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Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
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Study on Intermittent Theta Burst Stimulation Improves Expression Function and Mechanism in Patients With Aphasia

Guangtao Bai1,2,3, Liang Jiang4, Qi Li2

  • 1The Affiliated Hospital of Qingdao University, Shandong.

The Neurologist
|March 19, 2025
PubMed
Summary

Intermittent Theta Burst Stimulation (iTBS) combined with speech training significantly improved language expression in poststroke aphasia patients. This therapy enhances brain region activation in the left hemisphere, offering a potential mechanism for recovery.

Keywords:
aphsiadegree centralityfMRIfractional amplitude of low-frequency fluctuationintermittent theta burst stimulation

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Area of Science:

  • Neuroscience
  • Neurology
  • Rehabilitation Medicine

Background:

  • Stroke is a leading cause of aphasia, a disorder affecting language expression.
  • Post-stroke aphasia significantly impacts patients' quality of life and communication abilities.
  • Current treatments for aphasia, including speech therapy, show variable efficacy.

Purpose of the Study:

  • To investigate the efficacy of Intermittent Theta Burst Stimulation (iTBS) targeting the left posterior inferior frontal gyrus in improving expressive aphasia post-stroke.
  • To elucidate the neuroimaging mechanisms underlying iTBS effects using resting-state functional MRI (fMRI) with fractional amplitude of low-frequency fluctuation (fALFF) and degree centrality (DC) analyses.

Main Methods:

  • Forty patients with post-stroke aphasia were randomized into an iTBS group (iTBS + speech training) and a sham iTBS (S-iTBS) group (sham iTBS + speech training).
  • Language function was assessed using the Western Aphasia Test (Chinese version) for spontaneous language, naming, retelling, and aphasia quotient before and after treatment.
  • Resting-state fMRI scans were acquired pre- and post-treatment to analyze changes in fALFF and DC values in specific brain regions.

Main Results:

  • Both iTBS and S-iTBS groups showed significant improvements in language scores after treatment.
  • The iTBS group demonstrated significantly greater improvements in naming, retelling, and aphasia quotient compared to the S-iTBS group.
  • fALFF and DC analyses revealed increased activation in multiple left frontal and temporal brain regions in the iTBS group post-treatment compared to the S-iTBS group.

Conclusions:

  • Combined iTBS and speech training significantly enhances expressive language function in patients with post-stroke aphasia.
  • Increased activation in left hemisphere brain regions following iTBS is a key mechanism contributing to improved language expression.
  • iTBS represents a promising non-invasive neuromodulation technique for aphasia rehabilitation.