Excitatory deep transcranial magnetic stimulation with H-coil over the right homologous Broca's region improves naming in chronic post-stroke aphasia

Neurorehabil Neural Repair. 2014 Mar-Apr;28(3):291-8. doi: 10.1177/1545968313508471. Epub 2013 Nov 15.

Abstract

Background: The role of the right hemisphere in poststroke aphasia recovery is still controversial and the effects of repetitive transcranial magnetic stimulation (rTMS) over the right homologous Broca's region have been seldom investigated.

Objective: This study aimed to compare the effect of excitatory, inhibitory, and sham rTMS delivered with H-coil over the right inferior frontal gyrus in chronic aphasic patients.

Methods: Five right-handed poststroke aphasic patients underwent a picture naming task before and immediately after each of 3 sessions of rTMS: excitatory (10 Hz), inhibitory (1 Hz), and sham rTMS, in random sequence and separated by at least 1 week.

Results: Only the excitatory 10-Hz stimulation was associated with a significant improvement in naming performance (P = .043) and was significantly more effective than 1-Hz rTMS (P = .043).

Conclusions: A single session of excitatory deep brain rTMS over the right inferior frontal gyrus with H-coil significantly improves naming in right-handed chronic poststroke aphasic patients. This result is in line with the hypothesis of a positive, rather than detrimental, role of the right hemisphere in chronic aphasia due to a left-hemispheric stroke.

Keywords: H-coil; aphasia; rTMS; stroke rehabilitation; transcranial magnetic stimulation.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Aphasia / etiology*
  • Aphasia / therapy*
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Frontal Lobe*
  • Functional Laterality*
  • Humans
  • Language Tests
  • Male
  • Middle Aged
  • Stroke / complications*
  • Stroke Rehabilitation
  • Task Performance and Analysis
  • Transcranial Magnetic Stimulation / instrumentation
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome