Personalized Brain Functional Sector-guided Multi-target Continuous Theta Burst Stimulation Therapy for Aphasia After Stroke: a RCT
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Changping Laboratory
- Enrollment
- 60
- Locations
- 3
- Primary Endpoint
- Change in the Western Aphasia Battery scores
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
In this study, a randomized, double-blind, parallel-controlled trial was employed to evaluate the effectiveness and safety of personalized brain functional sectors (pBFS) technology-guided continuous theta burst stimulation (cTBS) on the inferior frontal gyrus (IFG) combined with the superior temporal gyrus (STG) and the superior frontal gyrus (SFG) for language function recovery in post-stroke aphasic patients.
Detailed Description
Increasing evidence suggests that rTMS has been effective in treating various psychological and neurological diseases, including treating post-stroke symptoms. Using the personalized brain functional sectors (pBFS) technique, investigators could precisely identify individualized brain functional networks and the personalized language-related stimulation site based on the resting-state functional MRI data. The current study proposes to conduct a double-blinded, randomized and parallel controlled design trial, to investigate the efficacy and safety of pBFS-guided multi-target rTMS intervention in post-stroke aphasic patients. Subjects will be randomly assigned to the following two groups: active continuous TBS (cTBS) group, or a sham control group. The allocation ratio will be 1:1. The stimulation protocol consisted of a 3-week treatment, with 5 consecutive workdays each week (totally 15 day-treatment). The stimulation procedure will be assisted with real-time neuronavigation to ensure its precision.
Investigators
Eligibility Criteria
Inclusion Criteria
- •The patient's age ranges from 35 to 75 years old (including 35 and 75 years old);
- •Meet the diagnostic criteria for ischemic stroke (according to the guidelines developed by the American Heart Association/American Stroke Association in 2019 and the guidelines developed by the Neurology Branch of the Chinese Medical Association in 2018) or meet the diagnostic criteria for hemorrhagic stroke (according to the guidelines developed by the American Heart Association/American Stroke Association in 2022 and the guidelines developed by the Neurology Branch of the Chinese Medical Association in 2019) ，with lesions located in the left hemisphere, and a duration of illness ranging from 15 days to 6 months.
- •Diagnosed as aphasia patient according to the Chinese version of Western Aphasia Battery (WAB), with a WAB-aphasia quotient of less than 93.8 points;
- •First onset of stroke;
- •Normal language function before the onset of stroke, and the patient's native language is Chinese with at least 6 years of education;
- •Understand the trial and signed the informed consent form.
Exclusion Criteria
- •Combined dysarthria (NIHSS item 10 score ≥2 points);
- •Aphasia caused by bilateral hemisphere stroke, brain tumor, traumatic brain injury, Parkinson's disease, motor neuron disease, or other diseases；
- •Patients with implanted electronic devices such as cardiac pacemakers, cochlear implants, or other metal foreign bodies, or those with MRI contraindications such as claustrophobia or TMS treatment contraindications;
- •History of epilepsy;
- •Patient with concomitant severe systemic diseases affecting the heart, lungs, liver, kidneys, etc., and uncontrolled by conventional medication, as detected and confirmed through laboratory testing and examination;
- •Patients with consciousness disorders (NIHSS 1(a) score ≥1);
- •Patients with malignant hypertension;
- •Patients with severe organic diseases, such as malignant tumors, with an expected survival time of less than 1 year;
- •Patients with severe hearing, visual, cognitive impairment or inability to cooperate with the trial;
- •Patients with severe depression, anxiety, or diagnosed with other mental illnesses that prevent them from completing the trial;
Outcomes
Primary Outcomes
Change in the Western Aphasia Battery scores
Time Frame: baseline, end of the 3-week therapy
The first four subsets of the WAB (Spontaneous Speech, Auditory verbal comprehension, Repetition, Naming and word finding) will be used to evaluate the participants' language ability impairments. A Chinese adapted version of WAB will be used. The scores from all four subsets will be calculated as an Aphasia Quotient (ranging from 0 to 100), with lower Aphasia Quotients indicating poorer language abilities.
Secondary Outcomes
- Boston Diagnostic Aphasia Examination Severity Ratings(baseline, end of the 3-week therapy，90 days after treatment initiation)
- Change in the Western Aphasia Battery scores(baseline, end of the 5-day therapy, 90 days after treatment initiation)
- Chinese-version Stroke and Aphasia Quality of Life Scale 39-generic version (SAQOL-39g)(baseline，end of the 3-week therapy，90 days after treatment initiation)
- Token test(baseline，end of the 3-week therapy，90 days after treatment initiation)