Facilitation of Auditory Comprehension After Theta Burst Stimulation of Wernicke's Area in Stroke Patients: A Pilot Study

Since the effect is transitory you will need to have your doctor and stroke hospital followup with researchers to ensure research on how to make this permanent is done.

Facilitation of Auditory Comprehension After Theta Burst Stimulation of Wernicke's Area in Stroke Patients: A Pilot Study

Viviana Versace^1,2*, Kerstin Schwenker^3,4, Patrick B. Langthaler³, Stefan Golaszewski^3,4, Luca Sebastianelli^1,2, Francesco Brigo^5,6, Elke Pucks-Faes⁷, Leopold Saltuari^2,7 and Raffaele Nardone^3,4,5

• ¹Department of Neurorehabilitation, Hopsital of Vipiteno-Sterzing, Vipiteno-Sterzing, Italy
• ²Research Unit for Neurorehabilitation of South Tyrol, Bolzano, Italy
• ³Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
• ⁴Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria
• ⁵Department of Neurology, Franz Tappeiner Hospital, Merano, Italy
• ⁶Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
• ⁷Department of Neurology, Hochzirl Hospital, Zirl, Austria

Introduction: 

Single-pulse transcranial magnetic stimulation (TMS) and high-frequency repetitive TMS (rTMS) over Wernicke's area were found to facilitate language functions in right-handed healthy subjects. We aimed at investigating the effects of excitatory rTMS, given as intermittent theta burst stimulation (iTBS) over left Wernicke's area, on auditory comprehension in patients suffering from fluent aphasia after stroke of the left temporal lobe.

Methods: 

We studied 13 patients with chronic fluent aphasia after an ischemic stroke involving Wernicke's area. iTBS was applied in random order to Wernicke's area, the right-hemisphere homologous of Wernicke's area, and the primary visual cortex. Auditory comprehension was blind assessed using the Token test before (T0), 5 (T1), and 40 min (T2) after a single session of iTBS.

Results: 

At the first evaluation (T1) after iTBS on left Wernike's area, but not on the contralateral homologous area nor on the primary visual cortex, the scores on the Token test were significantly increased. No significant effects were observed at T2.

Conclusion: 

We demonstrated that a single session of excitatory iTBS over Wernicke's area was safe and led to a transient facilitation of auditory comprehension in chronic stroke patients with lesions in the same area. Further studies are needed to establish whether TBS-induced modulation can be enhanced and transformed into longer-lasting effects by means of repeated TBS sessions and by combining TBS with speech and language therapy.