scholarly journals Non-invasive brain stimulation as add-on therapy for subacute post-stroke aphasia: a randomized trial (NORTHSTAR)

2020 ◽  
Vol 5 (4) ◽  
pp. 402-413
Author(s):  
Anna Zumbansen ◽  
Sandra E Black ◽  
Joyce L Chen ◽  
Dylan J Edwards ◽  
Alexander Hartmann ◽  
...  
Keyword(s):  
Brain Stimulation ◽  
Interquartile Range ◽  
Secondary Outcome ◽  
Broca’S Area ◽  
Broca's Area ◽  
Sham Stimulation ◽  
Post Stroke ◽  
Non Invasive ◽  
Pars Triangularis ◽  
The Right

Introduction Non-invasive brain stimulation (NIBS) with speech therapy might improve recovery from post-stroke aphasia. This three-armed sham-controlled blinded prospective proof-of-concept study tested 1 Hz subthreshold repetitive transcranial magnetic stimulation (rTMS) and 2-mA cathodal transcranial direct current stimulation (ctDCS) on the right pars triangularis in subacute post-stroke aphasia. Patients and methods Sixty-three patients with left middle cerebral artery infarcts were recruited in five hospitals (Canada/United States/Germany, 01–2014/03–2018) and randomized to receive rTMS ( N = 20), ctDCS ( N = 24) or sham stimulation ( N = 19) with ST for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Secondary outcome variable was the percent change in the Unified Aphasia Score. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment with a pre-planned subgroup analysis for lesion location (affecting Broca’s area or not). Results Naming was significantly improved by rTMS (median = 1.91/interquartile range = 0.77/ p =  .01) at 30 days versus ctDCS (median = 1.11/interquartile range = 1.51) and sham stimulation (median = 1.02/interquartile range = 1.71). All other primary results were non-significant. The rTMS effect was driven by the patient subgroup with intact Broca’s area where NIBS tended to improve UnAS (median = 33.2%/interquartile range = 46.7%/ p =  .062) versus sham stimulation (median = 12.5%/interquartile range = 7.9%) at day 30. Conversely, in patients with infarcted Broca’s area, UnAS tended to improve more with sham stimulation (median = 75.0%/interquartile range = 86.9%/ p =  .053) versus NIBS (median = 12.7%/interquartile range = 31.7). Conclusion: We found a delayed positive effect of low-frequency rTMS targeting the right pars triangularis on the recovery of naming performance in subacute post-stroke aphasia. This intervention may be beneficial only in patients with morphologically intact Broca’s area.

scholarly journals Cortical folding in Broca's area relates to obstetric complications in schizophrenia patients and healthy controls

2011 ◽  
Vol 42 (6) ◽  
pp. 1329-1337 ◽  
Author(s):  
U. K. Haukvik ◽  
M. Schaer ◽  
R. Nesvåg ◽  
T. McNeil ◽  
C. B. Hartberg ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Three Dimensional ◽  
Obstetric Complications ◽  
Healthy Controls ◽  
Broca’S Area ◽  
Cortical Folding ◽  
Broca's Area ◽  
Control Subjects ◽  
Pars Triangularis ◽  
The Right

BackgroundThe increased occurrence of obstetric complications (OCs) in patients with schizophrenia suggests that alterations in neurodevelopment may be of importance to the aetiology of the illness. Abnormal cortical folding may reflect subtle deviation from normal neurodevelopment during the foetal or neonatal period. In the present study, we hypothesized that OCs would be related to cortical folding abnormalities in schizophrenia patients corresponding to areas where patients with schizophrenia display altered cortical folding when compared with healthy controls.MethodIn total, 54 schizophrenia patients and 54 healthy control subjects underwent clinical examination and magnetic resonance image scanning on a 1.5 T scanner. Information on OCs was collected from original birth records. An automated algorithm was used to calculate a three-dimensional local gyrification index (lGI) at numerous points across the cortical mantle.ResultsIn both schizophrenia patients and healthy controls, an increasing number of OCs was significantly related to lowerlGI in the left pars triangularis (p<0.0005) in Broca's area. For five other anatomical cortical parcellations in the left hemisphere, a similar trend was demonstrated. No significant relationships between OCs andlGI were found in the right hemisphere and there were no significant case–control differences inlGI.ConclusionsThe reduced cortical folding in the left pars triangularis, associated with OCs in both patients and control subjects suggests that the cortical effect of OCs is caused by factors shared by schizophrenia patients and healthy controls rather than factors related to schizophrenia alone.

Does the right hemisphere take over after damage to Broca’s area? the Barlow case of 1877 and its history

2003 ◽  
Vol 85 (3) ◽  
pp. 385-395 ◽  
Author(s):  
Stanley Finger ◽  
Randy L. Buckner ◽  
Hugh Buckingham
Keyword(s):  
Right Hemisphere ◽  
Broca’S Area ◽  
Broca's Area ◽  
The Right

scholarly journals Transcranial brain stimulation (TMS and tDCS) for post-stroke aphasia rehabilitation: Controversies

2014 ◽  
Vol 8 (3) ◽  
pp. 207-215 ◽  
Author(s):  
Lucia Iracema Zanotto de Mendonça
Keyword(s):  
Left Hemisphere ◽  
Brain Stimulation ◽  
Right Hemisphere ◽  
Post Stroke ◽  
Transcranial Brain Stimulation ◽  
The Right ◽  
Dominance Pattern ◽  
Causal Event ◽  
Hemispheric Language Dominance ◽  
Language Network

Transcranial brain stimulation (TS) techniques have been investigated for use in the rehabilitation of post-stroke aphasia. According to previous reports, functional recovery by the left hemisphere improves recovery from aphasia, when compared with right hemisphere participation. TS has been applied to stimulate the activity of the left hemisphere or to inhibit homotopic areas in the right hemisphere. Various factors can interfere with the brain's response to TS, including the size and location of the lesion, the time elapsed since the causal event, and individual differences in the hemispheric language dominance pattern. The following questions are discussed in the present article: [a] Is inhibition of the right hemisphere truly beneficial?; [b] Is the transference of the language network to the left hemisphere truly desirable in all patients?; [c] Is the use of TS during the post-stroke subacute phase truly appropriate? Different patterns of neuroplasticity must occur in post-stroke aphasia.

scholarly journals Optical Mapping of Brain Activity Underlying Directionality and Its Modulation by Expertise in Mandarin/English Interpreting

2021 ◽  
Vol 15 ◽  
Author(s):  
Yan He ◽  
Yinying Hu ◽  
Yaxi Yang ◽  
Defeng Li ◽  
Yi Hu
Keyword(s):  
Prefrontal Cortex ◽  
Cognitive Skills ◽  
Near Infrared ◽  
Right Hemisphere ◽  
Brain Activity ◽  
Brain Regions ◽  
Broca’S Area ◽  
Broca's Area ◽  
Functional Near Infrared Spectroscopy ◽  
The Right

Recent neuroimaging research has suggested that unequal cognitive efforts exist between interpreting from language 1 (L1) to language 2 (L2) compared with interpreting from L2 to L1. However, the neural substrates that underlie this directionality effect are not yet well understood. Whether directionality is modulated by interpreting expertise also remains unknown. In this study, we recruited two groups of Mandarin (L1)/English (L2) bilingual speakers with varying levels of interpreting expertise and asked them to perform interpreting and reading tasks. Functional near-infrared spectroscopy (fNIRS) was used to collect cortical brain data for participants during each task, using 68 channels that covered the prefrontal cortex and the bilateral perisylvian regions. The interpreting-related neuroimaging data was normalized by using both L1 and L2 reading tasks, to control the function of reading and vocalization respectively. Our findings revealed the directionality effect in both groups, with forward interpreting (from L1 to L2) produced more pronounced brain activity, when normalized for reading. We also found that directionality was modulated by interpreting expertise in both normalizations. For the group with relatively high expertise, the activated brain regions included the right Broca’s area and the left premotor and supplementary motor cortex; whereas for the group with relatively low expertise, the activated brain areas covered the superior temporal gyrus, the dorsolateral prefrontal cortex (DLPFC), the Broca’s area, and visual area 3 in the right hemisphere. These findings indicated that interpreting expertise modulated brain activation, possibly because of more developed cognitive skills associated with executive functions in experienced interpreters.

Can neuromodulation techniques optimally exploit cerebello-thalamo-cortical circuit properties to enhance motor learning post-stroke?

2019 ◽  
Vol 30 (8) ◽  
pp. 821-837 ◽  
Author(s):  
Sharon Israely ◽  
Gerry Leisman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Animal Studies ◽  
Motor Recovery ◽  
Motor Deficits ◽  
Post Stroke ◽  
Non Invasive ◽  
Deep Brain

Abstract Individuals post-stroke sustain motor deficits years after the stroke. Despite recent advancements in the applications of non-invasive brain stimulation techniques and Deep Brain Stimulation in humans, there is a lack of evidence supporting their use for rehabilitation after brain lesions. Non-invasive brain stimulation is already in use for treating motor deficits in individuals with Parkinson’s disease and post-stroke. Deep Brain Stimulation has become an established treatment for individuals with movement disorders, such as Parkinson’s disease, essential tremor, epilepsy, cerebral palsy and dystonia. It has also been utilized for the treatment of Tourette’s syndrome, Alzheimer’s disease and neuropsychiatric conditions such as obsessive-compulsive disorder, major depression and anorexia nervosa. There exists growing scientific knowledge from animal studies supporting the use of Deep Brain Stimulation to enhance motor recovery after brain damage. Nevertheless, these results are currently not applicable to humans. This review details the current literature supporting the use of these techniques to enhance motor recovery, both from human and animal studies, aiming to encourage development in this domain.

Spatiotemporal Brain Activity During Hiragana Word Recognition Task

2011 ◽  
Vol 15 (3) ◽  
pp. 357-361 ◽  
Author(s):  
Hisashi Toyoshima ◽  
◽  
Takahiro Yamanoi ◽  
Toshimasa Yamazaki ◽  
Shin-ichi Ohnishi ◽  
...  
Keyword(s):  
Brain Activity ◽  
Recognition Task ◽  
Event Related Potentials ◽  
Dipole Source ◽  
Broca’S Area ◽  
Broca's Area ◽  
Current Dipole ◽  
Related Potentials ◽  
Wernicke’S Area ◽  
The Right

The 19-channel Event-Related Potentials (ERPs) we recorded during recognition of hiragana (one type of Japanese phonetic characters) were simultaneously and independently presented as a word and a nonword to opposite eyes using a field-sequential stereoscopic 3D display with a liquid-crystal shutter, a word and a non-word were simultaneously and independently presented to the left (right) and the right (left) eyes, respectively. Each word consists of 3 hiragana characters. Three subjects were instructed to press a button when they understood the meaning of the visual stimuli after 3,000 ms poststimulus. Equivalent Current Dipole source Localization (ECDL) with 3 unconstrained ECDs was applied to the ERPs. In the case of right-handed subjects, the ECDs were localized to the Wernicke’s area at around 600 ms. In the case of left-handed subject, the ECD was localized to the Wernicke’s homologue. After that ECDs were then localized to the prefrontal area, the superior frontal gyrus, and the middle frontal gyrus. At around 800 ms, the ECDs were localized to the Broca’s area, then after that ECDs were relocalized to the the Wernicke’s area and to the Broca’s area.

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