Universität zu Köln

Zumbansen, Anna ORCID: 0000-0003-2332-8263, Black, Sandra E., Chen, Joyce L., Edwards, Dylan, Hartmann, Alexander, Heiss, Wolf-Dieter, Lanthier, Sylvain ORCID: 0000-0001-9762-5514, Lesperance, Paul, Mochizuki, George, Paquette, Caroline, Rochon, Elizabeth A., Rubi-Fessen, Ilona, Valles, Jennie, Kneifel, Heike, Wortman-Jutt, Susan and Thiel, Alexander (2020). Non-invasive brain stimulation as add-on therapy for subacute post-stroke aphasia: a randomized trial (NORTHSTAR). Eur. Stroke J., 5 (4). S. 402 - 414. LONDON: SAGE PUBLICATIONS LTD. ISSN 2396-9881

Full text not available from this repository.

Abstract

Introduction: Non-invasive brain stimulation (NIBS) with speech therapy might improve recovery from post-stroke aphasia. This three-armed sham-controlled blinded prospective proof-of-concept study tested I Hz subthreshold repetitive transcranial magnetic stimulation (rTMS) and 2-mA cathodal transcranial direct current stimulation (ctDCS) on the right pars triangularis in subacute post-stroke aphasia. Patients and methods: Sixty-three patients with left middle cerebral artery infarcts were recruited in five hospitals (Canada/United States/Germany, 01-2014/03-2018) and randomized to receive rTMS (N=20), ctDCS (N=24) or sham stimulation (N=19) with ST for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Secondary outcome variable was the percent change in the Unified Aphasia Score. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment with a pre-planned subgroup analysis for lesion location (affecting Broca's area or not). Results: Naming was significantly improved by rTMS (median = 1.91/interquartile range = 0.77/p=.01) at 30 days versus ctDCS (median = 1.11/interquartile range = 1.51) and sham stimulation (median = 1.02/interquartile range = 1.71). All other primary results were non-significant. The rTMS effect was driven by the patient subgroup with intact Broca's area where NIBS tended to improve UnAS (median = 33.2%/interquartile range = 46.7%/p = .062) versus sham stimulation (median = 12.5%/interquartile range = 7.9%) at day 30. Conversely, in patients with infarcted Broca's area, UnAS tended to improve more with sham stimulation (median = 75.0%/interquartile range = 86.9%/ p = .053) versus NIBS (median = 12.7%/interquartile range = 31.7). Conclusion: We found a delayed positive effect of low-frequency rTMS targeting the right pars triangularis on the recovery of naming performance in subacute post-stroke aphasia. This intervention may be beneficial only in patients with morphologically intact Broca's area.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zumbansen, Anna UNSPECIFIED orcid.org/0000-0003-2332-8263 UNSPECIFIED Black, Sandra E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chen, Joyce L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Edwards, Dylan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Heiss, Wolf-Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Lanthier, Sylvain UNSPECIFIED orcid.org/0000-0001-9762-5514 UNSPECIFIED Lesperance, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Mochizuki, George UNSPECIFIED UNSPECIFIED UNSPECIFIED Paquette, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Rochon, Elizabeth A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rubi-Fessen, Ilona UNSPECIFIED UNSPECIFIED UNSPECIFIED Valles, Jennie UNSPECIFIED UNSPECIFIED UNSPECIFIED Kneifel, Heike UNSPECIFIED UNSPECIFIED UNSPECIFIED Wortman-Jutt, Susan UNSPECIFIED UNSPECIFIED UNSPECIFIED Thiel, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-328832
DOI:	10.1177/2396987320934935
Journal or Publication Title:	Eur. Stroke J.
Volume:	5
Number:	4
Page Range:	S. 402 - 414
Date:	2020
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	2396-9881
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NORMATIVE DATA; RECOVERY; STROKE; PERFORMANCE; AREAS; AGE Multiple languages Clinical Neurology; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32883