Therapeutic application of 6-Hz-primed low-frequency rTMS combined with intensive speech therapy for post-stroke aphasia

Abstract

Objective: To clarify the safety, feasibility and efficacy of 6-Hz-primed low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive speech therapy (ST) for post-stroke aphasic patients.

Methods: Four adult patients with history of left hemispheric stroke and with motor-dominant aphasia were studied. During 11-day hospitalization, each patient received 18 treatment sessions consisting of 10-min 6-Hz priming stimulation followed by 20-min 1-Hz low-frequency rTMS and intensive ST for 60 min daily. Both the priming stimulation and low-frequency rTMS were applied to the right frontal lobe. The intensive ST was provided on one-to-one basis. Language function was assessed by Standard Language Test of Aphasia (SLTA), Supplementary Test of SLTA (SLTA-ST), and the Japanese version of Western Aphasia Battery (WAB) within 2 weeks prior to the admission and on the day of discharge.

Results: The in-patient protocol was successfully completed by all patients without any adverse effects. Each patient showed an increase in the correct answer rate after the intervention. Improvement was found in both expressive and recessive language modalities in all patients.

Conclusions: The protocol of 6-Hz-primed low-frequency rTMS and intensive ST for post-stroke aphasia was safe and feasible, suggesting its potential usefulness in the treatment of this population.

• aphasia
• metaplasticity
• priming stimulation
• speech therapy
• stroke
• transcranial magnetic stimulation