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Updated: Mar 6, 2026

Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
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Lesion-dependent Cingulo-opercular Network and Language Network Integration in Post-stroke Aphasia.

Qiufang Ren1, Jian Guan1, Xiaohui Xie2

  • 1Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

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|March 4, 2026
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Summary

This study reveals that in poststroke aphasia (PSA) patients with direct language network (LN) damage, cingulo-opercular network (CON) connectivity is crucial for verbal fluency and linked to white matter integrity. This highlights CON-LN functional integration

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Poststroke aphasia (PSA) presents significant communication challenges.
  • Understanding the neural underpinnings of language recovery is critical.
  • The role of resting-state functional connectivity (rs-FC) and white matter integrity in PSA is an active area of research.

Purpose of the Study:

  • To investigate differential impairment patterns in rs-FC between the cingulo-opercular network (CON) and language networks (LN) in PSA.
  • To explore how language network (LN) lesion topography influences CON-LN connectivity and its relationship with behavior.
  • To examine the mediating role of white matter integrity in these structure-function relationships.

Main Methods:

  • Sixty-three first-time PSA patients were categorized into LN lesion-positive (LNL+) and LN lesion-negative (LNL-) groups.
  • rs-FC between CON and LN was assessed using individualized and group-based template analyses.
  • Correlations were performed between CON-LN rs-FC, verbal fluency, and white matter integrity (arcuate fasciculus [AF] and superior longitudinal fasciculus [SLF] subdivisions).

Main Results:

  • No baseline intergroup differences in CON-LN rs-FC were found.
  • In LNL+ patients, individualized CON-LN connectivity positively correlated with verbal fluency (r = .504, p = .009).
  • In LNL+ patients, CON-LN connectivity negatively correlated with damage severity in AF and SLF subdivisions, indicating impaired white matter integrity impacts function.

Conclusions:

  • CON-LN functional integration is vital for language recovery in PSA patients with direct LN damage.
  • Specific white matter tracts, including anterior/long AF segments and SLF II/III, are key substrates supporting this integration.
  • These findings underscore the importance of considering both lesion location and white matter integrity in understanding PSA and guiding rehabilitation strategies.