Effect of Trans Cranial Magnetic Stimulation in Management of Dysphasia, A Systematic Review | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 28, Volume 72, Issue 4, July 2018, Page 4392-4402 PDF (303.57 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2018.9297 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Amira Hashim  ; Mariam Shadi; Nirvana Hafez
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| ENT Department, Phoniatric Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Aphasia is the most disabling functional defect after ischemic stroke. It affects more than a third of all stroke victims. Effective therapeutic strategies are needed to treat aphasic patients. Novel techniques, such as methods of delivering cortical brain stimulation to modulate cortical excitability, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), are just beginning to be explored. The purpose of repetitive transcranial magnetic stimulation (rTMS) application in the neuro-rehabilitation of aphasic patients is to act on specific networks involved in the pathophysiology of language processing and to promote adaptive cortical reorganization after stroke. TMS was shown to have lasting effects on cortical excitability that persisted beyond the actual stimulus delivery. Given the ability of this treatment to modulate cortical activity in a focal way, focus was soon placed on the use of this technique in various neurological and psychiatric diseases such as aphasia. Aim of the work: The aim of this work is to evaluate the effect of Transcranial Magnetic Stimulation as a therapy for dysphasia in order to promote an evidence-based practice. This will be made by conducting a systematic review of literature in this topic area. Materials and Methods: This was a systematic review. Seven electronic databases (Medline, Google scholar, CINHAL, Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Embase) were searched for articles. Relevant studies were further evaluated and studies that met inclusion criteria were reviewed. Results: The literature search yielded 5097 studies. Twenty-six articles were further evaluated to be included. Eleven studies met all inclusion criteria and were chosen for review. The studies provided moderate to strong evidence that rTMS may be an effective treatment for non-fluent stroke aphasia. We have found significantly higher scores on the language assessment scales of patients after the rTMS treatment than those with sham TMS treatment, in most of the included studies. The studies reviewed here established the beneficial effect of rTMS in multiple language domains. The domain of naming is the most affected, with almost all studies demonstrating improvement in naming after stimulation. Conclusion: The current systematic review suggests that inhibitory low frequency rTMS with 90% resting motor threshold (rMT) targeting pars triangularis of the right inferior frontal gyrus can improve multiple language domains in right-handed post-ischemic stroke patients. | ||||
| Keywords | ||||
| Dysphasia; TMS; language assessment; Treatment | ||||
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