S-tDCS group 46.18 (19.29) (t = 2.760, p < 0.05). Upon further analysis of the WAB subscores, except for comprehension, all other items were significantly higher in the A-tDCS group than in the S-tDCS group (p < 0.05). CONCLUSION Our results suggest that left inferior gyrus frontalis anodic transcranial direct current stimulation is an effective adjuvant to conventional speech language therapy for patients with nonfluent PSA.
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Affiliation(s)
- Qi Zhao
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Zheng Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,Center for Cognition and Neuroergonomics, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University Zhuhai, Zhuhai, China
| | - Luping Song
- Department of Rehabilitation Medicine, Shenzhen University General Hospital, Shenzhen, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,Center for Cognition and Neuroergonomics, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University Zhuhai, Zhuhai, China
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Abstract
Although the treatment for lexical anomia in individuals with aphasia (IWA) was shown effective, little is known about the optimal treatment intensity required. The aim of this study was to verify whether intensive and non-intensive treatments led to different outcomes when parameters of intensity are rigorously controlled. Six IWA with post-stroke lexical anomia received phonological treatment at two distinct frequencies: intensive (four times a week) and non-intensive (once a week). Results showed that both treatments were equally effective. This finding is especially relevant in contexts in which speech-language therapy delivery services are limited.
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11
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Freire AMN, Gagliardi RJ, Santos MDD. Effect of speech therapy intervention program for non-fluent aphasic patients after stroke. Codas 2021; 32:e20190124. [PMID: 33503209 DOI: 10.1590/2317-1782/20202019124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/30/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE the objective of this paper is to verify the effect of speech therapy intervention program in patients with non-fluent aphasia due to stroke in language tasks related to verbal fluency in semantic and phonological categories. METHODS Patients with aphasia due to stroke were selected to take part in this study. Two groups were formed: diagnosed patients with Broca/transcortical motor aphasia (GA), and a control group (healthy individuals). GA took a fluency verbal task (FAS, other complementary categories: phonological /p/ /l/ and semantic: "fruits" and "names"). These patients were all engaged in a language intervention program developed by the authors of this study. GA received speech therapy sessions (ten sessions lasting for an hour once a week), following a specific language program. After the sessions, the patients were re-evaluated. RESULTS GA had statistical significant improvement in the verbal fluency task after the speech therapy program (p-value < 0,001). CONCLUSION The speech language therapy program we proposed was efficient enough to show improvement in the results for GA in the verbal fluency task.
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12
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Borisova V, Isakova E, Kotov S. Cognitive rehabilitation after stroke using non-pharmacological approaches. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:26-32. [DOI: 10.17116/jnevro202112112226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Aras B, İnal Ö, Kesikburun S, Yaşar E. Response to Speech and Language Therapy According to Artery Involvement and Lesion Location in Post-stroke Aphasia. J Stroke Cerebrovasc Dis 2020; 29:105132. [PMID: 32912512 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/03/2020] [Accepted: 07/04/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Aphasia is one of the most common complications after stroke and occurs in 21-38% of the patients during acute period. The present study aimed to investigate the response to speech and language therapy according to artery involvement and lesion location in patients with post-stroke aphasia. METHOD The medical records of 107 patients with post-stroke aphasia (mean age, 58.8 ± 14.8 years) who were admitted to a single rehabilitation center for usual care after stroke were reviewed. Location of the ischemic lesion and involved artery was determined assessing the brain MRI of the patients. All the patients received 24 sessions speech and language therapy (3 days a week) as a part of 8-week rehabilitation program. Evaluation of the aphasia was performed with Gülhane Aphasia Test-2 (GAT-2) at baseline and at the end of the rehabilitation program. RESULTS Baseline GAT-2 scores was significantly worse in patients with middle cerebral artery (MCA) involvement compared to patients with other artery involvements (p = 0.007). While the GAT-2 scores of patients with MCA involvement were improved significantly after speech and language therapy (p < 0.001), the changes in those with anterior cerebral artery (ACA) and posterior cerebral artery (PCA) involvements were not significant (p > 0.05). CONCLUSIONS The present findings suggested that speech functions might be more affected in ischemic lesion of MCA and response to SLT might be better in patients with MCA involvement.
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Affiliation(s)
- Berke Aras
- Kastamonu Rehabilitation Centre, Kastamonu, Turkey.
| | - Özgü İnal
- Department of Occupational Therapy, Trakya University, Faculty of Healty Sciences, Edirne, Turkey
| | - Serdar Kesikburun
- University of Healthy Science, Gülhane School of Medicine, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital Ankara, Turkey
| | - Evren Yaşar
- University of Healthy Science, Gülhane School of Medicine, Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital Ankara, Turkey
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14
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Altmann RF, Ortiz KZ, Benfica TR, de Oliveira EP, Pagliarin KC. Brief Montreal-Toulouse Language Assessment Battery: adaptation and content validity. PSICOLOGIA-REFLEXAO E CRITICA 2020; 33:18. [PMID: 32734309 PMCID: PMC7392960 DOI: 10.1186/s41155-020-00157-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/14/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Evaluating patients in the acute phase of brain damage allows for the early detection of cognitive and linguistic impairments and the implementation of more effective interventions. However, few cross-cultural instruments are available for the bedside assessment of language abilities. The aim of this study was to develop a brief assessment instrument and evaluate its content validity. METHODS Stimuli for the new assessment instrument were selected from the M1-Alpha and MTL-BR batteries (Stage 1). Sixty-five images were redesigned and analyzed by non-expert judges (Stage 2). This was followed by the analysis of expert judges (Stage 3), where nine speech pathologists with doctoral training and experience in aphasiology and/or linguistics evaluated the images, words, nonwords, and phrases for inclusion in the instrument. Two pilot studies (Stage 4) were then conducted in order to identify any remaining errors in the instrument and scoring instructions. RESULTS Sixty of the 65 figures examined by the judges achieved inter-rater agreement rates of at least 80%. Modifications were suggested to 22 images, which were therefore reanalyzed by the judges, who reached high levels of inter-rater agreement (AC1 = 0.98 [CI = 0.96-1]). New types of stimuli such as nonwords and irregular words were also inserted in the Brief Battery and favorably evaluated by the expert judges. Optional tasks were also developed for specific diagnostic situations. After the correction of errors detected in Stage 4, the final version of the instrument was obtained. CONCLUSION This study confirmed the content validity of the Brief MTL-BR Battery. The method used in this investigation was effective and can be used in future studies to develop brief instruments based on preexisting assessment batteries.
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Affiliation(s)
- Raira Fernanda Altmann
- Department of Speech-Language Pathology, Universidade Federal de Santa Maria, Santa Maria/RS, Brazil.
| | - Karin Zazo Ortiz
- Department of Speech-Language Pathology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Tainá Rossato Benfica
- Department of Speech-Language Pathology, Universidade Federal de Santa Maria, Santa Maria/RS, Brazil
| | | | - Karina Carlesso Pagliarin
- Department of Speech-Language Pathology, Universidade Federal de Santa Maria, Santa Maria/RS, Brazil
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15
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Harvey SR, Carragher M, Dickey MW, Pierce JE, Rose ML. Treatment dose in post-stroke aphasia: A systematic scoping review. Neuropsychol Rehabil 2020; 31:1629-1660. [PMID: 32631143 DOI: 10.1080/09602011.2020.1786412] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Little is known about how the amount of treatment a person with aphasia receives impacts aphasia recovery following stroke, yet this information is vital to ensure effective treatments are delivered efficiently. Furthermore, there is no standard dose terminology in the stroke rehabilitation or aphasia literature. This scoping review aims to systematically map the evidence regarding dose in treatments for post-stroke aphasia and to explore how treatment dose is conceptualized, measured and reported in the literature. A comprehensive search was undertaken in June 2019. One hundred and twelve intervention studies were reviewed. Treatment dose (amount of treatment) has been conceptualized as both a measure of time and a count of discrete therapeutic elements. Doses ranged from one to 100 hours, while some studies reported session doses of up to 420 therapeutic inputs per session. Studies employ a wide variety of treatment schedules (i.e., session dose, session frequency, and intervention duration) and the interaction of dose parameters may impact the dose-response relationship. High dose interventions delivered over short periods may improve treatment efficiency while maintaining efficacy. Person- and treatment-level factors that mediate tolerance of high dose interventions require further investigation. Systematic exploration of dose-response relationships in post-stroke aphasia treatment is required.
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Affiliation(s)
- Sam R Harvey
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Marcella Carragher
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Michael Walsh Dickey
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia.,Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - John E Pierce
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Miranda L Rose
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
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16
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Thunstedt DC, Young P, Küpper C, Müller K, Becker R, Erbert F, Lehner K, Rheinwald M, Pfahler A, Dieterich M, Kellert L, Feil K. Follow-Up in Aphasia Caused by Acute Stroke in a Prospective, Randomized, Clinical, and Experimental Controlled Noninvasive Study With an iPad-Based App (Neolexon®): Study Protocol of the Lexi Study. Front Neurol 2020; 11:294. [PMID: 32425873 PMCID: PMC7212356 DOI: 10.3389/fneur.2020.00294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/27/2020] [Indexed: 11/13/2022] Open
Abstract
Rationale: Treatment of aphasia is still challenging for clinicians and patients. So far, there is proven evidence for "face-to-face" speech therapy. However, the digital age potentially offers new and complementary strategies that may add to treatment outcome in a cost-effective way. Neolexon® is a commercial tablet-based software for treatment of aphasia, which can be applied with the help of a therapist or as self-training by the patient. Aims and hypothesis: In the Lexi study, we aim to determine whether treatment with Neolexon® is superior to standard therapy in acute post-stroke aphasia. Sample size estimates: A sample size of 180 patients, 90 for each group, will be included with an assumed dropout rate of ~20%. Methods and design: Prospective, randomized, parallel group, open-label, blinded-endpoint clinical, and experimental controlled non-invasive trial (PROBE). Adult German native speakers with acute aphasia after stroke are included. Computer-generated, blocked, and stratified randomization by aphasia severity will assign patients to one of two groups: 4 weeks of either standard logopedic speech therapy or logopedic speech therapy with the app version of Neolexon®. Both groups will be instructed in self-training: the frequency and duration of self-training will be documented. Screening for aphasia will be performed using the Language Screening Test (LAST). The severity of aphasia in general and in subitems will be assessed using the Bielefelder Aphasie Screening (BIAS) and the Aphasia Check List (ACL). Follow-up will be assessed after 3 months. Study outcomes: Based on the consensus in our study team, we considered a 10% mean difference in the change of percentile rank (PR) of BIAS to be a minimal and clinically important difference. The primary endpoint is defined as a significant difference in BIAS comparing the two groups. Differences in quality of life, Beck Depression Inventory (BDI), and modified Ranking Scale (mRS) will be evaluated as secondary outcome parameters. Discussion: This trial will determine whether speech therapy with the use of Neolexon® is superior to standard logopedic therapy. Subgroups with the greatest response to Neolexon® will be described. The trial was prospectively registered on the "EU Clinical Trials Register" (NCT04080817).
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Affiliation(s)
- Dennis C Thunstedt
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Peter Young
- Department of Neurology, Medical Park Bad Feilnbach, Reithofpark, Germany
| | - Clemens Küpper
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Katharina Müller
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Regina Becker
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Franziska Erbert
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany.,Clinic for Orthopedic Surgery, Physical Medicine and Rehabilitation, Munich, Germany
| | - Katharina Lehner
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany.,Clinic for Orthopedic Surgery, Physical Medicine and Rehabilitation, Munich, Germany
| | - Marika Rheinwald
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany.,Clinic for Orthopedic Surgery, Physical Medicine and Rehabilitation, Munich, Germany
| | - Angelika Pfahler
- Department of Neurology, Medical Park Bad Feilnbach, Reithofpark, Germany
| | - Marianne Dieterich
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany.,German Center for Vertigo and Balance Disorders, Ludwig Maximilians University (LMU), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Lars Kellert
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Katharina Feil
- Department of Neurology, Ludwig Maximilians University (LMU), Munich, Germany
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17
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Chen WL, Ye Q, Zhang SC, Xia Y, Yang X, Yuan TF, Shan CL, Li JA. Aphasia rehabilitation based on mirror neuron theory: a randomized-block-design study of neuropsychology and functional magnetic resonance imaging. Neural Regen Res 2019; 14:1004-1012. [PMID: 30762012 PMCID: PMC6404486 DOI: 10.4103/1673-5374.250580] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
When watching someone performs an action, mirror neurons are activated in a way that is very similar to the activation that occurs when actually performing that action. Previous single-sample case studies indicate that hand-action observation training may lead to activation and remodeling of mirror neuron systems, which include important language centers, and may improve language function in aphasia patients. In this randomized-block-design experiment, we recruited 24 aphasia patients from, Zhongda Hospital, Southeast University, China. The patients were divided into three groups where they underwent hand-action observation and repetition, dynamic-object observation and repetition, or conventional speech therapy. Training took place 5 days per week, 35 minutes per day, for 2 weeks. We assessed language function via picture naming tests for objects and actions and the Western Aphasia Battery. Among the participants, one patient, his wife and four healthy student volunteers underwent functional magnetic resonance imaging to analyze changes in brain activation during hand-action observation and dynamic-object observation. Results demonstrated that, compared with dynamic-object observation, hand-action observation led to greater performance with respect to the aphasia quotient and affiliated naming sub-tests and a greater Western Aphasia Battery test score. The overall effect was similar to that of conventional aphasia training, yet hand-action observation had advantages compared with conventional training in terms of vocabulary extraction and spontaneous speech. Thus, hand-action observation appears to more strongly activate the mirror neuron system compared with dynamic-object observation. The activated areas included Broca’s area, Wernicke’s area, and the supramarginal gyrus. These results suggest that hand-action observation combined with repetition might better improve language function in aphasia patients compared with dynamic-object observation combined with repetition. The therapeutic mechanism of this intervention may be associated with activation of additional mirror neuron systems, and may have implications for the possible repair and remodeling of damaged nerve networks. The study protocol was approved by the Ethical Committee of Nanjing Medical University, China (approval number: 2011-SRFA-086) on March 11, 2011. This trial has been registered in the ISRCTN Registry (ISRCTN84827527).
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Affiliation(s)
- Wen-Li Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing; Department of Rehabilitation Medicine, Zhangjiagang Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu Province, China
| | - Qian Ye
- School of Rehabilitation Sciences, Nanjing Normal University of Special Education, Nanjing, Jiangsu Province, China
| | - Si-Cong Zhang
- Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Xia
- Department of Rehabilitation Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China
| | - Xi Yang
- Department of Rehabilitation Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu Province, China
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun-Lei Shan
- Yueyang Hospital of Integrated Chinese and Western Medicine; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Institute of Rehabilitation Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jian-An Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
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18
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Hu XY, Zhang T, Rajah GB, Stone C, Liu LX, He JJ, Shan L, Yang LY, Liu P, Gao F, Yang YQ, Wu XL, Ye CQ, Chen YD. Effects of different frequencies of repetitive transcranial magnetic stimulation in stroke patients with non-fluent aphasia: a randomized, sham-controlled study. Neurol Res 2018; 40:459-465. [DOI: 10.1080/01616412.2018.1453980] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Xue-yan Hu
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Tong Zhang
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Gary B. Rajah
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Christopher Stone
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Li-xu Liu
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Jing-jie He
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Lei Shan
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Ling-yu Yang
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Ping Liu
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Fei Gao
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Yu-qi Yang
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Xiao-li Wu
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Chang-qing Ye
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Yu-dong Chen
- Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
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19
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Russo MJ, Prodan V, Meda NN, Carcavallo L, Muracioli A, Sabe L, Bonamico L, Allegri RF, Olmos L. High-technology augmentative communication for adults with post-stroke aphasia: a systematic review. Expert Rev Med Devices 2017; 14:355-370. [DOI: 10.1080/17434440.2017.1324291] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maria Julieta Russo
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Valeria Prodan
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Natalia Nerina Meda
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Lucila Carcavallo
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Anibal Muracioli
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Liliana Sabe
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Lucas Bonamico
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Ricardo Francisco Allegri
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
| | - Lisandro Olmos
- Rehabilitation Center, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina
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20
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Qiu WH, Wu HX, Yang QL, Kang Z, Chen ZC, Li K, Qiu GR, Xie CQ, Wan GF, Chen SQ. Evidence of cortical reorganization of language networks after stroke with subacute Broca's aphasia: a blood oxygenation level dependent-functional magnetic resonance imaging study. Neural Regen Res 2017; 12:109-117. [PMID: 28250756 PMCID: PMC5319215 DOI: 10.4103/1673-5374.198996] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aphasia is an acquired language disorder that is a common consequence of stroke. The pathogenesis of the disease is not fully understood, and as a result, current treatment options are not satisfactory. Here, we used blood oxygenation level-dependent functional magnetic resonance imaging to evaluate the activation of bilateral cortices in patients with Broca's aphasia 1 to 3 months after stroke. Our results showed that language expression was associated with multiple brain regions in which the right hemisphere participated in the generation of language. The activation areas in the left hemisphere of aphasia patients were significantly smaller compared with those in healthy adults. The activation frequency, volumes, and intensity in the regions related to language, such as the left inferior frontal gyrus (Broca's area), the left superior temporal gyrus, and the right inferior frontal gyrus (the mirror region of Broca's area), were lower in patients compared with healthy adults. In contrast, activation in the right superior temporal gyrus, the bilateral superior parietal lobule, and the left inferior temporal gyrus was stronger in patients compared with healthy controls. These results suggest that the right inferior frontal gyrus plays a role in the recovery of language function in the subacute stage of stroke-related aphasia by increasing the engagement of related brain areas.
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Affiliation(s)
- Wei-Hong Qiu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Hui-Xiang Wu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qing-Lu Yang
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zhuang Kang
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zhao-Cong Chen
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Kui Li
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Guo-Rong Qiu
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Chun-Qing Xie
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Gui-Fang Wan
- Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Shao-Qiong Chen
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
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