Combining Language Therapy With rTMS in Aphasia
- Conditions
- Aphasia
- Interventions
- Behavioral: Intensive Language-Action Therapy (ILAT)Device: Repetitive navigated Transcranial Magnetic Stimulation during naming training
- Registration Number
- NCT03629665
- Lead Sponsor
- Paula Heikkinen
- Brief Summary
With the present RCT, the investigators aimed at finding an optimal protocol for the neurorehabilitation of chronic post-stroke aphasia by combining two promising methods, ILAT (Intensive language action therapy) and 1-Hz rTMS to the right-hemispheric homologue of the anterior language area of Broca (pars triangularis), thus taking advantage of recent research in speech and language sciences, neurorehabilitation and brain research.
- Detailed Description
New neuromodulation technologies, such as transcranial magnetic stimulation (TMS), are promising tools for neurorehabilitation, aphasia therapy included. Combined with behavioral techniques, Intensive Language-Action Therapy (ILAT), TMS could substantially amplify the beneficial effect of such behavioral therapy alone.
In this randomized study of 17 subjects with post-stroke aphasia in the chronic stage will be studied the combined effect of ILAT and 1-Hz placebo-controlled navigated repetitive TMS (rTMS) to the right-hemispheric inferior frontal cortex (pars triangularis). Participant will be randomized to groups A and B. Participants in group A will receive a 2-week period of rTMS during naming training where they name pictures every ten second displayed on the screen, followed by 2-weeks of rTMS and naming combined with ILAT. Those in group B will receive the same behavioral therapy but TMS is replaced by sham stimulation.
Language performance will be measured before, during and after the interventions for 3 months.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 17
- age between 18 and 75 years
- presence of a single clinically documented stroke
- chronic stage (at least 12 months post-stroke)
- aphasia documented using the WAB test
- no recurring utterances or severe global (total) aphasia
- residual ability to understand simple task instructions
- availability of information about medication
- right-handedness
- native speakers of Finnish.
- severe global (total) aphasia (Boston naming test less 3 points)
- neglect, agnosia, severe vision impairment or hearing loss
- severe attention or memory deficits
- left-handedness
- cardiac pacemaker or other stimulators
- diagnosis of severe diabetes or severe depression
- additional neurological diagnoses
- other interventions, including speech therapy, in the same time period
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description sham rTMS and naming combined with ILAT Intensive Language-Action Therapy (ILAT) Interventions: sham Repetitive navigated Transcranial Magnetic Stimulation, picture naming and Intensive Language Action Therapy rTMS and naming combined with ILAT Intensive Language-Action Therapy (ILAT) Interventions: Repetitive navigated Transcranial Magnetic Stimulation, picture naming and Intensive Language Action Therapy rTMS and naming combined with ILAT Repetitive navigated Transcranial Magnetic Stimulation during naming training Interventions: Repetitive navigated Transcranial Magnetic Stimulation, picture naming and Intensive Language Action Therapy
- Primary Outcome Measures
Name Time Method The Western Aphasia Battery Change in AQ performed at weeks 1 (baseline), 4 and 7 and follow up 3 months after therapy completion aphasia quotient (AQ) measurement
- Secondary Outcome Measures
Name Time Method The Action naming test Change in picture naming ability between weeks 1 (baseline), 4 and 7 and follow up 3 months after therapy completion picture naming ability
The Boston naming test Change in picture naming ability between weeks 1 (baseline), 4 and 7 and follow up 3 months after therapy completion picture naming ability