Improved language performance subsequent to low-frequency rTMS in patients with chronic non-fluent aphasia post-stroke

TLDR

Low‑frequency (1 Hz) rTMS applied to homologous language sites has been used to improve picture‑naming, speech output, and other expressive language functions in chronic non‑fluent aphasia after stroke. In a randomized study, 20‑minute daily 1 Hz rTMS was delivered for 10 days to six real‑stimulation and six sham‑placebo patients, with language outcomes measured at baseline and two months post‑stimulation. At two months post‑stimulation, the real‑stimulation group showed significant improvements in naming, expressive language, and auditory comprehension compared with sham, supporting transcallosal disinhibition mechanisms and highlighting rTMS’s clinical potential for post‑stroke language rehabilitation.

Abstract

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. Methods: Low-frequency (1 Hz) rTMS was applied to six real stimulation and six sham placebo patients for 20 min per day, for 10 days, and behavioural language outcome measures were taken at baseline (pre-stimulation) and 2 months post-stimulation. Results: The findings demonstrate treatment-related changes observed in the stimulation group when compared to the placebo control group at 2 months post-stimulation on naming performance as well as other aspects of expressive language and auditory comprehension. Conclusions: These findings provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain and highlight the potential clinical applications for language rehabilitation post-stroke.