Using Non-invasive Brain Stimulation in the Treatment of Chronic Post-stroke Aphasia

Jeffry Alfaro

Students

College

Project Summary

Under the mentorship of Dr. Roy H. Hamilton, MD, MS, I was given the opportunity to work in a phase II clinical trial that evaluates the efficacy of Transcranial Magnetic Stimulation (TMS) as a supplementary tool to Constraint-Induced Language Therapy (CILT) in the treatment of chronic aphasia. The aim of my study was to see if using a safe and non-invasive brain stimulation technique while providing language therapy to aphasic patients would lead to better language performance on language tests than patients who received sham stimulation with therapy.

The project consisted of a double-blind randomized study where patients were allocated to groups in a 2:1 active TMS+CILT to sham TMS+CILT ratio. Patients would first be assessed at baseline using various language tests such as the Western Aphasia Battery. Then patients would receive either sham or active stimulation for 20 minutes each session followed by 60-90 minutes of therapy for 10 sessions over the course of 2 weeks. After treatment, patients would come in for a 3-month follow-up and 6-month follow-up and repeat the same language tests that they did at baseline. To assess whether patients had significant aphasia improvements, Western Aphasia Battery-Aphasia Quotient scores were compared between baseline, 3-month follow-up, and 6-month follow-up timepoints. Patients that scored at least 5 points higher in post-treatment testing were said to have responded to treatment and showed aphasia improvements.

Through this experience, I have gained valuable clinical experience working with patients that have neurodegenerative diseases and have had strokes. Additionally, I learned how to administer various types of brain stimulation and language tests (such as the Western Aphasia Battery) to classify aphasias and help provide treatment. With the help of lab members, I also learned how to score language tests, encode patient information in a secure database, and analyze preliminary data. I was able to see the smiles on patient’s faces when they could finally say a new word and the hardship many patients have when it comes time to communicate, something we often take for granted. This experience opened my eyes to the patience, communication, and respect that is needed to provide help to patients. While I learned many fundamental techniques, this experience has paved my path to exploring translational neuroscience that helps real people with neurologic problems that are too often forgotten.

I’d like to thank Dr. Hamilton, members of the Laboratory for Cognition and Neural Stimulation, and CURF for this experience!

https://youtu.be/CpywjIHAj70

To see my poster, visit Penn Presents: https://presentations.curf.upenn.edu/poster/using-non-invasive-brain-sti...