Effects of rTMS Based on Neural Activation in Language Performance in Stroke Patients With Non-fluent Aphasia

NCT ID: NCT02591719

Last Updated: 2025-07-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2023-10-20

Brief Summary

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The aim of this study is to assess the safety and clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) based on hemodynamic brain activity pattern with functional near infrared spectroscopy (fNIRS) in early poststroke nonfluent aphasia patients.

Detailed Description

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Most conventional rTMS studies employed an inhibitory low frequency protocol for the contralesional homologs of Broca's area.

In the present randomized controlled trial, investigators will perform fNIRS prior to rTMS treatment to select the stimulation method. Stimulation site (perilesional or contralesional) and frequency (excitatory high or inhibitory low) will be determined by activation pattern from the fNIRS with language task in individual patients.

The patient who shows a dominant neural activity at perilesional Broca's area on fNIRS scanning will be randomly allocated into two groups: high frequency stimulation group and sham stimulation group. If a patient shows a dominant neural activity at contralesional homologs of Broca's area on fNIRS scanning, the patient will be allocated to a low frequency stimulation group.

Conditions

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Stroke Aphasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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MagPro magnetic stimulator (HF rTMS)

Most activated area from fNIRS with language task: Perilesional Broca's area

Group Type EXPERIMENTAL

MagPro magnetic stimulator (HF rTMS)

Intervention Type DEVICE

Most activated area from fNIRS findings: Perilesional Broca's area. Use the true coil. High frequency rTMS (10Hz), Number of total stimuli: 800, Location: perilesional Broca's area, Intensity: 100% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

MagPro magnetic stimulator (sham)

Most activated area from fNIRS with language task: Perilesional Broca's area

Group Type SHAM_COMPARATOR

MagPro magnetic stimulator (sham)

Intervention Type DEVICE

Most activated area from fNIRS findings: Perilesional Broca's area. Use the sham coil. High frequency rTMS (10Hz), Number of total stimuli: 800, Location: perilesional Broca's area, Intensity: 100% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

MagPro magnetic stimulator (LF rTMS)

Most activated area from fNIRS with language task: Contralesional homologs of Broca's area

Group Type ACTIVE_COMPARATOR

MagPro magnetic stimulator (LF rTMS)

Intervention Type DEVICE

Most activated area from fNIRS findings: Contralesional homologs of Broca's area.

Use the true coil. Low frequency rTMS (1Hz), Number of total stimuli: 1200, Location: Contralesional homologs of Broca's area (Pars triangularis), Intensity: 90% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

Interventions

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MagPro magnetic stimulator (HF rTMS)

Most activated area from fNIRS findings: Perilesional Broca's area. Use the true coil. High frequency rTMS (10Hz), Number of total stimuli: 800, Location: perilesional Broca's area, Intensity: 100% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

Intervention Type DEVICE

MagPro magnetic stimulator (sham)

Most activated area from fNIRS findings: Perilesional Broca's area. Use the sham coil. High frequency rTMS (10Hz), Number of total stimuli: 800, Location: perilesional Broca's area, Intensity: 100% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

Intervention Type DEVICE

MagPro magnetic stimulator (LF rTMS)

Most activated area from fNIRS findings: Contralesional homologs of Broca's area.

Use the true coil. Low frequency rTMS (1Hz), Number of total stimuli: 1200, Location: Contralesional homologs of Broca's area (Pars triangularis), Intensity: 90% of resting motor threshold, Coil orientation: tangential to scalp, in combination with speech therapy(35-40min) after each rTMS session, Daily 10 treatment session

Intervention Type DEVICE

Other Intervention Names

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High frequency rTMS Sham stimulation low frequency rTMS

Eligibility Criteria

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Inclusion Criteria

* 18-80 yrs old
* Right-handed
* Radiologically confirmed left hemisphere stroke within 6 months
* Fluent in Korean
* First ever stroke
* Non-fluent (motor-dominant) aphasia
* Written informed consent

Exclusion Criteria

* Previous medical histories of stroke, cerebral vascular operation,
* Seizure
* Patients with traumatic brain injury
* Unable to perform the language task
* Severe cognitive impairment (MMSE less than 16)
* Skin lesion in the stimulation site of scalp
* Metal implants in the body (cardiac pacemaker or aneurysm clip)
* Pregnancy, breastfeeding
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Bundang Hospital

OTHER

Sponsor Role lead

Responsible Party

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Nam-Jong Paik

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nam-Jong Paik, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Locations

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Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital

Seongnam-si, Korea, Gyeonggi-do, South Korea

Site Status

Countries

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South Korea

Other Identifiers

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B-1507-308-006/P2

Identifier Type: -

Identifier Source: org_study_id

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