Add-on Effects of Repetitive Transcranial Magnetic Stimulation on Subacute Aphasia Therapy: Enhanced Improvement of Functional Communication and Basic.

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Presentation transcript:

Add-on Effects of Repetitive Transcranial Magnetic Stimulation on Subacute Aphasia Therapy: Enhanced Improvement of Functional Communication and Basic Linguistic Skills. A Randomized Controlled Study Ilona Rubi-Fessen, MSc, Alexander Hartmann, MD, Walter Huber, PhD, Bruno Fimm, PhD, Thomas Rommel, MD, Alexander Thiel, MD, Wolf-Dieter Heiss, MD Archives of Physical Medicine and Rehabilitation Volume 96, Issue 11, Pages 1935-1944.e2 (November 2015) DOI: 10.1016/j.apmr.2015.06.017 Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 Consolidated Standards of Reporting Trials flow diagram. Abbreviation: rTMS, repetitive transcranial magnetic stimulation. Archives of Physical Medicine and Rehabilitation 2015 96, 1935-1944.e2DOI: (10.1016/j.apmr.2015.06.017) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 Language performance regarding pre- and posttreatment. The graphs show mean values at baseline and after a 2-week treatment for the real stimulation group and sham group with respect to profile height of the AAT, AAT subtests, and naming screening. P values refer to group-by-time interaction in 2-way repeated-measures ANOVAs. Error bars represent SEs of the mean. Abbreviations: Lang, language; post, posttreatment; pre, pretreatment. Archives of Physical Medicine and Rehabilitation 2015 96, 1935-1944.e2DOI: (10.1016/j.apmr.2015.06.017) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Communicative measures regarding pre- and posttreatment. Graphs show mean values at baseline and after a 2-week treatment for the real stimulation group and sham group on A-scale of the ANELT, and subtests of the FIM. P values refer to group-by-time interaction in 2-way repeated-measures ANOVAs. Error bars represent SEs of the mean. Abbreviations: post, posttreatment; pre, pretreatment. Archives of Physical Medicine and Rehabilitation 2015 96, 1935-1944.e2DOI: (10.1016/j.apmr.2015.06.017) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 Group differences regarding gains in language performance between pre- and posttreatment. The bracket symbol indicates a significant difference between the gains of both groups; P values from ANOVA group-by-time interaction. Error bars represent SEs of the mean. Abbreviations: COMP, comprehension; NAM, naming; REP, repetition; Stim, stimulation; TT, Token Test; WRIT, written language. Archives of Physical Medicine and Rehabilitation 2015 96, 1935-1944.e2DOI: (10.1016/j.apmr.2015.06.017) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions

Supplemental Fig S1 Definition of lesion location: The vascular territory of the middle cerebral artery (MCA) was defined following standard vascular territory maps. The cortical region was the total of all cortical gray matter regions within the MCA territory, and it was subdivided along the central sulcus into an anterior and posterior MCA territory. All white matter within the MCA territory, as well as the basal ganglia and thalamus, was included in the subcortical MCA territory (see supplemental fig S1 for clarification of vascular territory borders). This basically corresponds to the typical vascular occlusion syndromes causing aphasia: Rolandic and pre-Rolandic artery occlusions (anterior M2 branches of the MCA) causing predominantly expressive aphasia syndromes and the posterior M2 branches (arteria gyri angularis and arteria supramarginalis) mainly causing sensory aphasia syndromes, while occlusion of the deep M1 segment perforators causes subcortical infarcts and the related aphasia symptoms. Archives of Physical Medicine and Rehabilitation 2015 96, 1935-1944.e2DOI: (10.1016/j.apmr.2015.06.017) Copyright © 2015 American Congress of Rehabilitation Medicine Terms and Conditions