Name: utilizing repetitive transcranial magnetic stimulation to improve language function in stroke patients with chronic non-fluent aphasia
Uploaded: 2013-07-02T13:00:00
Description: Watch this Scientific Journal Video about Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia at JoVE.com

支持这项工作是由以下资金来源： MAN：NIH 2R01 DC05672-04A2 RHH：美国国立卫生研究院/ NINDS 1K01NS060995的-01A1 RHH：罗伯特·伍德·约翰逊基金会/哈罗德·阿莫斯医学院的发展计划

1。治疗前评估<ol><li>招募患者为研究对象符合资格要求谁。这些标准包括一个单一的，单方面的，左侧大脑半球缺血性中风，不遗余力辅助运动区（SMA），轻度至中度非流利的讲话（定义的能力产生意味深长的话，至少有2-4个字长度的字符串）， 18和75岁之间的中风后至少六个月。 </li><li>此外，所有潜在的患者一定要能说出至少三个波士顿命名测试15，平均至少三张图片的前30项20时，?...

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这篇文章的目的是详细的操作步骤为确定一个响应目标网站在右半球在慢性非流​​利性失语患者。通过这样做，我们有能刺激目标区域治疗，刺激语言能力的影响进行评估，并使用低频rTMS的命名和流利的慢性非流利性失语患者引起长期的改善。我们的方式复制和扩展使用前调查，最引人注目Naeser，同事8的方法。重要的是，像一些事先调查8,12,13,23，我们已经观察到，大多数患者...

失语收购亏损的语言能力是一种常见的，往往使人衰弱的后果行程2。虽然一定程度上是典型的急性脑卒中后失语症恢复，许多患者至少经历某种程度的持续出现赤字，并且，现有语言疗法通常被认为是只温和有效地促进恢复3-5。近年来，非侵入性的刺激技术的出现，如经颅磁刺激（TMS）作为中风后赤字各种潜力的治疗方法，包括失语。 TMS采用电磁感应原理，和涉及迅速熔剂的磁场的产生，在一个线圈。当线圈被放置在邻近的被摄体的头部，磁场穿透头皮和头骨，诱导潜在的皮质神经元中的电流是足够的去极化神经细胞膜和基因率动作电位3。 TMS的参数，如频率，强度和脉冲数，可以是多种多样的，以引起不同的神经生理，行为和感知效果4,5。重复TMS（磁刺激）必须管理的一系列脉冲，以预定频率产生的影响，可以长久刺激的应用。目前的实验证据表明，在低频rTMS的交付（0.5-2赫兹）往往灶性降低大脑皮层的兴奋性，而高频刺激已与大脑皮层的兴奋3有密切关系。磁刺激已探索作为治疗各种神经和精神疾病，最显着的凹部6。 越来越多的证据表明，低频rTMS治疗与慢性中风引起的失语者，可用于提高语言恢复。 Naeser和同事7,8率先采用1赫兹inhibitoRY rTMS治疗20分钟，每周五天四个右手的患者与慢性非流利性失语两周右额下回。显着改善的命名进行了观察，持续至少8个月完成后，刺激8。随后，我们复制和扩大这些成果，并已经证明，1 Hz的刺激导致在命名和自发的讲话引起慢性非流利失语症患者9-11持续改善。令人鼓舞的是，像这样的小规模研究的结果已被复制与慢性中风12例患者在进一步调查中，以及在亚急性中风失语13例。 非流利性失语患者前TMS研究中的一个重要的和几乎无处不在的特点是有益的刺激效果，似乎是特定网站。采用的方法最初受雇于Naeser和他的同事，最rTMS的调查已被用来促进语言恢复有针对性的正确的收杆三角1（布罗德曼区45）。事实上，最近的证据表明，刺激其他地区的右额下回可能是无效的，甚至可能产生有害影响语文成绩14，强调需要仔细的个体识别的最佳刺激点。 建立的方法由Naeser和同事8时，我们正在进行调查研究的影响抑制rTMS的额下回语言能力，还考察了地形特异的rTMS治疗效果在右额叶。在这篇文章中，我们提供了详细描述了如何刺激的最佳网站可以识别患者与慢性非流利性失语。然后，我们描述的治疗rTMS的管理和解释瓯的ŗ技术评估刺激的功效，加强在这一人群中的语言恢复。

<table border="1">
 <tbody>
 <tr>
 <td>Name of Reagent/Material</td>
 <td>Company</td>
 <td>Catalog Number</td>
 <td>Comments</td>
 </tr>
 <tr>
 <td>Rapid transcranial magnetic stimulator</td>
 <td>Magstim</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>3.0 Trio Scanner</td>
 <td>Siemens</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>8 channel head coil</td>
 <td>Siemens</td>
 <td></td>
 <td></td>
 </tr>
 <tr>
 <td>Brainsight neuronavigational system</td>
 <td>Rogue Research</td>
 <td></td>
 <td></td>
 </tr>
 </tbody>
</table>

utilizing repetitive transcranial magnetic stimulation to improve language function in stroke patients with chronic non-fluent aphasia

经颅磁刺激（TMS）已被证明能显着改善与非流利性失语患者语言功能的。在这个实验中，我们展示了低频重复性TMS（rTMS的）管理与慢性非流利性失语患者的最佳刺激的部位在右半球。电池管理标准化语言措施，以评估基准性能。其后患者随机分为接受真正的rTMS治疗或初始假刺激。在现实的刺激患者经过现场调查阶段，包括了一系列的六个rTMS的会话管理五天的刺激传递到不同的站点在右额叶每个会话期间。每个站点发现会话由600脉冲1赫兹rTMS治疗，之前和之后的图片命名任务。 CAND刺激引起的命名能力的瞬态变化程度比较IDATE网站，我们能够找到的区域为每个病人的最佳响应。然后我们管理rTMS的这个网站在治疗阶段。患者在治疗期间，共经历了10天的刺激，在短短两周的每个会话由1赫兹rTMS的交付90％的静息运动阈值的20分钟。刺激配对的功能磁共振成像命名任务上的第一个和最后一个天的治疗。处理后的阶段完成后，在基线的语言电池重复2个月和6个月后，刺激，以便确定rTMS的性能引起的变化。 fMRI的命名任务还多次治疗后2个月和6个月。谁是病人随机分为假臂的研究进行假现场发现，假治疗，功能磁共振成像研究命名，并重复语言测试后两个月完成假治疗。深水患者，然后到真正的刺激臂跨越，完成真正的网站发现，真正的treatm耳鼻喉科，功能磁共振成像，两个刺激后六个月语言测试。

在本次调查的现场调查阶段，大多数但不是所有的患者反应最佳图片命名任务，刺激的右三角14杆收杆。根据我们的经验，患者图片命名上的表现是一贯促进刺激腹后收杆三角方面（图3）。 标准化语言评估长期改善性能， 如图4所示。此图显示的结果在其中一个有代表性的病人的BNT和BDAE的（命名分类小节）图片命名精度rTMS的治疗后，随着时?...

Watch this Scientific Journal Video about Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia at JoVE.com

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia

我们探索利用重复经颅磁刺激（rTMS的）改善慢性中风和非流利性失语患者的语言能力。识别一个网站为每一个病人的右额下回响应最佳刺激后，我们针对这个网站在10天的rTMS治疗。

利用重复经颅磁刺激改善脑卒中患者的语言功能与慢性非流利性失语

Transcranial magnetic stimulation (TMS) has been shown to significantly improve language function in patients with non-fluent aphasia1. In this ...

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利用经颅磁刺激，以研究人类的神经肌肉系统

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