Original ArticleNon-invasive Repeated Therapeutic Stimulation for Aphasia Recovery: A Multilingual, Multicenter Aphasia Trial
Section snippets
Design
NORTHSTAR is a 3-armed sham-controlled blinded prospective proof-of-concept study. Patients will be randomized to either sham or rTMS or tDCS treatment. Patients randomized to rTMS treatment will in addition receive sham tDCS, and patients with tDCS treatment will be receiving sham rTMS. Patients randomized to the sham group will receive both sham conditions. All patients will receive 45 minutes of model-oriented individualized aphasia therapy administered by a certified therapist and according
Rationale for Patient Selection and Stimulation Site
If noninvasive brain stimulation has the potential to become a clinically relevant adjunctive therapy for aphasia it has to have a broad applicability and needs to be cost effective. The eligibility criteria have thus been selected such that the resulting study population will reflect a typical clinical population of aphasic stroke patients. Stroke location and aphasia type are not inclusion or exclusion criteria but will be tracked with MRI to ensure a similar distribution between treatment
Conclusion
NORTHSTAR is the first multicenter proof-of-concept study, which seeks to directly compare 2 novel and experimental noninvasive brain stimulation methods as adjuvant therapy for rehabilitation of poststroke aphasia, based on the pathophysiologic concept of transcallosal inhibition, thus, potentially translating a novel, nonpharmacologic, model-driven approach to neurorehabilitation into clinical practice. In addition, this trial will address the more fundamental question of the equivalence of 2
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2019, Brain and CognitionCitation Excerpt :While the relevance of intrahemispheric ipsilesional connectivity is plausible and has been demonstrated as uniquely important for language functions (Siegel, Ramsey et al., 2016), the relevance of interhemispheric connectivity is surprising considering the lateralization of language functions (Gotts et al., 2013). This might imply a functional role of right hemisphere cortical areas for language functions especially in the subacute phase post stroke although their precise role – compensatory (Geranmayeh et al., 2014; Saur et al., 2006; Xing et al., 2016) or maladaptive (Heiss et al., 1999; Naeser et al., 2005; Thiel et al., 2015) – cannot be inferred from the presented data. In fact, current models (Hickok & Poeppel, 2007) propose a bilateral organization for ventral stream regions within the temporal lobes.
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The authors declare no conflicts of interest.
The study was funded by Canadian Institutes for Health Research (MOP125954).