Resting-State Network Changes Following Transcranial Magnetic Stimulation in Patients With Aphasia-A Randomized...

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Stroke-related aphasia significantly impacts communication abilities.
• Repetitive transcranial magnetic stimulation (rTMS) shows potential for treating post-stroke aphasia.
• Neuroimaging changes following rTMS for aphasia require further elucidation.

Purpose of the Study:

• To investigate neuroimaging correlates of language recovery in nonfluent aphasia patients undergoing rTMS.
• To examine brain activation changes using resting-state functional magnetic resonance imaging (rsfMRI) during rTMS intervention.
• To correlate neural activity changes with improvements in language function.

Main Methods:

• A randomized, double-blinded study involving 26 stroke patients with nonfluent aphasia.
• Ten days of 1-Hz inhibitory rTMS applied to the right pars triangularis (PTr), comparing real vs. sham stimulation.
• rsfMRI and the Concise Chinese Aphasia Test (CCAT) administered pre- and post-intervention.

Main Results:

• The real rTMS group showed significant improvements in overall CCAT scores and subscores for conversation, description, and expression compared to the sham group.
• Increased fractional amplitude of low-frequency fluctuation (fALFF) was observed in the right superior temporal gyrus, right dorsolateral prefrontal gyrus, insular cortex, and caudate nucleus post-intervention.
• Suppressed fALFF was noted in the right thalamus, and enhanced frontotemporal activity correlated with CCAT score improvements.

Conclusions:

• Right frontotemporal and subcortical regions play a crucial role in language recovery following rTMS in aphasia patients.
• Inhibitory rTMS may enhance language expression by modulating activity in the right frontotemporal region.
• Findings support refining rTMS protocols for optimized brain stimulation treatments in aphasia recovery.