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Written by—Xie Xiaohui, Bai Tongjian, editors—Wang Sizhen, Fang Yiyi, editor—Wang Sizhen
with post-stroke aphasia ( Post-stroke aphasia (PSA) is one of the most common sequelae of stroke and an important factor
affecting the recovery and quality of life of stroke patients.
Although spontaneous recovery from aphasia after stroke is possible, two-thirds of patients with aphasia recover poorly and develop chronic aphasia [1], with patients with speech comprehension disorders having more difficulty
recovering.
Speech and language therapy (SLT) is currently the first-line treatment for post-stroke aphasia [2].
However, the effect on language comprehension is limited
.
Recently, non-invasive brain stimulation techniques, such as cranial magnetic stimulation and transcranial electrical stimulation, have been gradually used in post-stroke rehabilitation [3].
However, there is still a lack of effective treatment for speech comprehension disorders in patients with PSA
.
Since most patients with aphasia after stroke have varying degrees of comprehension impairment, the improvement of language comprehension ability is conducive to the recovery
of language expression ability and overall language function of PSA patients.
Therefore, it is important to target the language comprehension disorder of PSA and explore more effective treatment modalities for post-stroke
aphasia.
On December 6, 2022, Wang Kai's research group from the First Affiliated Hospital of Anhui Medical University was in Published in Brain Stimulation "Transcranial alternating current stimulation enhances speech comprehension in chronic post-stroke aphasia patients: A single-blind sham-controlled study" The application of transcranial alternating current stimulation technology in the rehabilitation of
aphasia after chronic stroke was proposed.
Xie Xiaohui is the first author of the paper, and Professor Wang Kai and Bai Tongjian are the co-corresponding authors
of the paper.
In this study, the authors found that TranscranialAlternatingC urrent Stimulation, tACS) combined with SLT can significantly improve a patient's overall language ability Verbal expression and language comprehension skills
.
Moreover, tACS plus SLT was significantly superior to SLT alone in terms of language comprehension improvement
.
The results of the study revealed that transcranial alternating current stimulation is safe and effective
for the rehabilitation of speech in aphasia after chronic stroke.
Neuronal oscillations in language-related brain regions are considered necessary
for effective speech processing [4].
Transcranial alternating current stimulation (tACS) can regulate neuronal oscillations [5] and regulate speech processing in healthy subjects [6,7].
。 Recent studies from post-stroke aphasia imaging have shown that the assisted motor region (SMA), as a universal region of language, produces speech in people with aphasia [8] and comprehension [9] are crucial
.
SMA may be a potential target for effective treatment of PSA
.
In a study in which tACS in different frequency bands stimulated healthy people to perform auditory speech tasks, tACS at theta frequencies (4-8 Hz) enhanced the ability of healthy subjects to distinguish speech from noise [6]
。 However, this model has not been applied
in patients with language disorders.
Therefore, the authors explored whether θ-tACS stimulation of SMA improves language function in patients with PSA
。
The investigators used 6Hz-tACS in combination with SLT for the treatment of chronic-phase PSA
.
The specific treatment mode is shown in Figure 1A
.
The assessment of PSA language disorder uses the Chinese aphasia set test, a language assessment scale suitable for Chinese people[10].
The scale consists of four sub-items, including self-speaking (informative and fluent), listening comprehension, retelling, and naming
。 The aphasia quotient (AQ) is calculated based on these four sub-items to assess the overall language function
of the person with aphasia.
This study shows that SLT combined with tACS has achieved significant efficacy
in the treatment of chronic PSA.
Consistent with previous studies, the administration of SLT alone primarily improved the naming function of patients (Figure 1F) while tACS was used in combination.
In addition to significantly improving the patient's language comprehension (Figure 1C), the patient's other language domains (including self-speaking, repetition, and naming skills) were also improved (Figure 1D-F
。 In addition, this study also suggests that SLT combined with tACS and SLT alone had a language comprehension score (F = 24.
15, p There was an interaction effect on the <0.
001) and AQ score (F = 15.
56, p = 0.
001) on the time of group × (Figure 1B, C).
。 In other language subterms, no interaction effect was found for group × time (p < 0.
01 is statistically significant, Bonferroni corrected).
Figure 1: Timeline and effect of transcranial alternating current stimulation (tACS) combined with speech-language therapy (SLT) in the treatment of chronic post-stroke aphasia (Source: Xie, XH.
et al.
, Brain Stimulation, 2022)
Transcranial alternating current stimulation combined with speech-language therapy significantly improved language comprehension in patients with chronic post-stroke aphasia
.
The researchers speculate that people with aphasia can better acquire language under the premise of better comprehension function, which may be a mutually reinforcing and mutually reinforcing model
.
This mutually reinforcing model was verified in this study, thus providing important reference value and inspiration
for future rehabilitation of post-stroke aphasia.
This study also illustrates that transcranial alternating current stimulation is a promising treatment modality, and its huge potential needs to be explored
by more researchers.
Of course, there are still some unresolved problems
in this study.
For example, only 72% of participants completed a follow-up of 1 month after treatment, and the results showed that the effect lasted at least one month
.
This short follow-up period is a major problem
that future studies must address.
Second, some effects may be underestimated
due to small sample sizes and large patient heterogeneity.
In addition, lack of blinding of assessment may have contributed to bias in the results
.
Nevertheless, these results provide the primary evidence
for language rehabilitation in people with aphasia after chronic stroke.
Original link: https://doi.
org/10.
1016/j.
brs.
2022.
12.
001
Corresponding author: Wang Kai (Photo courtesy of Wang Kai Research Group, Anhui Province "Neuropsychiatric Disorders and Mental Health" Collaborative Innovation Center).
Corresponding author bio (swipe up and down to read).
Dr.
Kai Wang/Professor, Level 1 Chief Physician, Doctoral Supervisor
.
Changjiang Scholar Distinguished Professor, "Leading Talent" of 10,000 Talents Program, National Candidate of "New Century Millions of Talents Project", and won the "Chinese Medical Doctor Association" China Outstanding Neurologist - Academic Achievement" Award
.
He is the director of the Academic Committee of Anhui Medical University, the president of the Anhui Institute of Translational Medicine, the director of the Anhui Collaborative Innovation Center for "Neuropsychiatric Diseases and Mental Health", and the vice president
of the Neurologist Branch of the Chinese Medical Doctor Association.
He has presided over 9 projects of the National Natural Science Foundation of China (including 1 major project and 1 major research plan), and 4 sub-projects of 973 , 3 national key research and development plans
.
The research results have been published in Nature Genetics, European Heart Journal, Nature Neuroscience, PNAS, Neurology, Stroke, Schizophrenia Bulletin, Radiology, Neuroimage and other journals, published 285 SCI papers, including 211 SCI papers by the first and corresponding
authors.
He won the first and second prizes of Anhui Province Science and Technology Progress Award (ranked 1st), the first prize of Chinese Medical Science and Technology Award (3) and the first prize of Jiangsu Province Science and Technology Progress Award (3).
Welcome to scan the code to join Logical Neuroscience Literature learning 2 group remarks format: Name--Research field-Degree/Title/Title/ Position Selected articles from previous issues [1] Aging Cell | Du Yifeng's team reveals a new mechanism of long-term aerobic exercise against Alzheimer's disease memory decline [2] Nat Hum Behav—Wu Tangchun/Li Liming's team reveals how residents cook for health [3] CRPS—self-powered speech recognition system developed by Guo Wenxi/Wu Ronghui's research group of Xiamen University for the hearing impaired [4] J Neurosc—the first time! Spatial-temporal development patterns of perinatal thalamic morphology, microstructure and connectivity[5] Cell Rep—Li Fei/Li Weiguang/Zhang Xiaoyong/Mei Bing team proposed classification criteria
for autism social disorder based on synaptic cell biological characteristics[6] Expert comments iScience—Li Yan's team revealed the molecular mechanism of familial epilepsy [7] Cell Death Discov—Kang Jiuhong's team found that NRG1 is expected to be a new target for the treatment of schizophrenia caused by intrauterine growth restriction [8] Nature—Zhang Shicheng et al.
analyzed the design principle of DREADD, a chemical genetic tool based on muscarinic acetylcholine receptors [9] eLife—Chen Shuyi's team first revealed the m6A epitranscriptional regulation mechanism of state transition between neural progenitor cells and glial cells [10] Nature—Shi Songhai's research group revealed a new mechanism that regulates the spatial fine structure arrangement and loop assembly of neurons in the neocortex of the brain, NeuroAI Reading Club[1] NeuroAI Reading Club Launched—Exploring the Frontier Intersection
of Neuroscience and Artificial Intelligence Recommended High-quality Research Training Courses [1] Symposium on Patch Clamp and Optogenetics and Calcium Imaging Technology (January 7-8, 2023 Tencent Meeting)【2】The 10th NIR Training Camp (Online: 2022.
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Reference (Swipe Up and Down to Read).
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Cortical oscillations and speech processing: emerging computational principles and operations.
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[6] Keshavarzi M, Kegler M, Kadir S, Reichenbach T.
Transcranial alternating current stimulation in the theta band but not in the delta band modulates the comprehension of naturalistic speech in noise.
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[7] Riecke L, Formisano E, Sorger B, Baskent D, Gaudrain E.
Neural Entrainment to Speech Modulates Speech Intelligibility.
Curr Biol 2018; 28(2):161-9 e5.
[8] Geranmayeh F, Chau TW, Wise RJS, Leech R, Hampshire A.
Domain-general subregions of the medial prefrontal cortex contribute to recovery of language after stroke.
Brain 2017; 140(7):1947-58.
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