Treatment of dysphasia with rTMS and language therapy after childhood stroke: Multimodal imaging of plastic change

Publication date: August 2016
Source:Brain and Language, Volume 159
Author(s): Helen L. Carlson, Zeanna Jadavji, Aleksandra Mineyko, Omar Damji, Jacquie Hodge, Jenny Saunders, Mia Hererro, Michele Nowak, Rebecca Patzelt, Anya Mazur-Mosiewicz, Frank P. MacMaster, Adam Kirton
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.



from #ENT via xlomafota13 on Inoreader http://ift.tt/1TSnJAQ
via IFTTT