Theta burst stimulation effectively improves post-stroke aphasia: A systematic review and meta-analysis of randomized...

Post-stroke aphasia (PSA) is a common disabling sequela of stroke, and existing speech therapies have limitations, such as inefficiency and high cost. Theta burst stimulation (TBS), a novel non-invasive brain stimulation technique, improves language function by modulating neuroplasticity; however, systematic evidence is lacking to support its efficacy and optimal intervention parameters. This study aimed to evaluate the rehabilitative effect of TBS on language function in patients with PSA.

We searched six major Chinese and English databases, including PubMed and Web of Science, for relevant literature from inception to October 04, 2025, and ultimately included 12 RCTs (combined n = 524). Additionally, subgroup analyses were conducted to explore the effects of different stimulation methods, stimulation site, stage of stroke, and treatment sessions on the efficacy of the treatment, and to analyze the related factors in depth.

TBS significantly improved overall speech function (SMD = 0.97, 95 % CI: 0.51-1.43, P < 0.001), particularly effective in enhancing naming, auditory comprehension, repetition, and spontaneous speech abilities. Selecting stimulation of Broca's area, the iTBS protocol, early-stage (acute/subacute) patients, and multiple interventions (≥10 sessions) can significantly improve PSA. However, given the high degree of heterogeneity, caution should be exercised when interpreting our findings.

These findings suggest that TBS may represent a promising adjunct to conventional speech rehabilitation for patients with PSA.