| Background:Acute cerebrovascular disease has been the most leading cause of deformity in the world.In China,the incidence,morbidity and mortality of stroke are much higher than developed countries.After stroke,about 21 to 38%of patients have various degree of aphasia,which seriously affects patients' social functional recovery.Clinical observations found that patients with post-stroke aphasia often have post-stroke cognitive impairment(PSCI).Now,it has been confirmed by functional imaging researches that there is an anatomical overlapping of linguistic area and some cognitive areas,and both of them have a common material basis of brain.Besides,the normal expression of the language cannot be separated from the assistance of various cognitive function.Repetitive transcranial magnetic stimulation(rTMS),as a new non-invasive cortical stimulation method,has been used in the treatment of multiple complications after stroke.At present,the research on the rTMS treatment for nonfluent aphasia is a well-tried remedy which is perfectly safe to take.However,the research on monitoring the changes of patients ' cognitive function during the course of treatment is relatively rare.Objective:In this study,we aim to investigate the efficacy of low-frequency rTMS with SLT in aphasia patient at the subacute stage after ischemic stroke and assess the impairment of cognitive function.Then we will analyze the occurrence and recovery mechanism of aphasia and cognitive impairment,as well as the relationship between them.We hope to provide a new supplementary way for the treatment of aphasia and cognitive impairment.Method:In this study,17 patients with subacute phase after ischemic stroke and non-fluent aphasia(Broca's aphasia)were subjected.Patients were randomly divided into treatment group(8 cases)and control group(9 cases).During hospitalization,each patient of treatment group received 10 treatment sessions consisting of 20 min 1-Hz low-frequency rTMS to stimulate the right frontal inferior gyrus(R-IFG)and combined with SLT after rTMS treatment daily.The control group received sham rTMS treatment with same parameter pseudo-coil and combined with SLT treatment after sham rTMS treatment.The Aphasia Battery of Chinese Scale(ABC),Montreal Congnitive Assessment Scale(MoCA),Non-Language-Based Cognitive Assessment Scale(NLCA)were taken at baseline(pre-stimulation),2 weeks and 3 months post-treatment to determine its efficacy.Result:Each group enrolled ABC scores,MoCA scores,NLCA scores were no significant difference before treatment(P>0.05).After 2 weeks of treatment,two groups enrolled ABC scores,MoCA scores,NLCA scores were all improved but there was no significant difference in two groups,no matter between groups or intraclass correlation(P>0.05).After 3 months of treatment,the scores of ABC,MoCA and NLCA in the two groups were significantly higher than before treatment(P<0.05),and the treatment group was more significantly improved than the control group(P<0.05).Conclusion:1.rTMS treatment can improve the non-fluent aphasia during the subacute period of stroke;2.No matter the treatment group or the control group,the language function and cognitive function were improved in different degree after the treatment,the therapeutic effect of the treatment group was significantly better than the control group,showing that rTMS can promote the recovery of language functions and cognitive function. |
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