Effect of Repetitive Transcranial Magnetic Stimulation on Post-stroke Non-fluent Aphasia in Relation with Broca's Area

This study investigated the differences in the effect of repetitive transcranial magnetic stimulation (rTMS) between patients with and without the involvement of Broca's area (IBA).The medical records of 20 stroke patients treated with rTMS for non-fluent aphasia were reviewed. Patients completed the Korean version of the Western Aphasia Battery (K-WAB) pre- and post-rTMS. Magnetic resonance T1-weighted images of the brain were analyzed using SPM12 software. Montreal Neurological Institute templates and Talairach coordinates were used to determine Broca's area involvement and segregate patients into 2 groups: IBA and non-IBA (NBA) groups. All statistical analyses were performed using the SPSS software.Twenty subjects were included in the study. The K-WAB scores revealed improvements in the total subjects and IBA and NBA groups. There were no statistical differences between the IBA and NBA groups in the ΔK-WAB scores of aphasia quotient, fluency, comprehension, repetition, and naming. The rTMS was positive for non-fluent aphasia patients, but there was no significant difference in effectiveness depending on the IBA. Further research with a larger number of patients is needed to identify the differences in the effect of rTMS on the IBA.

Correlation between Dysarthria and Aspiration in Patients with Stroke / 대한연하장애학회지

Objective@#This study examined the correlation between dysarthria and aspiration to determine if dysarthria can predict aspiration in stroke patients. @*Methods@#The medical records of 176 patients with first stroke, who underwent a videofluoroscopic swallowing study (VFSS) and Urimal test of articulation and phonology (U-TAP) at the same time between January 2012 and December 2015 in the authors’ hospital, were reviewed retrospectively. The correlation between the penetration aspiration scale (PAS) score and U-TAP score was analyzed in all patients. The mean PAS score and frequency of each PAS score in the dysarthria group and non-dysarthria group were compared. In addition, the aspiration was analyzed based on the severity of dysarthria in the dysphagia group. All statistical analyses were performed using SPSS software. @*Results@#The correlation between the PAS score and U-TAP score was not statistically significant in all the subjects.The mean PAS score was 3.46±5.52 and 3.07±5.49 in the dysphagia and non-dysphagia group, respectively. The mean PAS score of the dysphagia group was higher than that of the non-dysphagia group. On the other hand, it was not statistically significant. In addition, there was no significant difference in the frequency of the PAS scores between the two groups. The aspiration was compared with the severity of dysarthria according to the U-TAP score; there was no statistically significant difference. @*Conclusion@#No correlation was observed between dysarthria and aspiration in stroke patients. In addition, there was no difference in the frequency of aspiration with or without dysarthria. According to the results of this study, aspiration cannot be predicted by dysarthria in stroke patients. Therefore, each diagnostic test and assessment should be performed for each symptom.