{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:14:13Z","timestamp":1790234053169,"version":"4.1.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:00:00Z","timestamp":1606780800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Non-invasive brain stimulation (NIBS) with speech therapy might improve recovery from post-stroke aphasia. This three-armed sham-controlled blinded prospective proof-of-concept study tested 1\u2009Hz subthreshold repetitive transcranial magnetic stimulation (rTMS) and 2-mA cathodal transcranial direct current stimulation (ctDCS) on the right pars triangularis in subacute post-stroke aphasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Sixty-three patients with left middle cerebral artery infarcts were recruited in five hospitals (Canada\/United States\/Germany, 01\u20132014\/03\u20132018) and randomized to receive rTMS (N\u2009=\u200920), ctDCS (N\u2009=\u200924) or sham stimulation (N\u2009=\u200919) with ST for 10\u2009days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Secondary outcome variable was the percent change in the Unified Aphasia Score. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment with a pre-planned subgroup analysis for lesion location (affecting Broca\u2019s area or not).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Naming was significantly improved by rTMS (median\u2009=\u20091.91\/interquartile range\u2009=\u20090.77\/p\u2009=\u2009.01) at 30\u2009days versus ctDCS (median\u2009=\u20091.11\/interquartile range\u2009=\u20091.51) and sham stimulation (median\u2009=\u20091.02\/interquartile range\u2009=\u20091.71). All other primary results were non-significant. The rTMS effect was driven by the patient subgroup with intact Broca\u2019s area where NIBS tended to improve UnAS (median\u2009=\u200933.2%\/interquartile range\u2009=\u200946.7%\/p\u2009=\u2009.062) versus sham stimulation (median\u2009=\u200912.5%\/interquartile range\u2009=\u20097.9%) at day 30. Conversely, in patients with infarcted Broca\u2019s area, UnAS tended to improve more with sham stimulation (median\u2009=\u200975.0%\/interquartile range\u2009=\u200986.9%\/p\u2009=\u2009.053) versus NIBS (median\u2009=\u200912.7%\/interquartile range\u2009=\u200931.7).<\/jats:p>\n                    <jats:p>Conclusion: We found a delayed positive effect of low-frequency rTMS targeting the right pars triangularis on the recovery of naming performance in subacute post-stroke aphasia. This intervention may be beneficial only in patients with morphologically intact Broca\u2019s area.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2396987320934935","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T01:17:56Z","timestamp":1593566276000},"page":"402-413","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Non-invasive brain stimulation as add-on therapy for subacute post-stroke aphasia: a randomized trial (NORTHSTAR)"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2332-8263","authenticated-orcid":false,"given":"Anna","family":"Zumbansen","sequence":"first","affiliation":[{"name":"Jewish General Hospital, Lady Davis Institute for Medical Research, Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra E","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Medicine-Neurology and Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce L","family":"Chen","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology and Physical Education, and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"J Edwards","sequence":"additional","affiliation":[{"name":"Burke Neurological Institute, White Plains, NY, USA 4"},{"name":"Moss Rehabilitation Research Institute, Elkins Park, PA, USA 5"},{"name":"School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital of the City of Cologne, University of Witten-Herdecke, Germany 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Dieter","family":"Heiss","sequence":"additional","affiliation":[{"name":"Max Planck Institute f\u00fcr Stoffwechsel Forschung -- MPI for Metabolism Research, and Department of Neurology, Universit\u00e4t zu K\u00f6ln, Cologne, Germany 8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9762-5514","authenticated-orcid":false,"given":"Sylvain","family":"Lanthier","sequence":"additional","affiliation":[{"name":"H\u00f4pital du Sacr\u00e9-C\u0153ur de Montreal, and Department of medicine, Universit\u00e9 de Montr\u00e9al, Quebec 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