全失型失語症患者接受語言治療合併重覆經顱磁刺激治療之病例報告

A Case Report of Speech Therapy Combined with Repetitive Transcranial Magnetic Stimulation in Patients with Global Aphasia

賴世真(Shih-Chen Lai) ； 林雁婷(Yan-Ting Lin) ； 戴龍偉(Long-Wei Dai)

《台灣復健醫學雜誌》 50卷2期 (2022/12) Pp. 159-166

https://doi.org/10.6315/TJPMR.202212_50(2).0009

摘要

因腦中風（cerebrovascular accident, CVA）造成失語症（aphasia）之患者接受語言治療為常見之復健方式，然近年來，重覆經顱磁刺激（repetitive transcranial magnetic stimulation, rTMS）應用於腦中風相關合併症之治療漸增。本文將討論一位全失型失語症患者經由傳統語言治療合併重覆經顱磁刺激後之語言表現，並討論治療期間語言特徵之變化。

關鍵字

失語症（aphasia） ； 重覆經顱磁刺激（repetitive transcranial magnetic stimulation, rTMS） ； 語言治療（speech therapy）

並列摘要

For patients with stroke-induced aphasia, speech therapy is the most common speech rehabilitation program. In recent years, increasing empirical discussions have been conducted on the application of repetitive transcranial magnetic stimulation in treating stroke-related comorbidities; however, such discussions are lacking in Chinese. The present case report investigated a patient with global aphasia who received frequent sessions of conventional speech therapy (2.5 hours per week) in conjunction with repetitive transcranial magnetic stimulation (5 sessions per week). The total intervention period was 6 months. The Concise Chinese Aphasia Test was used to conduct a pretest and posttest before and after the intervention. This study also observed and documented how the patient's speech characteristics changed. The tests revealed substantial improvement in the patient's listening, speaking, reading, writing, and daily communication abilities. In particular, the level of assistance required by the patient reduced from full assistance to partial assistance at the start of the intervention in the following tasks: listening comprehension, picture-word matching, naming, duplicate writing, reading, and daily communication. In terms of oral expression (including duplicate speaking, spontaneous speaking, and serial language), the patient improved from needing partial assistance to completing the task independently. At the later stage of intervention, particularly large improvement was noted in the patient's writing ability and daily communication function (e.g., social communication and communication for basic needs), in which the patient was able to complete some of the tasks independently. According to the results, the patient made considerable progress in all communication aspects within 6 months. The study also discussed related questions to provide insights into clinical applications and explorations.

並列關鍵字

aphasia ； repetitive transcranial stimulation ； speech therapy

參考文獻

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