Document Detail


Improved language in a chronic nonfluent aphasia patient after treatment with CPAP and TMS.
MedLine Citation:
PMID:  20299861     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To present pretreatment and post-treatment language data for a nonfluent aphasia patient who received 2 treatment modalities: (1) continuous positive airway pressure (CPAP) for his sleep apnea, starting 1-year poststroke; and (2) repetitive transcranial magnetic brain stimulation (TMS), starting 2 years poststroke.
BACKGROUND: Language data were acquired beyond the spontaneous recovery period of 3 to 6 months poststroke onset. CPAP restores adequate oxygen flow throughout all stages of sleep, and may improve cognition. A series of slow, 1 Hz repetitive TMS treatments to suppress a posterior portion of right pars triangularis has been shown to improve phrase length and naming in chronic nonfluent aphasia.
METHOD: The Boston Diagnostic Aphasia Examination and Boston Naming Test were administered pre-CPAP, and after 2 to 5 months of CPAP. These same tests were administered pre-TMS, and at 3 and 6 months post-TMS, and again 2.4 years later.
RESULTS: Post-CPAP testing showed increased Phrase Length, Auditory Comprehension, and naming Animals and Tools/Implements (Boston Diagnostic Aphasia Examination). Testing at 3 and 6 months post-TMS showed significant increase in Phrase Length, Auditory Comprehension, and Boston Naming Test compared with pre-TMS. These gains were retained at 2.4 years post-TMS. CPAP use continued throughout.
CONCLUSIONS: Physiologic treatment interventions may promote language recovery in chronic aphasia.
Authors:
Margaret A Naeser; Paula I Martin; Kristine Lundgren; Reva Klein; Jerome Kaplan; Ethan Treglia; Michael Ho; Marjorie Nicholas; Miguel Alonso; Alvaro Pascual-Leone
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology     Volume:  23     ISSN:  1543-3641     ISO Abbreviation:  Cogn Behav Neurol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-06-23     Revised Date:  2012-02-15    
Medline Journal Info:
Nlm Unique ID:  101167278     Medline TA:  Cogn Behav Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-38     Citation Subset:  IM    
Affiliation:
Department of Neurology, Harold Goodglass Boston University Aphasia Research Center, Boston University School of Medicine and the Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA. mnaeser@bu.edu
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MeSH Terms
Descriptor/Qualifier:
Aphasia, Broca / diagnosis,  therapy*
Chronic Disease
Continuous Positive Airway Pressure / methods*
Humans
Language*
Male
Middle Aged
Neuropsychological Tests
Severity of Illness Index
Transcranial Magnetic Stimulation / methods*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K24 RR018875-05/RR/NCRR NIH HHS; M01 RR001032-316089/RR/NCRR NIH HHS; P30 DC005207-08/DC/NIDCD NIH HHS; R01 DC005672-05/DC/NIDCD NIH HHS
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