Evidence map›Paper›PMID 35337223›Full record

Trial reportNeurorehabilitation and neural repair2022

Differential Effects of Speech and Language Therapy and rTMS in Chronic Versus Subacute Post-stroke Aphasia: Results of the NORTHSTAR-CA Trial.

Anna Zumbansen, Heike Kneifel, Latifa Lazzouni, Anja Ophey, Sandra E Black, Joyce L Chen, Dylan Edwards, Thomas Funck, Alexander Erich Hartmann, Wolf-Dieter Heiss and 11 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurorehabilitation and neural repair, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02020421 (NOn-invasive Repeated THerapeutic STimulation for Aphasia Recovery), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02020421 nacompletednot on this map

NOn-invasive Repeated THerapeutic STimulation for Aphasia Recovery

TypeinterventionalSponsorDr. Alexander ThielRan2013 to 2018Enrolled63ConditionsAphasiaArmsrTMS, tDCS, Sham rTMS, Sham tDCS
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
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  7. Review
  8. Article
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  13. Narrative Review of Noninvasive Brain Stimulation in Stroke Rehabilitation.Medical science monitor : international medical journal of experimental and clinical research · 2022
    Review
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  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 12 institutions in 4 countries.

Anna ZumbansenJewish General Hospital, 5620McGill University, Montreal, QC, Canada.ORCID 0000-0003-2332-8263
Heike KneifelJewish General Hospital, 5620McGill University, Montreal, QC, Canada.ORCID 0000-0003-0524-3143
Latifa LazzouniJewish General Hospital, 5620McGill University, Montreal, QC, Canada.
Anja OpheyJewish General Hospital, 5620McGill University, Montreal, QC, Canada.ORCID 0000-0001-5858-7762
Sandra E BlackDepartment of Medicine-Neurology and Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, 71545University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-7093-8289
Joyce L ChenFaculty of Kinesiology and Physical Education, and Rehabilitation Sciences Institute, 177420University of Toronto, Toronto, ON, Canada.
Dylan Edwards10997Burke Neurological Institute, White Plains, NY, USA.ORCID 0000-0001-7346-3100
Thomas FunckJewish General Hospital, 5620McGill University, Montreal, QC, Canada.
Alexander Erich HartmannHospital of the City of Cologne and Department of Neurosurgery, 163483University of Witten-Herdecke, Germany.
Wolf-Dieter HeissMax Planck Institute für Stoffwechsel Forschung - MPI for Metabolism Research, and 28302Universität zu Köln, Cologne, Germany.
Franziska HildesheimJewish General Hospital, 5620McGill University, Montreal, QC, Canada.
Sylvain LanthierHôpital du Sacré-Cœur de Montreal, 12368Université de Montréal, Montreal, QC, Canada.
Paul LespéranceCHUM, 12368Université de Montréal, Montreal, QC, Canada.
George MochizukiSchool of Kinesiology and Health Science, 56014York University, Toronto, ON, Canada.
Caroline PaquetteJewish General Hospital, 5620McGill University, Montreal, QC, Canada.ORCID 0000-0001-8109-5301
Elizabet RochonKITE Research Institute, Toronto Rehabilitation Institute, 12366University Health Network, University of Toronto, Toronto, ON, Canada.
Ilona Rubi-FessenRehaNova, Neurological Rehabilitation Clinic, Cologne, Germany.ORCID 0000-0002-9775-3812
Jennie Valles10997Burke Rehabilitation Hospital, White Plains, NY, USA.
Susan Wortman-Jutt10997Burke Neurological Institute, White Plains, NY, USA.
Alexander ThielJewish General Hospital, 5620McGill University, Montreal, QC, Canada.
NORTHSTAR-study group
Jewish General Hospital · CAUniversity of Cologne · DEBurke Rehabilitation Hospital · USUniversity of Ottawa · CAEdith Cowan University · AUHôpital du Sacré-Cœur de Montréal · CASunnybrook Health Science Centre · CAUniversité de Montréal · CAUniversity Health Network · CAUniversity of Toronto · CAWitten/Herdecke University · DEYork University · CA

Funding

CIHR MOP125954
6 · The paper itself

Abstract

BACKGROUND &

objectiveContralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5-45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia (>6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases.

methodsSixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment. Chronic and subacute results were compared.

resultsAdverse events were rare, mild, and did not differ between groups. Language outcomes improved significantly in all groups irrespective of treatment and recovery phase. At 30-day follow-up, there was a significant interaction of stimulation and recovery phase on naming recovery (

conclusionsThe addition of rTMS to SLT led to significant supplemental gains in naming recovery in the subacute phase only. While this needs confirmation in larger studies, our results clarify neuromodulatory vs training-induced effects and indicate a possible window of opportunity for contralesional inhibitory stimulation interventions in post-stroke aphasia. NORTHSTAR

trial registrationhttps://clinicaltrials.gov/ct2/show/NCT02020421.

Indexed as

AphasiaTranscranial Magnetic StimulationHumansLanguage TherapySpeechSpeech TherapyTreatment Outcomeaphasialanguage therapyrandomized controlled trialspeech therapystroketranscranial magnetic stimulation

Identifiers

PMID35337223
PMCPMC9003806
OpenAlexW4221068947

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.