Dual Hemisphere rTMS for Rehabilitation of Post Stroke Aphasia

Treatment of Aphasic Stroke Patients With rTMS

To investigate the therapeutic effect of dual hemisphere repetitive transcranial magnetic stimulation (rTMS) on post-stroke non fluent aphasia.

Thirty patients with subacute post-stroke non-fluent aphasia were randomly allocated with a ratio 2:1 to receive real (n = 20) or sham (n = 10) rTMS of the affected motor cortex. Each patient received 1000 rTMS pulses (1 Hertz at 110% of resting motor threshold) over the unaffected Broca's area and 1000 pulses (20 Hertz at 100% resting motor threshold) over affected left Broca's area for 10 consecutive days. LANGUAGE section of hemispheric stroke scale, Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H) and NIH stroke scale were assessed before, post sessions, 1 and 2 months after the last session . Motor threshold was assessed before and after the end of last session.

Inclusion Criteria:

• acute hemiplegia with non-fluent aphasia, single thromboembolic non-haemorrhagic infarction documented by computerized tomography (CT) in the distribution of middle cerebral artery.

Exclusion Criteria:

• head injury or neurological disease other than stroke,
• Unstable cardiac dysrhythmia,
• Fever,
• Infection,
• Hyperglycaemia
• Prior administration of tranquilizer
• Patients with no motor evoked response recorded from first dorsal interosseus (FDI) muscle of the affected hand