Transcranial magnetic stimulation (TMS) combined with language therapy may help slow the progression of primary progressive aphasia (PPA), a neurological condition that damages the parts of the brain that control speech and language, a study in JAMA Network Open suggests.
Lucia Fernandez-Romero, M.Sc., of the Universidad Complutense de Madrid, and colleagues enrolled 63 older adults who had PPA to receive either active TMS using an intermittent theta-burst TMS protocol or sham TMS for six months. All participants received language therapy immediately after each TMS session; the language therapy was adapted from lexical retrieval treatment, which consists of a sequence of tasks to guide the engagement, strengthening, and active use of central components of language processing. Participants were trained to learn five nouns per session that they were not able to name correctly on two occasions before language therapy began.
Participants received 10 TMS plus language therapy sessions during the first two weeks, followed by once per week for 22 weeks. Language skills were assessed at baseline, three months, and six months via the Mini Linguistic State Examination (MLSE), how well participants identified their trained nouns when they looked at pictures (confrontation naming), and how many words per minute they named in a spontaneous speech task.
At three months, participants in the active TMS group had higher MLSE scores and greater success at confrontation naming than those in the sham TMS group. At six months, MLSE scores improved slightly in both groups. However, confrontation naming declined slightly in the sham TMS group whereas it continued to improve in the active TMS group. At three months, participants in the active TMS group named about 65 words per minute on average, dropping to about 63 words per minute at six months, whereas participants in the sham group consistently named about 59 words per minute at both three and six months.
“Another important finding was the improvement in daily living activities and neuropsychiatric symptoms, suggesting that the therapy’s effects extend beyond trained language skills alone.,” the researchers wrote. “Given that individuals with PPA experience continual and inevitable progression of symptoms, these results suggest that TMS paired with evidence-based speech-language intervention may slow the progression of symptoms and associated brain changes.”
For related information, see the Journal of Neuropsychiatry and Clinical Neurosciences article “Advances in Treatment of Frontotemporal Dementia.”
(Image: Getty Images/iStock/pixdeluxe)
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