| Authors | Szaflarski JP, Griffis J, Vannest J, Allendorfer JB, Nenert R, Amara AW, Sung V, Walker HC, Martin AN, Mark VW, Zhou X |
| Title | A feasibility study of combined intermittent theta burst stimulation and modified constraint-induced aphasia therapy in chronic post-stroke aphasia |
| Reference | Restor Neurol Neurosci 2018; 36: 503-518 |
| PMID | 29889086 |
| DOI | 10.3233/rnn-180812 |
| Language | US English |
| Inclusion criteria | — |
| Number of individuals with aphasia | 12 (plus 1 excluded: scanned at only 2 out of 3 time points) |
| Number of control participants | 0 |
| Were any of the participants included in any previous studies? | No |
| Is age reported for patients and controls, and matched? | Yes (range 26-66 years) |
| Is sex reported for patients and controls, and matched? | Yes (males: 9; females: 3) |
| Is handedness reported for patients and controls, and matched? | Yes (right: 11; left: 1) |
| Is time post stroke onset reported and appropriate to the study design? | Yes (range 1-12 years) |
| To what extent is the nature of aphasia characterized? | Comprehensive battery |
| Language evaluation | WAB, BNT, semantic fluency, phonemic fluency |
| Aphasia severity | AQ range 10.4-94.6 |
| Aphasia type | 8 anomic, 2 Broca's, 1 conduction, 1 global |
| First stroke only? | Yes |
| Stroke type | Not stated |
| To what extent is the lesion distribution characterized? | Individual lesions |
| Lesion extent | Not stated |
| Lesion location | L MCA |
| Participants notes | — |
| Modality | fMRI |
| Is the study cross-sectional or longitudinal? | Longitudinal—chronic treatment |
| If longitudinal, at what time point(s) were imaging data acquired? | T1: pre-treatment/chronic (1-2 weeks prior to treatment); T2: post-treatment (within 1 week after end of 2-week treatment); T3: 13-20 weeks after end of treatment |
| If longitudinal, was there any intervention between the time points? | Modified CIAT + intermittent theta burst stimulation to residual left hemispheric language activation, 45 minutes/session, 5 days/week, 2 weeks |
| Is the scanner described? | Yes (Siemens Allegra 3 Tesla) |
| Is the timing of stimulus presentation and image acquisition clearly described and appropriate? | Yes |
| Design type | Block |
| Total images acquired | 330 |
| Are the imaging acquisition parameters, including coverage, adequately described and appropriate? | Yes (whole brain) |
| Is preprocessing and intrasubject coregistration adequately described and appropriate? | Yes |
| Is first level model fitting adequately described and appropriate? | Yes |
| Is intersubject normalization adequately described and appropriate? | Yes |
| Imaging notes | — |
| Are the conditions clearly described? | Yes |
| Condition | Response type | Repetitions | All groups could do? | All individuals could do? |
|---|---|---|---|---|
| semantic decision | Button press | 5 | Unknown | Unknown |
| tone decision | Button press | 6 | Unknown | Unknown |
| Conditions notes | — |
| Are the contrasts clearly described? | Yes |
| Language condition | Semantic decision |
| Control condition | Tone decision |
| Are the conditions matched for visual demands? | Yes |
| Are the conditions matched for auditory demands? | Yes |
| Are the conditions matched for motor demands? | Yes |
| Are the conditions matched for cognitive/executive demands? | Yes |
| Is accuracy matched between the language and control tasks for all relevant groups? | Unknown, not reported |
| Is reaction time matched between the language and control tasks for all relevant groups? | Unknown, not reported |
| Behavioral data notes | — |
| Are control data reported in this paper or another that is referenced? | Yes |
| Does the contrast selectively activate plausible relevant language regions in the control group? | Yes |
| Are activations lateralized in the control data? | Yes |
| Control activation notes | L frontal and temporal, plus other semantic regions |
| Contrast notes | — |
| Are the analyses clearly described? | Yes |
| First level contrast | Semantic decision vs tone decision |
| Analysis class | Longitudinal change in aphasia |
| Group(s) | Aphasia T2 vs T1 |
| Covariate | — |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on cluster_threshold_beta |
| Software | SPM12 |
| Voxelwise p | .05 |
| Cluster extent | 0.928 cc |
| Statistical details | — |
| Findings | ↑ L supramarginal gyrus ↑ L intraparietal sulcus ↑ L precuneus ↑ L posterior STG ↑ L Heschl's gyrus ↑ L mid temporal ↑ L anterior temporal ↑ R supramarginal gyrus ↑ R superior parietal ↑ R precuneus ↑ R mid temporal ↑ R anterior cingulate ↓ L IFG pars opercularis ↓ L dorsolateral prefrontal cortex ↓ L ventral precentral/inferior frontal junction ↓ L dorsal precentral ↓ L SMA/medial prefrontal ↓ L somato-motor ↓ L superior parietal ↓ L occipital |
| Findings notes | — |
| First level contrast | Semantic decision vs tone decision |
| Analysis class | Longitudinal change in aphasia |
| Group(s) | Aphasia T3 vs T2 |
| Covariate | — |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on cluster_threshold_beta |
| Software | SPM12 |
| Voxelwise p | .05 |
| Cluster extent | 0.928 cc |
| Statistical details | — |
| Findings | ↑ L dorsolateral prefrontal cortex ↑ L angular gyrus ↑ L precuneus ↑ L posterior STS ↓ L SMA/medial prefrontal ↓ L anterior temporal ↓ L anterior cingulate ↓ R IFG ↓ R dorsolateral prefrontal cortex ↓ R ventral precentral/inferior frontal junction ↓ R SMA/medial prefrontal ↓ R somato-motor ↓ R precuneus ↓ R posterior STG/STS/MTG ↓ R anterior temporal |
| Findings notes | — |
| First level contrast | Semantic decision vs tone decision |
| Analysis class | Longitudinal change in aphasia |
| Group(s) | Aphasia T3 vs T1 |
| Covariate | — |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on cluster_threshold_beta |
| Software | SPM12 |
| Voxelwise p | .05 |
| Cluster extent | 0.928 cc |
| Statistical details | — |
| Findings | ↑ L supramarginal gyrus ↑ L angular gyrus ↑ L precuneus ↑ L posterior STG ↑ L mid temporal ↑ L anterior temporal ↑ L posterior cingulate ↓ L somato-motor ↓ R dorsolateral prefrontal cortex |
| Findings notes | — |
| First level contrast | Semantic decision vs tone decision |
| Analysis class | Longitudinal correlation with language or other measure |
| Group(s) | Aphasia T3 vs aphasia T2 |
| Covariate | Δ WAB AQ |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on cluster_threshold_beta |
| Software | SPM12 |
| Voxelwise p | .05 |
| Cluster extent | 0.928 cc |
| Statistical details | Inclusive mask of voxels that differed between T2 and T3 |
| Findings | ↓ L inferior parietal lobule |
| Findings notes | — |
| First level contrast | Semantic decision vs tone decision |
| Analysis class | Longitudinal correlation with language or other measure |
| Group(s) | Aphasia T3 vs aphasia T1 |
| Covariate | Δ BNT |
| Is the second level contrast valid in terms of the group(s), time point(s), and measures involved? | Yes |
| Is accuracy matched across the second level contrast? | Unknown, not reported |
| Is reaction time matched across the second level contrast? | Unknown, not reported |
| Behavioral data notes | — |
| Type of analysis | Voxelwise |
| Search volume | Whole brain |
| Correction for multiple comparisons | Clusterwise correction based on cluster_threshold_beta |
| Software | SPM12 |
| Voxelwise p | .05 |
| Cluster extent | 0.928 cc |
| Statistical details | Inclusive mask of voxels that differed between T1 and T3 |
| Findings | ↓ R IFG |
| Findings notes | — |
| Excluded analyses | — |