Aphasia & Stroke
Brain damage from stroke, including aphasia, can be effectively treated months, even years after the injury. Transcranial magnetic stimulation (TMS) allows TheraMind physicians to stimulate damaged brain structures and enhance the brain’s natural neuroplasticity (ability of the brain to form and reorganize synaptic connections).
What is stroke?
Stroke is loss of blood supply to the brain (ischemia) or hemorrhage (bleeding) in the brain. There are approximately 795,000 cases of stroke in the U.S. each year. [1,2] About one-third of all strokes result in aphasia. [3] Stroke is the fifth leading cause of death in the U.S.[2] Strokes may be caused by high blood pressure, diabetes, high cholesterol, smoking, obesity and other health conditions. [3] The severity of the symptoms depends on the area of the brain affected and the extent of damage caused. Traditional post-stroke therapies include physical therapy, occupational therapy and speech therapy. [4]
What is aphasia?
Aphasia is a neurological disorder resulting from damage or injury to the language area in the brain. [5] It is exemplified by impairment of language, speech, comprehension, and the ability to read and write. Medical science recognizes three different types of aphasia: comprehensive; expressive; and global. [5] There are approximately 200,000 new cases of aphasia in the U.S. each year and roughly 2,000,000 Americans are afflicted with this condition. [6] Aphasia may result from stroke, head trauma, tumors, or infections. Traditional treatments for aphasia include speech and language therapy or surgery.
Our approach
State-of-the-art diagnostic technologies like functional Magnetic Resonance Imaging (fMRI) have made it possible to locate and image damaged brain tissue and develop precise targets for treatment. At the TheraMind Center of Santa Barbara, our team of TMS-certified physicians working with TheraMind neurologists who are specialists in fMRI imaging studies, have developed patient-specific treatment regimens and specific brain locations to help the brain recover from stroke or the damage which caused aphasia. TMS therapy has been shown in multiple studies[7] to alleviate aphasia symptoms in victims when properly targeted using fMRI-based diagnostic imaging techniques. For aphasia patients (or stroke victims with language impairment) our physicians typically work with speech therapists in tandem with providing targeted TMS therapy.
Results
Several studies have reported on the efficacy of TMS therapy in the treatment of aphasia. In 2012 the results of the studies done to that date were summarized in a literature review as follows: “In summary, the TMS studies by Naeser et al, as well as these new TMS studies, all suggest that use of 1-Hz rTMS for a series of at least 10 rTMS treatments results in significant improvement in naming, and often in phrase length during propositional speech. These improvements are long-lasting, up to 2 months, or even as long as 2 years, post-TMS. Functional imaging studies report significant improvement in naming in those cases with new LH activation or a shift to overall LH lateralization. When TMS is combined with speech therapy, additional improvement has been observed, beyond TMS alone. Additional TMS studies in aphasia are likely to replicate and expand these findings.” [7]
References
- Kochanek KD, Xu JQ, Murphy SL, Arias E. Mortality in the United States, 2013. NCHS Data Brief, No. 178. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services; 2014.
- Mozzafarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation 2016;133(4):e38–360.
- “Stroke Facts.” CDC.gov, Centers of Disease Control and Prevention, https://www.cdc.gov/stroke/facts.htm. January 31, 2020.
- “Recovering From Stroke.” CDC.gov, Centers of Disease Control and Prevention, https://www.cdc.gov/stroke/recovery.htm. January 31, 2020.
- “Aphasia, Symptoms and Causes.” Mayoclinic.org, The Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518. April 22, 2020.
- “Aphasia Statistics.” Aphasia.org, National aphasia association, https://www.aphasia.org/aphasia-resources/aphasia-statistics/.
- Ho, Michael & Treglia, Ethan & Kaplan, Elina & Bashir, Shahid & Pascual-Leone, Alvaro. (2012). Transcranial Magnetic Stimulation and Aphasia Rehabilitation. Archives of physical medicine and rehabilitation. 93. S26-34. 10.1016/j.apmr.2011.04.026.
Additional Resources: An excellent summary of clinical research into the efficacy of TMS therapy for aphasia and stroke can be found at Jean-PascalLefaucheur, et al, “Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018), Clinical Neurophysiology, Volume 131, Issue 2, February 2020, Pages 474-528.