ABSTRACT
Transcranial magnetic stimulation (TMS) has been found to be promising in the neurorehabilitation of post-stroke patients. Aphasia and cognitive impairment (CI) are prevalent post-stroke; however, there is still a lack of consensus about the characteristics of interventions based on TMS and its neuropsychological and anatomical-functional benefits. Therefore, studies that contribute to creating TMS protocols for these neurological conditions are necessary. To analyze the evidence of the neuropsychological and anatomical-functional TMS effects in post-stroke patients with CI and aphasia and determine the characteristics of the most used TMS in research practice. The present study followed the PRISMA guidelines and included articles from PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE databases, published between January 2010 and March 2023. In the 15 articles reviewed, it was found that attention, memory, executive function, language comprehension, naming, and verbal fluency (semantic and phonological) are the neuropsychological domains that improved post-TMS. Moreover, TMS in aphasia and post-stroke CI contribute to greater frontal activation (in the inferior frontal gyrus, pars triangularis, and opercularis). Temporoparietal effects were also found. The observed effects occur when TMS is implemented in repetitive modality, at a frequency of 1 Hz, in sessions of 30 min, and that last more than 2 weeks in duration. The use of TMS contributes to the neurorehabilitation process in post-stroke patients with CI and aphasia. However, it is still necessary to standardize future intervention protocols based on accurate TMS characteristics.
ABSTRACT
BACKGROUND: Semantic and Phonological fluency (SF and PF) are routinely evaluated in patients with Alzheimer's disease (AD). There are disagreements in the literature regarding which fluency task is more affected while developing AD. Most studies focus on SF assessment, given its connection with the temporoparietal amnesic system. PF is less reported, it is related to working memory, which is also impaired in probable and diagnosed AD. Differentiating between performance on these tasks might be informative in early AD diagnosis, providing an accurate linguistic profile. OBJECTIVE: Compare SF and PF performance in healthy volunteers, volunteers with probable AD, and patients with AD diagnosis, considering the heterogeneity of age, gender, and educational level variables. METHODS: A total of 8 studies were included for meta-analysis, reaching a sample size of 1,270 individuals (568 patients diagnosed with AD, 340 with probable AD diagnosis, and 362 healthy volunteers). RESULTS: The three groups consistently performed better on SF than PF. When progressing to a diagnosis of AD, we observed a significant difference in SF and PF performance across our 3 groups of interest (pâ=â0.04). The age variable explained a proportion of this difference in task performance across the groups, and as age increases, both tasks equally worsen. CONCLUSION: The performance of SF and PF might play a differential role in early AD diagnosis. These tasks rely on partially different neural bases of language processing. They are thus worth exploring independently in diagnosing normal aging and its transition to pathological stages, including probable and diagnosed AD.
Subject(s)
Alzheimer Disease , Semantics , Humans , Alzheimer Disease/diagnosis , Verbal Behavior , Neuropsychological Tests , LinguisticsABSTRACT
Existen 3 variantes de afasia progresiva primaria (APP), que se distinguen según el dominio lingüístico predominantemente alterado: no fluente, logopénica y semántica. Una herramienta que ayuda a su clasificación es el Sydney Language Battery (Sydbat), el cual no se encuentra validado en Chile. El objetivo del presente trabajo es analizar la posible relación entre edad, años de escolaridad y rendimiento obtenido en las subpruebas del Sydbat en adultos sanos. Participaron 38 adultos sanos a losque se les aplicó el test.El promedio de edad fue 56,8 años (DE = 8,3) y tenían una media de 13,8 años de escolaridad (DE = 3,9). Todos provenían de la Región Metropolitana. Se realizaron correlaciones de Pearson y Spearman, para explorar la correlación entre el rendimiento en las subpruebas, la edad y la escolaridad. Considerando la variabilidad en el rendimiento en las subpruebas, se realizaron modelos uni y multivariados. Se encontraron correlaciones significativas entre edad y la subprueba comprensión (p<0,05) y los años de escolaridad con las subpruebas asociación semántica (p<0,001) y nominación (p<0,01). En personas con más de 12 años de escolaridad, el puntaje en la subprueba asociación semántica varió aproximadamente 2 puntos, con respecto a personas con menos de 12 años de escolaridad (p<0,01). Se concluye que las variaciones en el rendimiento del test, dependen la edad y la escolaridad. A mayor edad, menor es el rendimiento en la subprueba de comprensión. A mayor escolaridad, mayor es el rendimiento en las subpruebas de asociación semántica y nominación. El efecto mencionado debe ser considerado en el proceso de validación de Sydbat.
There are 3 variants of primary progressive aphasia (APP), which are distinguished according to the predominantly altered linguistic domain: non-fluent, logopenic, and semantic. A tool that helps in its classification is the Sydney Language Battery (Sydbat), which is not validated in Chile. The objective of this work is to analyze the possible relationship between age, years of schooling and performance obtained in the Sydbat subtests in healthy adults. 38 healthy adults participated in the test. The average age was 56.8 years (SD = 8.3) and they had a mean of 13.8 years of schooling (SD = 3.9). They all came from the Metropolitan Region. Pearson and Spearman correlations were performed to explore the correlation between subtest performance, age, and schooling. Considering the variability in performance in the subtests, univariate and multivariate models were performed. Significant correlations were found between age and the comprehension subtest (p <0.05) and the years of schooling with the semantic association (p <0.001) and nomination (p <0.01) subtests. In participants with more than 12 years of schooling, the score in the semantic association subtest varied approximately 2 points, with respect to people with less than 12 years of schooling (p <0.01). It is concluded that the variations in test performance depend on age andeducation. The older participants are, the lower their performance on the comprehension subtest. The higher the schooling, the higher the performance on the semantic association and nomination subtests. The mentioned effect must be considered in the Sydbat validation process.
