Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies

Shahd Al-Janabi, Lyndsey A. Nickels, Paul F. Sowman, Hana Burianová, Dawn L. Merrett, William F. Thompson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog and MIT has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia.

LanguageEnglish
Article number37
Pages1-12
Number of pages12
JournalFrontiers in Psychology
Volume5
DOIs
Publication statusPublished - 4 Feb 2014

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Transcranial Magnetic Stimulation
Brain
Aphasia
Therapeutics
Language
Linguistics
Clinical Protocols
Prefrontal Cortex
Stroke
Magnetic Resonance Imaging
Broca Area

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Copyright the Author/s. This Document is protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.

Cite this

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title = "Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies",
abstract = "The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog and MIT has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia.",
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Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function : two case studies. / Al-Janabi, Shahd; Nickels, Lyndsey A.; Sowman, Paul F.; Burianová, Hana; Merrett, Dawn L.; Thompson, William F.

In: Frontiers in Psychology, Vol. 5, 37, 04.02.2014, p. 1-12.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function

T2 - Frontiers in Psychology

AU - Al-Janabi, Shahd

AU - Nickels, Lyndsey A.

AU - Sowman, Paul F.

AU - Burianová, Hana

AU - Merrett, Dawn L.

AU - Thompson, William F.

N1 - Copyright the Author/s. This Document is protected by copyright and was first published by Frontiers. All rights reserved. It is reproduced with permission.

PY - 2014/2/4

Y1 - 2014/2/4

N2 - The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog and MIT has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia.

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