The Current Role of Neuromodulation in the Intervention of Post-Stroke Aphasia

Year 2024, Volume: 7 Issue: 2, 226 - 256, 29.08.2024

Hazel Zeynep Kurada

https://doi.org/10.58563/dkyad-2024.72.5

Abstract

Purpose: Aphasia is a complex language disorder that occurs when the language centers of the brain are damaged. It involves difficulties in speaking, understanding, and repeating language. Aphasia primarily impacts the language regions in the left hemisphere of the brain, causing significant disruptions in communication skills and creating significant challenges for persons in their daily activities and overall well-being. Speech and language therapy is widely acknowledged as the foundation of aphasia rehabilitation. It plays a crucial role in helping individuals regain their communication abilities and accelerating their path to recovery. Recently, non-invasive brain stimulation approaches have become a promising addition to standard therapy for managing aphasia. Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) are methods that have gained attention for their potential effectiveness, especially in treating post-stroke aphasia. These therapies work by adjusting neural activity in specific areas of the brain that are involved in language processing. This helps improve language recovery and enhance communication results. This comprehensive review aims to investigate the applications and protocols of brain stimulation used in the rehabilitation of post-stroke aphasia. The main goal is to increase knowledge of different therapeutic options in clinical settings by carefully analyzing the existing state of neurostimulation practices. Furthermore, this review aims to stimulate additional theoretical or experimental research by highlighting current patterns and important discoveries in the literature on aphasia neurostimulation.

Method: A literature review was conducted using databases such as PubMed and Google Scholar with search terms like “TMS,” “tDCS,” “aphasia,” “post-stroke aphasia,” and “non-fluent chronic aphasia” to identify current and relevant studies in this field. The search results were compiled by categorizing the studies annually and reviewing content specific to the topic.

Results: The review findings suggest that neuromodulatory tools, particularly when combined with standard speech and language therapy, accelerate the recovery process in post-stroke aphasia rehabilitation and support language skills such as fluency, naming, and repetition. These integrative therapies have shown promise in strengthening basic language abilities. Despite the positive progress, there are still many important questions that are uncertain. Further empirical research is needed to determine the effectiveness, dependability, and best stimulation parameters required to produce long-lasting therapeutic benefits. Moreover, a thorough understanding of the neurobiological foundations is essential for improving these interventions and maximizing their effectiveness in managing post-stroke aphasia. The review findings provide information on current practices and encourage further research in aphasia management. It highlights the potential of neurostimulation techniques to become a crucial part of aphasia rehabilitation strategies.

Conclusion: Though more research is needed to fully understand how these therapeutic effects work, how safe they are, the best stimulation parameters for long-term effects, and how they work, brain stimulation techniques seem to be useful for rehabilitating people with aphasia, improving both their communication skills and quality of life.

Keywords

aphasia, post-stroke aphasia, neuromodulation, transcranial magnetic stimulation, transcranial direct current stimulation

Nöromodülasyon Kavramı ve İnme Sonrası Afazi Müdahalesindeki Güncel Rolü

Abstract

Amaç: Afazi, beyinin sol hemisferindeki dil alanlarının hasar görmesiyle ortaya çıkar. Bu durum, iletişim yeteneklerinin derinden etkilenmesine yol açmaktadır. Altın standart olarak kabul edilen dil ve konuşma terapisi, afazi rehabilitasyonunda ve iletişim becerilerinin yeniden kazandırılmasında kritik öneme sahiptir. Geleneksel terapi yaklaşımının yanı sıra, son yıllarda giderek yaygınlaşan Transkraniyal Manyetik Uyarım ve Transkraniyal Doğru Akım Uyarımı gibi girişimsel olmayan beyin uyarımı yöntemlerinin de özellikle inme sonrası afazi yönetiminde etkili olduğu öne sürülmektedir. Bu derleme yazısında inme sonrası afazi rehabilitasyonunda kullanılan beyin uyarımı uygulamaları ve çeşitli uyarım protokolleri incelenerek, klinik pratikte bu tür alternatif uygulamalara yönelik farkındalığı artırmak, afazide nöromodülasyon uygulamalarına ilişkin alanyazın yönelim ve bulgularını ortaya koyarak kuramsal ya da deneysel çalışmaları teşvik etmek ve bu konuda çalışma yapmayı düşünenler için genel bir çerçeve oluşturmak amaçlanmıştır.

Yöntem: Literatür taraması, “TMS”, “tDCS”, “aphasia”, “post-stroke aphasia” ve “non-fluent chronica aphasia” gibi arama terimleri ile PubMed ve Google Scholar gibi veri tabanları kullanılarak gerçekleştirilmiştir. Arama sonuçları, çalışmaların yıllık bazda sınıflandırılması ve konuya özgü içeriklerin incelenmesiyle derlenmiştir.

Bulgular: Derlemeden ortaya çıkan sonuçlar, nöromodülatör araçların inme sonrası afazi rehabilitasyonunda özellikle standart dil ve konuşma terapisi ile kombine edildiğinde iyileşme sürecini hızlandırdığını, akıcılık, adlandırma ve tekrarlama gibi dil becerilerini desteklediğini göstermektedir.

Sonuç: Beyin uyarım yöntemlerinin inme sonrası afazi yönetimindeki etkililiği, güvenirliği, uzun dönem etkileri için gereken optimal stimülasyon parametreleri ve ayrıca terapötik etkilerinin altında yatan mekanizmaları aydınlatmak için daha fazla çalışmaya ihtiyaç duyulsa da bu teknikler afazi rehabilitasyonunda hem iletişim becerilerini hem de yaşam kalitesini artırmak adına değerli bir araç haline gelmiş görünmektedir.

Keywords

afazi, inme sonrası afazi, nöromodülasyon, transkraniyal manyetik stimülasyon, transkraniyal doğru akım uyarımı

References

• Abel, S., Weiller, C., Huber, W., Willmes, K., ve Specht, K. (2015). Therapy-induced brain reorganization patterns in aphasia. Brain, 138(4), 1097-1112. https://doi.org/10.1093/brain/awv022
• Amiaz, R., Levy, D., Vainiger, D., Grunhaus, L., ve Zangen, A. (2009). Repeated high-frequency transcranial magnetic stimulation over the dorsolateral prefrontal cortex reduces cigarette craving and consumption. Addiction, 104(4), 653-660. https://doi.org/10.1111/j.1360-0443.2008.02448.x
• Antal, A., Alekseichuk, I., Bikson, M., Brockmöller, J., Brunoni, A. R., Chen, R., Cohen, L. G., Dowthwaite, G., Ellrich, J., Flöel, A., Fregni, F., George, M. S., Hamilton, R., Haueisen, J., Herrmann, C. S., Hummel, F. C., Lefaucheur, J. P., Liebetanz, D., Loo, C. K., … Paulus, W. (2017). Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clinical Neurophysiology, 128(9), 1774-1809. https://doi.org/10.1016/j.clinph.2017.06.001 Ardila, A. (2010). A review of conduction aphasia. Current Neurology and Neuroscience Reports, 10(6), 499-503. https://doi.org/10.1007/s11910-010-0142-2
• Baizabal-Carvallo, J. F., Kagnoff, M. N., Jimenez-Shahed, J., Fekete, R., ve Jankovic, J. (2014). The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond. Journal of Neurology, Neurosurgery & Psychiatry, 85(5), 567-572. https://doi.org/10.1136/jnnp-2013-304943
• Baker, J. M., Rorden, C., ve Epstein, A. (2009). Improvement in aphasia after repetitive transcranial magnetic stimulation. Journal of Cognitive Neuroscience, 21(9), 1677-1689. https://doi.org/10.1162/jocn.2009.21120
• Baker, S. S., & Swinburn, K. (2009). The efficacy of speech and language therapy in chronic aphasia: A meta-analysis. Aphasiology, 23(10), 1254-1270. https://doi.org/10.1080/02687030802624953
• Baker, J. M., Rorden, C., ve Fridriksson, J. (2010). Using transcranial direct-current stimulation to treat stroke patients with aphasia. Stroke, 41(6), 1229-1236. https://doi.org/10.1161/STROKEAHA.109.576785
• Barker, A. T., Jalinous, R., ve Freeston, I. L. (1985). Non-invasive magnetic stimulation of human motor cortex. The Lancet, 325(8437), 1106-1107. https://doi.org/10.1016/S0140-6736(85)92413-4
• Barwood, C. H. S., Murdoch, B. E., Whelan, B.-M., Lloyd, D., Riek, S., O’Sullivan, J., Coulthard, A., Wong, A., Aitken, P., ve Hall, G. (2011). The effects of low frequency repetitive transcranial magnetic stimulation (rTMS) and sham condition rTMS on behavioural language in chronic non-fluent aphasia: Short term outcomes. NeuroRehabilitation, 28(2), 113-128. https://doi.org/10.3233/NRE-2011-0640
• Bikson, M., & Edwards, D. J. (2017). Transcranial direct current stimulation: A meta-analysis of clinical trials and a look into future research. Frontiers in Human Neuroscience, 11, 1-19.
• Biou, E., Cassoudesalle, H., Cogné, M., Sibon, I., De Gabory, I., Dehail, P., Aupy, J., ve Glize, B. (2019). Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review. Annals of Physical and Rehabilitation Medicine, 62(2), 104-121. https://doi.org/10.1016/j.rehab.2019.01.003
• Boccard, S. G. J., Fitzgerald, J. J., Pereira, E. A. C., Moir, L., Van Hartevelt, T. J., Kringelbach, M. L., Green, A. L., ve Aziz, T. Z. (2014). Targeting the affective component of chronic pain: A case series of deep brain stimulation of the anterior cingulate cortex. Neurosurgery, 74(6), 628-637. https://doi.org/10.1227/NEU.0000000000000321
• Bolognini, N., Pascual-Leone, A., ve Fregni, F. (2009). Using non-invasive brain stimulation to augment motor training-induced plasticity. Journal of NeuroEngineering and Rehabilitation, 6(1), 8. https://doi.org/10.1186/1743-0003-6-8
• Brugnoli, P., (2015). Transcranial direct current stimulation in aphasia: A systematic review and meta-analysis. Brain Stimulation, 8(4), 645-654.
• Bucur, M., & Papagno, C. (2019). Are transcranial brain stimulation effects long-lasting in post-stroke aphasia? A comparative systematic review and meta-analysis on naming performance. Neuroscience & Biobehavioral Reviews, 102, 264-289. https://doi.org/10.1016/j.neubiorev.2019.04.019
• Cappa, S. F., & Pellegrini, S. (2018). Combined transcranial magnetic stimulation and language therapy for aphasia. Journal of Neurology, 265(6), 1339-1348. https://doi.org/10.1007/s00415-018-8872-4
• Cerruti, C., & Schlaug, G. (2009). Anodal transcranial direct current stimulation of the prefrontal cortex enhances complex verbal associative thought. Journal of Cognitive Neuroscience, 21(10), 1980-1987. https://doi.org/10.1162/jocn.2008.21143
• Cherney, L. R., & Small, S. L. (2011). Therapeutic approaches for chronic aphasia: An update on evidence-based practices. Journal of Neurolinguistics, 24(4), 239-253. https://doi.org/10.1016/j.jneuroling.2010.12.002
• Chen, R. (2000). Studies of human motor physiology with transcranial magnetic stimulation. Muscle & Nerve, 23(S9), S26-S32.
• Corrales Quispiricra, C., Gadea Doménech, M. E., ve Espert Tortajada, R. (2020). Estimulación de corriente continua transcraneal e intervención logopédica en personas con afasia: Revisión sistemática de la bibliografía. Revista de Neurología, 70(10), 351. https://doi.org/10.33588/rn.7010.2019397
• Di Lazzaro, V., Pilato, F., Saturno, E., Oliviero, A., Dileone, M., Mazzone, P., ... ve Rothwell, J. (2005). Theta‐burst repetitive transcranial magnetic stimulation suppresses specific excitatory circuits in the human motor cortex. The Journal of Physiology, 565(3), 945-950.
• Dickey, L., Kagan, A., Lindsay, M. P., Fang, J., Rowland, A., ve Black, S. (2010). Incidence and profile of inpatient stroke-induced aphasia in Ontario, Canada. Archives of Physical Medicine and Rehabilitation, 91(2), 196-202. https://doi.org/10.1016/j.apmr.2009.09.020
• Dionísio, A., Duarte, I. C., Patrício, M., ve Castelo-Branco, M. (2018). The use of repetitive transcranial magnetic stimulation for stroke rehabilitation: A systematic review. Journal of Stroke and Cerebrovascular Diseases, 27(1), 1-31. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.09.008
• Dronkers, N. F., Ivanova, M. V., ve Baldo, J. V. (2017). What do language disorders reveal about brain–language relationships? From classic models to network approaches. Journal of the International Neuropsychological Society, 23(9-10), 741-754. https://doi.org/10.1017/S1355617717001126
• Elsner, B., Kugler, J., ve Mehrholz, J. (2020). Transcranial direct current stimulation (tDCS) for improving aphasia after stroke: A systematic review with network meta-analysis of randomized controlled trials. Journal of NeuroEngineering and Rehabilitation, 17(1), 88. https://doi.org/10.1186/s12984-020-00708-z
• Enticott, P. G., Fitzgibbon, B. M., Kennedy, H. A., Arnold, S. L., Elliot, D., Peachey, A., Zangen, A., ve Fitzgerald, P. B. (2014). A double-blind, randomized trial of deep repetitive transcranial magnetic stimulation (rTMS) for autism spectrum disorder. Brain Stimulation, 7(2), 206-211. https://doi.org/10.1016/j.brs.2013.10.004
• Fiori, V., Coccia, M., Marinelli, C. V., Vecchi, V., Bonifazi, S., Ceravolo, M. G., Provinciali, L., Tomaiuolo, F., ve Marangolo, P. (2011). Transcranial direct current stimulation improves word retrieval in healthy and nonfluent aphasic subjects. Journal of Cognitive Neuroscience, 23(9), 2309-2323. https://doi.org/10.1162/jocn.2010.21579
• Fisher, R., Salanova, V., Witt, T., Worth, R., Henry, T., Gross, R., Oommen, K., Osorio, I., Nazzaro, J., Labar, D., Kaplitt, M., Sperling, M., Sandok, E., Neal, J., Handforth, A., Stern, J., DeSalles, A., Chung, S., Shetter, A., … the SANTE Study Group. (2010). Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia, 51(5), 899-908. https://doi.org/10.1111/j.1528-1167.2010.02536.x
• Fitzgerald, P. B., Herring, S., Hoy, K., McQueen, S., Segrave, R., Kulkarni, J., ve Daskalakis, Z. J. (2008). A study of the effectiveness of bilateral transcranial magnetic stimulation in the treatment of the negative symptoms of schizophrenia. Brain Stimulation, 1(1), 27-32. https://doi.org/10.1016/j.brs.2007.08.001
• Fitzgerald, P. B., Hoy, K. E., Herring, S. E., Clinton, A. M., Downey, G., ve Daskalakis, Z. J. (2013). Pilot study of the clinical and cognitive effects of high-frequency magnetic seizure therapy in major depressive disorder. Depression and Anxiety, 30(2), 129-136. https://doi.org/10.1002/da.22005
• Fregni, F., Boggio, P. S., ve Lima, M. A. (2006). Repetitive transcranial magnetic stimulation for the treatment of chronic aphasia after stroke. Brain Research Reviews, 52(2), 275-286. https://doi.org/10.1016/j.brainresrev.2006.05.007
• Fregni, F., & Pascual-Leone, A. (2007). Technology insight: Noninvasive brain stimulation in neurology—perspectives on the therapeutic potential of rTMS and tDCS. Nature Clinical Practice Neurology, 3(7), 383-393. https://doi.org/10.1038/ncpneuro0530
• Fridriksson, J., Basilakos, A., Stark, B. C., Rorden, C., Elm, J., Gottfried, M., George, M. S., Sen, S., ve Bonilha, L. (2019). Transcranial direct current stimulation to treat aphasia: Longitudinal analysis of a randomized controlled trial. Brain Stimulation, 12(1), 190-191. https://doi.org/10.1016/j.brs.2018.09.016
• George, M. S., & Belmaker, R. H. (Eds.). (2007). Transcranial magnetic stimulation in clinical psychiatry. American Psychiatric Publishing.
• Georgiou, A. M., Phinikettos, I., Giasafaki, C., ve Kambanaros, M. (2020). Can transcranial magnetic stimulation (TMS) facilitate language recovery in chronic global aphasia post-stroke? Evidence from a case study. Journal of Neurolinguistics, 55, 100907. https://doi.org/10.1016/j.jneuroling.2020.100907
• Greenberg, B. D., Gabriels, L. A., Malone, D. A., Rezai, A. R., Friehs, G. M., Okun, M. S., Shapira, N. A., Foote, K. D., Cosyns, P. R., Kubu, C. S., Malloy, P. F., Salloway, S. P., Giftakis, J. E., Rise, M. T., Machado, A. G., Baker, K. B., Stypulkowski, P. H., Goodman, W. K., Rasmussen, S. A., ve Nuttin, B. J. (2010). Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: Worldwide experience. Molecular Psychiatry, 15(1), 64-79. https://doi.org/10.1038/mp.2008.55
• Hamada, M.(2013). Online vs. offline TMS: A comparative study of motor cortex excitability modulation. Journal of Neuroscience, 33(12), 4989-4996.
• Hamilton, R. H., Chrysikou, E. G., ve Coslett, B. (2011). Mechanisms of aphasia recovery after stroke and the role of noninvasive brain stimulation. Brain and Language, 118(1-2), 40-50. https://doi.org/10.1016/j.bandl.2011.02.005
• Han, C., Tang, J., Tang, B., Han, T., Pan, J., ve Wang, N. (2024). The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: A systematic review and meta-analysis. Medicine, 103(2), e36880.
• Hartman, J. (1981). Measurement of early spontaneous recovery from aphasia with stroke. Annals of Neurology, 9(1), 89-91.
• Hartwigsen, G. (2015). The neurophysiology of language: Insights from non-invasive brain stimulation in the healthy human brain. Brain and Language, 148, 81-94. https://doi.org/10.1016/j.bandl.2014.10.007
• Harvey, D. Y., & Hamilton, R. (2022). Noninvasive brain stimulation to augment language therapy for poststroke aphasia. In Handbook of Clinical Neurology (Vol. 185, pp. 241-250). Elsevier. https://doi.org/10.1016/B978-0-12-823384-9.00012-8
• Holland, A. L., & Fridriksson, J. (2012). Combining rTMS and speech therapy for aphasia recovery: A randomized controlled trial. Brain Stimulation, 5(4), 556-563. https://doi.org/10.1016/j.brs.2011.07.001
• Huang, Y. Z., & Rothwell, J. C. (2004). The effect of short-duration bursts of high-frequency, low-intensity transcranial magnetic stimulation on the human motor cortex. Clinical Neurophysiology, 115(5), 1069-1075.
• Huang, Y. Z., Edwards, M. J., Rounis, E., Bhatia, K. P., ve Rothwell, J. C. (2005). Theta burst stimulation of the human motor cortex. Neuron, 45(2), 201-206.
• Ilkhani, M., Shojaie Baghini, H., Kiamarzi, G., Meysamie, A., ve Ebrahimi, P. (2018). The effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the treatment of aphasia caused by cerebrovascular accident (CVA). Medical Journal of the Islamic Republic of Iran, 32, 25. https://doi.org/10.14196/mjiri.32.25
• Kang, E. K., Kim, Y. K., Sohn, H. M., Cohen, L. G., ve Paik, N.-J. (2011). Improved picture naming in aphasia patients treated with cathodal tDCS to inhibit the right Broca’s homologue area. Restorative Neurology and Neuroscience, 29(3), 141-152. https://doi.org/10.3233/RNN-2011-0587
• Kapoor, A. (2017). Repetitive transcranial magnetic stimulation therapy for post-stroke non-fluent aphasia: A critical review. Topics in Stroke Rehabilitation, 24(7), 547-553. https://doi.org/10.1080/10749357.2017.1331417 Kemmerer, D. (2022). Cognitive neuroscience of language (2nd ed.). Routledge. https://doi.org/10.4324/9781138318427
• Kiran, S., & Thompson, C. K. (2012). Combining transcranial magnetic stimulation with traditional aphasia therapy: A review. Aphasiology, 26(5), 622-640. https://doi.org/10.1080/02687038.2012.670188
• Kobayashi, M., & Pascual-Leone, A. (2004). Transcranial magnetic stimulation: Examining the interaction between cortical excitability and connectivity. Clinical Neurophysiology, 115(3), 255-263. https://doi.org/10.1016/j.clinph.2003.09.015
• Kohn, S. E., & Goodglass, H. (1985). Picture-naming in aphasia. Brain and Language, 24(2), 266-283. Kratzer, S. (2020). Mechanisms of cortical plasticity and their implications for clinical applications of TMS. Journal of NeuroEngineering and Rehabilitation, 17(1), 80.
• Kunst, L. R., Oliveira, L. D., Costa, V. P., Wiethan, F. M., ve Mota, H. B. (2013). Speech therapy effectiveness in a case of expressive aphasia resulting from stroke. Revista CEFAC, 15(6), 1712-1717.
• Laska, A. C., Kahan, T., Hellblom, A., Murray, V., ve Von Arbin, M. (2011). A randomized controlled trial on very early speech and language therapy in acute stroke patients with aphasia. Cerebrovascular Diseases Extra, 1(1), 66-74. https://doi.org/10.1159/000329835
• Lefaucheur, J. P., André-Obadia, N., Antal, A., Ayache, S. S., Baeken, C., Benninger, D. H., ... ve Garcia-Larrea, L. (2014). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clinical Neurophysiology, 125(11), 2150-2206.
• Lerner, A. J., Wassermann, E. M., ve Tamir, D. I. (2019). Seizures from transcranial magnetic stimulation 2012–2016: Results of a survey of active laboratories and clinics. Clinical Neurophysiology, 130(8), 1409-1416. https://doi.org/10.1016/j.clinph.2019.03.016
• Li, L. M., Uehara, K., ve Hanakawa, T. (2014). The contribution of interindividual factors to variability of response in transcranial direct current stimulation studies. Frontiers in Cellular Neuroscience, 8, 83. https://doi.org/10.3389/fncel.2014.00083
• Lomas, J., & Kertesz, A. (1978). Patterns of spontaneous recovery in aphasic groups: A study of adult stroke patients. Brain and Language, 15(2), 388-401.
• Marangolo, P., Fiori, V., Calpagnano, M. A., Campana, S., Razzano, C., Caltagirone, C., ve Marini, A. (2013). tDCS over the left inferior frontal cortex improves speech production in aphasia. Frontiers in Human Neuroscience, 7. https://doi.org/10.3389/fnhum.2013.00539
• Marangolo, P., Fiori, V., Calpagnano, M. A., Campana, S., Razzano, C., Caltagirone, C., ve Marini, A. (2013). Bilateral transcranial direct current stimulation language treatment enhances functional connectivity in the left hemisphere: Preliminary data from aphasia. Journal of Cognitive Neuroscience, 25(11), 1657-1671. https://doi.org/10.1162/jocn_a_00431
• Martin, P. I., Naeser, M. A., ve Ho, M. S. (2009). Repetitive transcranial magnetic stimulation (rTMS) for the treatment of aphasia: A systematic review. Brain Stimulation, 2(2), 111-121. https://doi.org/10.1016/j.brs.2008.12.002
• McNeil, M. R., & Pratt, S. R. (2001). Defining aphasia: Some theoretical and clinical implications of operating from a formal definition. Aphasiology, 15(10-11), 900-911.
• Monti, A., Cogiamanian, F., Marceglia, S., Ferrucci, R., Mameli, F., Mrakic-Sposta, S., ... ve Priori, A. (2013). Improved naming after transcranial direct current stimulation in aphasia. Journal of Neurology, Neurosurgery & Psychiatry, 84(9), 1035-1040. https://doi.org/10.1136/jnnp-2012-303825
• Musso, M., Weiller, C., Kiebel, S., Müller, S. P., Bülau, P., ve Rijntjes, M. (1999). Training-induced brain plasticity in aphasia. Brain, 122(9), 1781-1790. https://doi.org/10.1093/brain/122.9.1781
• Müller, H. H., & Behrens, T. E. J. (2009). Transcranial magnetic stimulation and functional magnetic resonance imaging in the study of brain plasticity. Frontiers in Psychology, 1, 8. https://doi.org/10.3389/fpsyg.2010.00008
• Navarro, P. A., Contreras-Lopez, W. O., Tello, A., Cardenas, P. L., Vargas, M. D., Martinez, L. C., ve Yepes-Nuñez, J. J. (2024). Effectiveness and safety of non-invasive neuromodulation for vision restoration: A systematic review and meta-analysis. Neuro-Ophthalmology, 48(2), 93-110.
• Nitsche, M. A., & Paulus, W. (2000). Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. The Journal of Physiology, 527(3), 633-639. https://doi.org/10.1111/j.1469-7793.2000.t01-1-00633.x
• Nitsche, M. A., & Paulus, W. (2001). Sustained changes in synaptic plasticity induced by transcranial direct current stimulation in humans. Neurology, 57(10), 1761-1767.
• Nitsche, M. A., Seeber, A., Frommann, K., Klein, C. C., Rochford, C., Nitsche, M. S., Fricke, K., Liebetanz, D., Lang, N., Antal, A., Paulus, W., ve Tergau, F. (2005). Modulating parameters of excitability during and after transcranial direct current stimulation of the human motor cortex. The Journal of Physiology, 568(1), 291-303. https://doi.org/10.1113/jphysiol.2005.092429
• Odekerken, V. J. J., Boel, J. A., Schmand, B. A., De Haan, R. J., Figee, M., Van Den Munckhof, P., Schuurman, P. R., De Bie, R. M. A., For the NSTAPS study group, NSTAPS study group, De Bie, R. M. A., Bour, L., Contarino, M. F., De Haan, R. J., Iwan, M., Mink, M. S. J., Van Den Munckhof, P., Odekerken, V. J. J., Postma, M., … Van Vugt, J. P. P. (2016). GPi vs STN deep brain stimulation for Parkinson disease: Three-year follow-up. Neurology, 86(8), 755-761. https://doi.org/10.1212/WNL.0000000000002401
• Oğuz, Ö., & Toğram, B. (2020). Afazili bireylerde yaşam kalitesi ve yaşam kalitesini etkileyen faktörler. Dil Konuşma ve Yutma Araştırmaları Dergisi, 2(3), 247-278.
• Pascual-Leone, A. (1999). Modulation of motor performance and perception by repetitive transcranial magnetic stimulation. Journal of Clinical Neurophysiology, 16(4), 430-439.
• Pascual-Leone, A. (2000). Transcranial magnetic stimulation in cognitive neuroscience – virtual lesion, chronometry, and functional connectivity. Current Opinion in Neurobiology, 10(2), 232-237. https://doi.org/10.1016/S0959-4388(00)00081-7
• Pascual-Leone, A., Valls-Solé, J., Wassermann, E. M., ve Hallett, M. (1994). Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex. Brain, 117(4), 847-858. https://doi.org/10.1093/brain/117.4.847
• Pedersen, P. M., Vinter, K., ve Olsen, T. S. (2004). Aphasia after stroke: Type, severity and prognosis. Cerebrovascular Diseases, 17(1), 35-43. https://doi.org/10.1159/000073896
• Petersen, J. B. (2017). Effect of transcranial direct current stimulation on aphasia in post-stroke patients: A randomized, double-blind, placebo-controlled trial. Journal of Neurology, 264(5), 1024-1034.
• Price, C. J., & Friston, K. J. (2002). Degeneracy and specificity in cognitive function: The implications for neuroimaging. NeuroImage, 15(1), 108-119. https://doi.org/10.1006/nimg.2001.0978
• Rossi, S., Hallett, M., Rossini, P. M., ve Pascual-Leone, A. (2009). Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clinical Neurophysiology, 120(12), 2008-2039. https://doi.org/10.1016/j.clinph.2009.08.016
• Rossini, P. M., & Rossi, S. (2007). Transcranial magnetic stimulation: Diagnostic, therapeutic, and research potential. Neurology, 68(7), 484-488. https://doi.org/10.1212/01.wnl.0000250268.13789.b2
• Rubi-Fessen, I., Hirschfeld, R., Thiel, A., Hartmann, A., Huber, W., Fimm, B., Heiss, W.-D., ve Stenneken, P. (2018). Stimulating communication? The combination of language therapy and repetitive transcranial magnetic stimulation (rTMS) enhances improvement of functional communication and linguistic skills in patients with subacute aphasia. Aphasiology, 32(sup1), 62-63. https://doi.org/10.1080/02687038.2018.1485852
• Sarasso, S., Santhanam, P., Määtta, S., Poryazova, R., Ferrarelli, F., Tononi, G., ve Small, S. L. (2010). Non-fluent aphasia and neural reorganization after speech therapy: Insights from human sleep electrophysiology and functional magnetic resonance imaging. Archives Italiennes De Biologie, 148(3), 271-278.
• Saur, D. (2006). Dynamics of language reorganization after stroke. Brain, 129(6), 1371-1384. https://doi.org/10.1093/brain/awl090
• Sarno, M. T., & Levita, E. (1981). Recovery in aphasia during the first year post stroke. Brain and Language, 13(1), 1-12.
• Schlaug, G., Marchina, S., ve Wan, C. Y. (2011). Transcranial direct current stimulation in stroke recovery. Archives of Neurology, 68(11), 1491-1497. https://doi.org/10.1001/archneurol.2011.339
• Sebastian, R., Kim, J. H., Brenowitz, R., Tippett, D. C., Desmond, J. E., Celnik, P. A., & Hillis, A. E. (2020). Cerebellar neuromodulation improves naming in post-stroke aphasia. Brain Communications, 2(2), fcaa179. https://doi.org/10.1093/braincomms/fcaa179
• Shah-Basak, P. P., Norise, C., Garcia, G., Torres, J., Faseyitan, O., ve Hamilton, R. H. (2015). Individualized treatment with transcranial direct current stimulation in patients with chronic non-fluent aphasia due to stroke. Frontiers in Human Neuroscience, 9. https://doi.org/10.3389/fnhum.2015.00201
• Shin, J. H., Kim, Y. H., ve Kwon, H. J. (2010). Repetitive transcranial magnetic stimulation for the treatment of post-stroke aphasia: A meta-analysis. Neuropsychology Review, 20(3), 298-309. https://doi.org/10.1007/s11065-010-9142-5
• Siebner, H. R., Hartwigsen, G., Kassuba, T., ve Rothwell, J. C. (2009). How does transcranial magnetic stimulation modify neuronal activity in the brain? Implications for studies of cognition. Cortex, 45(9), 1035-1042.
• Szaflarski, J. P., Griffis, J., Vannest, J., Allendorfer, J. B., Nenert, R., Amara, A. W., Sung, V., Walker, H. C., Martin, A. N., Mark, V. W., ve Zhou, X. (2018). A feasibility study of combined intermittent theta burst stimulation and modified constraint-induced aphasia therapy in chronic post-stroke aphasia. Restorative Neurology and Neuroscience, 36(4), 503-518. https://doi.org/10.3233/RNN-180812
• Vines, B. W., Nair, D., ve Schlaug, G. (2008). Modulating activity in the motor cortex affects performance for the two hands differently depending upon which hemisphere is stimulated. European Journal of Neuroscience, 28(8), 1667-1673. https://doi.org/10.1111/j.1460-9568.2008.06459.x
• Walsh, V., & Cowey, A. (2000). Transcranial magnetic stimulation and cognitive neuroscience. Nature Reviews Neuroscience, 1, 73–79.
• Wang, C., Nie, P., Wang, P., Wang, Y., Zang, Y., ve Zhang, Y. (2023). The therapeutic effect of transcranial magnetic stimulation on post-stroke aphasia and the optimal treatment parameters: A meta-analysis. Archives of Physical Medicine and Rehabilitation, S0003-9993(23), 00659-7. https://doi.org/10.1016/j.apmr.2023.11.006
• Wassermann, E. M., Epstein, C. M., Ziemann, U., Walsh, V., Paus, T., ve Lisanby, S. H. (Eds.). (2008). The Oxford handbook of transcranial stimulation. Oxford University Press.
• Wilson, S. M., Entrup, J. L., Schneck, S. M., Onuscheck, C. F., Levy, D. F., Rahman, M., ... ve Kirshner, H. S. (2023). Recovery from aphasia in the first year after stroke. Brain, 146(3), 1021-1039.
• Wu, D., Wang, J., ve Yuan, Y. (2015). Effects of transcranial direct current stimulation on naming and cortical excitability in stroke patients with aphasia. Neuroscience Letters, 589, 115-120. https://doi.org/10.1016/j.neulet.2015.01.045
• Wong, P. K., & Wong, R. Y. (2017). Advances in neuromodulation: From electrical to magnetic stimulation. Neurotherapeutics, 14(4), 817-832.
• Wurzer, H., & Hauptmann, C. (2018). Adapted acoustic CR neuromodulation in patients with chronic tonal tinnitus and hearing loss. Frontiers in Medicine, 5, 288.
• Yaşa, İ. C., Maviş, İ., Şalçin, C., ve Midi, İ. (2023). Comparing the efficiency of speech and language therapy and transcranial magnetic stimulation for treating Broca’s aphasia. Journal of Stroke and Cerebrovascular Diseases, 32(6), 107108. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107108
• You, Y., Li, Y., Zhang, Y., Fan, H., Gao, Q., ve Wang, L. (2023). Long-term effects of transcranial direct current stimulation (tDCS) combined with speech language therapy (SLT) on post-stroke aphasia patients: A systematic review and network meta-analysis of randomized controlled trials. NeuroRehabilitation, (Preprint), 1-12.
• Zhao, R., He, Z.-Y., Cheng, C., Tian, Q.-Q., Cui, Y.-P., Chang, M.-Y., Wang, F.-M., Kong, Y., Deng, H., Yang, X.-J., ve Sun, J.-B. (2022). Assessing the effect of simultaneous combining of transcranial direct current stimulation and transcutaneous auricular vagus nerve stimulation on the improvement of working memory performance in healthy individuals. Frontiers in Neuroscience, 16, 947236. https://doi.org/10.3389/fnins.2022.947236