137. rTMS in the Primary Progressive Aphasia: Two case-reports taken from open study treatment protocol

Repetitive transcranial magnetic stimulation (rTMS) improved action naming in subjects with aphasia in neurodegenerative disorders in a single session. We decided to investigate possible utility of rTMS in a rehabilitation setting in addition as to logopedic treatment. Consecutive patients affected by Progressive Primary Aphasia (PPA)—nonfluent type, were underware to a cycle of 3 weeks of high frequency rTMS of dorsolateral prefrontal cortex (DLPFC) and logopedic treatments. The patients’ performance was evaluated on a battery of language (Italian version of AAT), before and after treatments. We evaluated two subjects. First showed a significant improvement of patient’s performance in subtest “denomination”; a slight increase in “written language” and fewer number of error in “Token Test”. The second with severe disease discontinued treatment after 8 days for the occurrence of adverse events. The finding in mild disease patient suggests that rTMS of DLPFC may strengthen the neural connections within an area of metabolic dysfunction with a facilitation effect on lexical retrieval processes. According to our experience, the rTMS may not be indicated, for the safety of patient, in advanced and severe stages of disease. A Randomized Control Trial is needed to verify the utility of rTMS for neurodegenerative forms of aphasia.