Papers by Caroline H S Barwood
Aphasia is recognised as a common and debilitating communication impairment, as a result of a str... more Aphasia is recognised as a common and debilitating communication impairment, as a result of a stroke lesion. Language deficits in aphasia transpire as a result of damage to the primary language centres in the human cortex. Specifically, anterior cortical lesions result in expressive language deficits, termed non-fluent aphasia (Broca's type aphasia). Persons who suffer from aphasia, even in its mildest form, describe the impairment in communication as a significant impediment to activities of daily living.
There is a growing body of evidence to support the use of non-invasive brain stimulation techniqu... more There is a growing body of evidence to support the use of non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) for the treatment of acquired speech and language disorders. The aim of the present paper is to review evidence to support the use of these procedures in the treatment of aphasia and dysarthria.
Background: Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as a po... more Background: Low-frequency repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential tool for neurorehabilitation and remediation of language in chronic non-fluent aphasia post-stroke. Inhibitory (1 Hz) rTMS has been applied to homologous language sites to facilitate behavioural language changes. Improvements in picture-naming performance and speech output over time have been reported.
…, Jan 1, 2011
Background: There has been little research as to how society accommodates the communicative needs... more Background: There has been little research as to how society accommodates the communicative needs of people with aphasia. The accessibility of public transport becomes important post stroke and good communication skills are vital for successful travel. Aims: This pilot study aims to identify the communicative barriers and facilitators that exist when people with aphasia use public transport. Methods & Procedures: The qualitative study used in‐depth, semi‐structured interviews and observations with seven participants who ...
Brain and language, Jan 1, 2010
Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to ... more Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1 Hz) rTMS was applied to the anterior portion of the homologue to Broca's area (pars triangularis), for 20 min per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6 years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1 week and 2 months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2 months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1 week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS.
… Pacific Journal of …, Jan 1, 2010
Brain Stimulation, Jan 1, 2011
The results of this investigation are consistent with the findings of previous research studies, ... more The results of this investigation are consistent with the findings of previous research studies, reporting behavioral language changes after rTMS in nonfluent aphasia. Additional evidence is provided to demonstrate that rTMS may facilitate retrieval mechanisms involved in picture naming.
Procedia: Social …, Jan 1, 2011
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique to induce electric... more Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique to induce electric currents in the brain. Although rTMS is being evaluated as a possible alternative to electroconvulsive therapy for the treatment of refractory depression, little is known about the pattern of activation induced in the brain by rTMS. We have compared immediate early gene expression in rat brain after rTMS and electroconvulsive stimulation, a well-established animal model for electroconvulsive therapy. Our result shows that rTMS applied in conditions effective in animal models of depression induces different patterns of immediate-early gene expression than does electroconvulsive stimulation. In particular, rTMS evokes strong neural responses in the paraventricular nucleus of the thalamus (PVT) and in other regions involved in the regulation of circadian rhythms. The response in PVT is independent of the orientation of the stimulation probe relative to the head. Part of this response is likely because of direct activation, as repetitive magnetic stimulation also activates PVT neurons in brain slices.
…, Jan 1, 2011
Introduction: The application of low frequency (1 Hz) Repetitive Transcranial Magnetic Stimulatio... more Introduction: The application of low frequency (1 Hz) Repetitive Transcranial Magnetic Stimulation (rTMS) to right hemisphere (RH) language homologues in non-fluent aphasic populations has yielded improvements in behavioural language function, up to 43 months post stimulation 32. Functional imaging studies have demonstrated RH language homologue "overactivation" post left inferior frontal gyrus (IFG) damage, in chronic non-fluent aphasia. The effects of low frequency (inhibitory) rTMS are postulated to be as a result of a reduction of overactivation in RH language homologues, facilitating the reorganisation of neural language networks. Methods: Low frequency (1 Hz) rTMS was applied to the anterior portion of a Broca's area homologue (pars triangularis), for 20 minutes per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent aphasic patients (six real stimulation and six sham), 2-10 years post stroke were stimulated. Behavioural language outcome measures were taken at baseline and 1 week post rTMS. Results: Comparisons between the real stimulation and sham conditions indicated significant main effects between the stimulation and sham groups to 1 week post stimulation for naming accuracy, latency and repetition. Conclusions: This study indicates that rTMS has the capacity to modulate neural language networks, to facilitate improvements in behavioural language function, 1 week post TMS.
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Papers by Caroline H S Barwood