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Folia Phoniatrica Et Logopaedica :... 2015To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related...
Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials.
OBJECTIVE
To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related to communication and swallowing functions.
METHODS
A search was conducted on PubMed, Clinical Trials, Cochrane Library, and ASHA electronic databases. Studies were judged according to the eligibility criteria and analyzed by 2 independent and blinded researchers.
RESULTS
We analyzed 9 studies: 4 about aphasia, 3 about dysphagia, 1 about dysarthria in Parkinson's disease and 1 about linguistic deficits in Alzheimer's disease. All aphasia studies used low-frequency rTMS to stimulate Broca's homologous area. High-frequency rTMS was applied over the pharyngoesophageal cortex from the left and/or right hemisphere in the dysphagia studies and over the left dorsolateral prefrontal cortex in the Parkinson's and Alzheimer's studies. Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. The other 2 studies related to aphasia found a benefit restricted to subgroups with a severe case or injury on the anterior portion of the language cortical area, respectively, whereas the Alzheimer's study demonstrated positive effects specific to auditory comprehension. There were no changes for vocal function in the Parkinson's study.
CONCLUSION
The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still uncertain. Therefore, other randomized controlled trials are needed to clarify the optimal stimulation protocol for each disorder studied and its real effects.
Topics: Aged; Aged, 80 and over; Humans; Male; Communication Disorders; Deglutition Disorders; Reference Values; Sound Spectrography; Speech Acoustics; Statistics as Topic; Transcranial Magnetic Stimulation; Voice Quality; Randomized Controlled Trials as Topic
PubMed: 26580744
DOI: 10.1159/000439128 -
Revista de Neurologia Jun 2015Stroke is one of the main causes of death and disability and has a high economic cost. Anger after stroke is common and worsens functionality and quality of life. The... (Review)
Review
INTRODUCTION
Stroke is one of the main causes of death and disability and has a high economic cost. Anger after stroke is common and worsens functionality and quality of life. The study of this comorbidity has been hampered by the lack of standardization in anger's evaluation.
AIM
To show the current evidence of anger's prevalence and anger's associated factors after stroke.
MATERIALS AND METHODS
Medline systematic review of original papers studying prevalence and associated factors of anger after stroke.
RESULTS
Post-stroke anger has a high prevalence (15-57.2%). Most studies have found a lack of association between irritability and sex, age, type, size, laterality and severity of the stroke and functionality. Occasionally anger has been associated with frontal infarcts and aphasia. Data regarding the association between anger and motor deficits and cognitive impairment has been inconclusive while the association between anger and psychiatric history, post stroke emotional incontinence and post stroke depression has been widely replicated. Environmental factors have been difficult to study but may be relevant.
CONCLUSION
There is a high prevalence of anger post stroke. Psychiatric factors have been associated to it, while other associations are less conclusive. To improve anger knowledge and management, it would be necessary to improve its definition and assessment.
Topics: Anger; Humans; Prevalence; Stroke
PubMed: 26005071
DOI: No ID Found