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Therapeutic Applications of rTMS for Aphasia After Stroke

  • Priyanka P. Shah-Basak
  • Roy H. HamiltonEmail author
Chapter

Abstract

Repetitive transcranial magnetic stimulation is a powerful treatment tool for aphasia because it can directly leverage our understanding of neural basis of language disorders and provide a novel and promising treatment. The reorganization in the neural representation of language functions after an aphasia-causing stroke critically underpins spontaneous language recovery. The course of this reorganization is largely shaped by the extent of damage and the duration since stroke onset. The therapeutic applications of rTMS in poststroke aphasia have capitalized on a growing but incomplete understanding of these neural changes, in order to guide the location and type of stimulation. Converging evidence from a variety of treatment studies suggests that rTMS can significantly augment performance of a number of language functions. However, evidence also suggests that aphasic patients exhibit significant variability in clinical characteristics and in turn in their response to rTMS treatment. In this chapter, we provide a review and a critical appraisal of published rTMS treatment studies in patients with aphasia (PWA). Based on this evidence, we conclude that rTMS can be effective in reducing symptoms of aphasia. However, because of a great deal of heterogeneity in rTMS methodologies, we recommend standardization and further investigation of rTMS in a context of large-scale clinical randomized trials. These trials should take an individualized treatment approach that is informed by mechanism(s) of recovery on a patient-by-patient basis rather an one-size-fits-all approach.

Keywords

rTMS Stroke Aphasia Neuroplasticity GRADE system Clinical trials 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of NeurologyUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Laboratory for Cognition and Neural StimulationUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Goddard Laboratories, Room 518University of PennsylvaniaPhiladelphiaUSA

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