Effects of Neuronavigated Theta Burst Stimulation in Therapy of Post-stroke Aphasia
Stroke, Ischemic, Aphasia Non Fluent
About this trial
This is an interventional treatment trial for Stroke, Ischemic focused on measuring Aphasia, Stroke, Theta Burst Stimulation, Therapy, Rehabilitation, Noninvasive Transcranial Brain Stimulation
Eligibility Criteria
Inclusion Criteria:
- First-ever left middle cerebral artery ischemic stroke (brain damage localization confirmed by magnetic resonance imaging, MRI)
- 3 or more months from the onset of stroke
- Non-fluent aphasia (confirmed in the BDAE test) with functional communication difficulties ranging from mild to significant (grades from 2 to 4 in ASRS), marked difficulties in naming, and relatively preserved everyday speech comprehension
- Native Polish speaker
- Right-handedness prior to stroke
- Signing of the informed consent for the participation in the study.
Exclusion Criteria:
- Psychiatric and/or neurological comorbidity (e. g. dementia, depressive disorder, alcohol dependence)
- Diagnose of epilepsy or epileptic changes in EEG, also frequent losses of consciousness of unclear etiology which might suggest epileptic seizures
- History of any neurosurgical procedure around the head area
- 1.5 T MRI examination contraindications (metal elements in the body, e. g. implantable cardioverter-defibrillator, deep brain stimulation devices; claustrophobia)
- Regular intake of medication that could affect cortical excitability (e. g. antiepileptic or antipsychotic drugs, antidepressants, benzodiazepines) or medication influencing neuroplastic processes (e. g. dopamine)
- Significant cognitive impairment limiting patient's cooperation during assessment and behavioral aphasia therapy
- Visual deficits significantly hindering the perception of therapeutic tasks presented visually on a computer's screen
- New neurological episode (e. g. another brain stroke) or somatic illness (e. g. COVID-19) during the cycle of the therapy, requiring its interruption.
Sites / Locations
- Institute of Psychiatry and NeurologyRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Sham Comparator
Intermittent TBS (iTBS) of the left hemisphere plus behavioral aphasia therapy
Continuous TBS (cTBS) of the right hemisphere plus behavioral aphasia therapy
Sham TBS (sTBS) of the left hemisphere plus behavioral aphasia therapy
15 sessions of 200-second of iTBS over the pars triangularis of Broca's area in the left hemisphere (BA 45), preceding 45-minutes of behavioral aphasia therapy.
15 sessions of 40 seconds of cTBS over the pars triangularis of the right inferior frontal gyrus (BA 45 homologue), preceding 45-minutes of behavioral aphasia therapy.
15 sessions of sham TBS over the pars triangularis of Broca's area in the left hemisphere (BA 45), preceding 45-minutes of behavioral aphasia therapy.