Functional MRI-based therapeutic rTMS strategy for aphasic stroke patients: a case series pilot study

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Aphasia is a common and debilitating consequence of stroke, significantly impacting communication.
• Motor-dominant aphasia presents specific challenges in speech and language recovery.
• Current neurorehabilitative strategies for poststroke aphasia require further investigation and optimization.

Purpose of the Study:

• To evaluate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) as a therapeutic intervention for poststroke motor-dominant aphasia.
• To determine the clinical feasibility of a targeted rTMS protocol based on functional MRI (fMRI) findings.

Main Methods:

• Four patients diagnosed with poststroke motor-dominant aphasia participated in the study.
• Each patient underwent 10 treatment sessions of low-frequency rTMS, with 1,200 pulses per session.
• The stimulation site was identified as an area homologous to the most activated region on pre-treatment fMRI, targeting either the left or right frontal lobe.

Main Results:

• All four participants demonstrated notable improvements in language function following the rTMS treatment protocol.
• The targeted application of rTMS to specific frontal lobe areas yielded positive therapeutic outcomes.
• No adverse effects were reported, indicating a favorable safety profile for the intervention.

Conclusions:

• Low-frequency rTMS, when applied to fMRI-identified homologous brain regions, represents a clinically feasible neurorehabilitative approach for poststroke aphasia.
• This therapeutic strategy offers a promising avenue for enhancing language recovery in patients affected by stroke-induced aphasia.
• Further research with larger cohorts is warranted to solidify these findings and explore optimal rTMS parameters.