Repetitive transcranial magnetic stimulation as a treatment for articulatory dysfunction in Parkinson’s disease

Neuroimaging has demonstrated that improved speech outcomes in Parkinson’s disease (PD) subsequent to behavioral treatment approaches is associated with increased activity in the motor and pre-motor cortex. High frequency repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity and has been reported to have significant benefit to general motor function in PD. It is possible therefore, that high frequency rTMS may also have …postprintThe 19th World Congress on Parkinson’s Disease and Related Disorders, Shanghai, China, 11-14 December 2011

Repetitive transcranial magnetic stimulation as a treatment for articulatory dysfunction in Parkinson’s disease

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Treatment of articulatory dysfunction in Parkinson's disease using repetitive transcranial magnetic stimulation

Background and purpose: Neuroimaging has demonstrated that improved speech outcomes in Parkinson's Disease (PD) subsequent to behavioural treatment approaches are associated with increased activity in the motor and pre-motor cortex. High-frequency repetitive transcranial magnetic stimulation (rTMS) is capable of modulating cortical activity and has been reported to have significant benefit to general motor function in PD. It is possible that high-frequency rTMS may also have beneficial outcomes on speech production in PD. Methods: High-frequency (5Hz) rTMS was applied to 10 active stimulation and 10 sham placebo patients for 10min/day (3000 pulses), for 10days and speech outcome measures and lingual kinematic parameters recorded at baseline and 1week, 2 and 12months post-stimulation. Results: The findings demonstrated positive treatment-related changes observed in the active rTMS group when compared to the sham placebo control group at 2 and 12months post-stimulation in speech intelligibility, communication efficiency ratio, maximum velocity of tongue movements and distance of tongue movements. Conclusion: The results support the use of high-frequency rTMS as a therapeutic tool for the treatment of articulatory dysfunction in PD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.link_to_subscribed_fulltex

Modulation of N400 in chronic non-fluent aphasia using low frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43. months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1. Hz) rTMS was applied to the anterior portion of the homologue to Broca's area (pars triangularis), for 20. min per day for 10. days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6. years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1. week and 2. months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2. months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1. week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS. © 2010 Elsevier Inc