Efficacy of Verb Network Strengthening Treatment Combined with Repetitive Transcranial Magnetic Stimulation in Chronic Individuals with Agrammatic Aphasia

Aphasia is an acquired language disorder, that affects speech production and comprehension, and is one of the most spread consequences of stroke in the left hemisphere. With a growing number of stroke cases in Russia there is a need in new effective methods of treatment. Recent investigations on noninvasive brain stimulation along with behavioral therapies showed efficacy of combining repetitive TMS and language therapy in patients with post-stroke aphasia. Furthermore, according to previous studies suppression of right pars triangularis contributes to recovery of language functions and can make treatment more productive. The goal of the present study is to investigate the efficacy of the Russian-language version of Verb Network Strengthening Treatment (VNeST) combined with low frequency rTMS applied to the right pars triangularis in chronic patients with agrammatism. VNeST seems to be an appropriate tool for patients with difficulties in verb, sentence and discourse production and contributes to recovery of the connected speech. Two chronic individuals with moderate efferent-motor aphasia participated in this pilot study. The treatment lasted for 12 days and included 20 minutes of rTMS and one hour of language therapy. The outcomes of the treatment were assessed with three formal linguistic tests, completed by participants before and after the therapy course. The results of the statistical analysis showed no significant changes in both participants. However, there were some improvements in language comprehension in one of the individuals. Despite several limitations, the present study reveals the potential efficacy of the new method and demonstrates the need for further investigations.