Unlocking Language: Can Cerebellar Stimulation Help Stroke Aphasia?

Published on June 2, 2022

Imagine trying to find a lost key in a dark room. You search and search, but the key remains elusive. In a similar vein, post-stroke aphasia patients struggle to recover their language abilities with limited success. But fear not, science may have a solution! Researchers are investigating the use of continuous theta burst stimulation (cTBS) on the cerebellum as a potential therapy for post-stroke aphasia. This technique, which involves stimulating specific areas of the brain with magnetic fields, has shown promising results in improving language dysfunctions. By targeting the cerebellum, which plays a crucial role in various language functions, cTBS aims to unlock the power of language recovery. In a randomized controlled trial, patients with chronic post-stroke aphasia will receive either real cTBS or a sham treatment. The Western Aphasia Battery will be used to assess the treatment outcome and secondary measures such as fMRI data will be examined to explore changes in brain connectivity. This exciting research holds the key to unlocking language skills for individuals living with post-stroke aphasia!

BackgroundLanguage recovery is limited in moderate to severe post-stroke aphasia patients. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising tool in improving language dysfunctions caused by post-stroke aphasia, but the treatment outcome is as yet mixed. Considerable evidence has demonstrated the essential involvement of the cerebellum in a variety of language functions, suggesting that it may be a potential stimulation target of TMS for the treatment of post-stroke aphasia. Theta burst stimulation (TBS) is a specific pattern of rTMS with shorter stimulation times and better therapeutic effects. The effect of continuous TBS (cTBS) on the cerebellum in patients with aphasia with chronic stroke needs further exploration.MethodsIn this randomized, sham-controlled clinical trial, patients (n = 40) with chronic post-stroke aphasia received 10 sessions of real cTBS (n = 20) or sham cTBS (n = 20) over the right cerebellar Crus I+ a 30-min speech-language therapy. The Western Aphasia Battery (WAB) serves as the primary measure of the treatment outcome. The secondary outcome measures include the Boston Diagnostic Aphasia Examination, Boston Naming Test and speech acoustic parameters. Resting-state fMRI data were also obtained to examine treatment-induced changes in functional connectivity of the cerebro-cerebellar network. These outcome measures are assessed before, immediately after, and 12 weeks after cerebellar cTBS intervention.DiscussionThis protocol holds promise that cerebellar cTBS is a potential strategy to improve language functions in chronic post-stroke aphasia. The resting-state fMRI may explore the neural mechanism underlying the aphasia rehabilitation with cerebellar cTBS.

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