A review on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) on post-stroke aphasia
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Ivy S.Y. Wong
Ivy S.Y. Wong has an over 17-year experience as a speech therapist in a hospital and special school. She is currently the Honorary Clinical Supervisor of the Division of Speech and Hearing Sciences, University of Hong Kong. Ms. Wong received her degree in Speech and Hearing Sciences at the University of Hong Kong in 1994. Currently, she is studying Master of Sciences in Rehabilitation Sciences at The Hong Kong Polytechnic University. Her research interests include evidence-based practice of speech therapy in neurogenic communication disorders and dysphagia, and implementation of medical informatics among allied health professionals in Hong Kong. Ms. Wong has recently published a paper in the European Journal of Integrative Medicine.
Hector W.H. Tsang is a registered occupational therapist in Hong Kong and the United States. He is currently Professor and Associate Head of the Department of Rehabilitation Sciences at The Hong Kong Polytechnic University. He has an array of clinical experiences working with people with mental illness and geriatric populations in hospital and community settings. Prof. Tsang’s research interests have focused on neuropsychiatric rehabilitation for people with psychosis and complementary and alternative treatments. He has authored a series of studies and reviews investigating the effects of mindfulness exercises and alternative therapies in treating people with chronic illnesses such as dysphagia, aphasia, and knee osteoarthritis, and people with stress-related disorders such as depression and anxiety. Altogether, he has published >120 articles in high-quality peer-reviewed journals and is currently serving as an associate editor of the American Journal of Occupational Therapy.
Abstract
Background: This evidence-based review reports an updated evaluation and critical appraisal of available studies that investigated the effectiveness of repetitive transcranial magnetic stimulation (rTMS) on post-stroke aphasia rehabilitation.
Methods: A literature search was performed to identify studies that investigated the therapeutic effects of rTMS on post-stroke aphasia in various electronic databases, from their inception to 2011. The selected studies were classified according to the types of participants, types of interventions, outcome measures, and results. The methodological qualities of the selected studies were evaluated using the Physiotherapy Evidence Database scale.
Results: The current review was based on 12 studies, including open-label designs and controlled trials, that showed a positive effect of rTMS, with or without conventional rehabilitation, on post-stroke aphasia compared with sham or conventional rehabilitation alone. About 41% of the selected studies reported the long-term effect of rTMS on aphasia recovery. No adverse effect was reported.
Conclusions: The current review reveals that rTMS with or without conventional rehabilitation has positive effects on post-stroke aphasia. The studies also contributed to the plausible mechanisms of stroke recovery. However, with the concerns over the methodology of the selected studies in this review, a larger-scale, multicenter, well-designed randomized controlled trial involving different phases and types of aphasia needs to be carried out before recommending rTMS as a complementary treatment for post-stroke aphasia.
About the authors
Ivy S.Y. Wong has an over 17-year experience as a speech therapist in a hospital and special school. She is currently the Honorary Clinical Supervisor of the Division of Speech and Hearing Sciences, University of Hong Kong. Ms. Wong received her degree in Speech and Hearing Sciences at the University of Hong Kong in 1994. Currently, she is studying Master of Sciences in Rehabilitation Sciences at The Hong Kong Polytechnic University. Her research interests include evidence-based practice of speech therapy in neurogenic communication disorders and dysphagia, and implementation of medical informatics among allied health professionals in Hong Kong. Ms. Wong has recently published a paper in the European Journal of Integrative Medicine.
Hector W.H. Tsang is a registered occupational therapist in Hong Kong and the United States. He is currently Professor and Associate Head of the Department of Rehabilitation Sciences at The Hong Kong Polytechnic University. He has an array of clinical experiences working with people with mental illness and geriatric populations in hospital and community settings. Prof. Tsang’s research interests have focused on neuropsychiatric rehabilitation for people with psychosis and complementary and alternative treatments. He has authored a series of studies and reviews investigating the effects of mindfulness exercises and alternative therapies in treating people with chronic illnesses such as dysphagia, aphasia, and knee osteoarthritis, and people with stress-related disorders such as depression and anxiety. Altogether, he has published >120 articles in high-quality peer-reviewed journals and is currently serving as an associate editor of the American Journal of Occupational Therapy.
©2013 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Masthead
- Masthead
- Dissecting circuit mechanisms by genetic manipulation of specific neural pathways
- The basal ganglia: motor and cognitive relationships in a clinical neurobehavioral context
- Putting an object in context and acting on it: neural mechanisms of goal-directed response to contextual object
- Aversive motivation and the maintenance of monogamous pair bonding
- The roles of MAGE-D1 in the neuronal functions and pathology of the central nervous system
- Multiple sclerosis and glutamate excitotoxicity
- Spatial frequencies and emotional perception
- A review on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) on post-stroke aphasia
