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Brain and Language 2016-Aug

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

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Il collegamento viene salvato negli appunti
Helen L Carlson
Zeanna Jadavji
Aleksandra Mineyko
Omar Damji
Jacquie Hodge
Jenny Saunders
Mia Hererro
Michele Nowak
Rebecca Patzelt
Anya Mazur-Mosiewicz

Parole chiave

Astratto

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.

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