The Effect Of Repetitive Transcranial Magnetic Stimulation On Right Hemisphere In Patients With Poststroke Aphasia

PARTâ… Objective:We studied whether a decreased excitability of right hemisphere induced by 0.5 Hz repetitive transcranial magnetic stimulation(rTMS)caused an improved language performance of the patients with poststroke aphasia.Methods:We conducted a study of rTMS in patients with poststroke aphasia.31 right handed patients enrolled in the study,all of them are good at basic Chinese.They were randomly assigned to 2 groups,all the patients were given routine drug treatment and language training.One group received a period of rTMS treatment at LA(language area)of right hemisphere.All the patients were evaluated by ABC before and after the period of rTMS treatment,and 90 days after stroke.Also they were evaluated by NIHSS and BI before the period of TMS treatment,and 90 days after stroke.Results:Compared with the control group,ABC scales,NIHSS and BI scales of the rTMS treated group before and after the period of rTMS treatment were not significantly different;90 days after stroke,we found ABC scales were significantly different between the two group,but couldn't found that in NIHSS and BI scales.In the rTMS treated group,we found ABC scales before and after the period of TMS treatment were significantly different,but couldn't found that in control group;90 days after stroke,ABC scales,NIHSS and BI scales were respectively significantly different from the scales before the period of TMS treatment in both the two group.When compared with the control group,the rTMS treated group make more progress in ABC scales 90 days after stroke than the scales before and after the period of TMS treatment,but we couldn't found that in NIHSS scales and BI scales.Conclusions:The low-frequency rTMS to the LA of unaffected hemisphere would decrease interhemispheric inhibition of the lesioned hemisphere and improve language function in patients with poststroke aphasia. PARTâ…¡Objective:We investigated the pattern of recruitment of brain regions during a language task as measured using functional MRI after 0.5 Hz repetitive transcranial magnetic stimulation(rTMS)in patients with poststroke aphasia.Methods:We recruited 10 patients with poststroke aphasia,who were in 7 days after their first ever stroke.All of them received a period of rTMS treatment at the contralesional LA,they were evaluated by ABC before the period of rTMS treatment, and 90 days after stroke.All subjects were scanned whilst performing an isometric, dynamic paced language task in 7 days and 90 days after stroke.The degree and amplitude of task-related activation in LA are evaluated.Results:The ABC scales 90 days after stroke were significantly different from the scales in 7 days.There was no significant difference in the degree of activation in the bilateral hemisphere in 7 days and 90 days after stroke,which could be seen in the amplitude of activation in the bilateral hemisphere.And we found that there was significant difference in the amplitude of activation between the two hemisphere 90 days after stroke,but not found in 7 days after stroke.Conclusions:After a period of rTMS treatment,the patients make a progress in language performance 90 days after stroke than in 7 days.We found that the amplitude of activation decrease in both the two hemisphere 90 days after stroke.We also found that patients were more likely to have "normal" task-related brain activation during the language task 90 days after stroke.There was a tendency of focusing on ipsilateral LA.These results further our understanding of the relationship between task-related activation of the language system,rTMS and outcome after stroke.We supposed that rTMS would promote the functional organization after stroke for the better rehabilitation.