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Updated: Apr 1, 2026
Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
Published on: July 2, 2013
High-frequency rTMS applied to the right hemisphere promotes aphasia recovery and brain microstructural changes in
Qiwei Yu1, Yan Sun2, Xiaowen Ju3
1Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China; Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215008, China.
Background:
The role of the right hemisphere in post-stroke aphasia (PSA) remains one of the key controversies in contemporary neuroscience. While accumulating evidence has demonstrated the clinical potential of repetitive transcranial magnetic stimulation (rTMS) for the management of PSA, consensus regarding optimal stimulation strategies has not yet been established. The present study aimed to investigate the therapeutic effects of high-frequency rTMS applied to the right hemisphere in patients with PSA.
Methods:
Sixty-one patients with PSA were enrolled in this study. Language function was assessed before and following the rehabilitation regimen. Among the participants, 32 received adjunctive rTMS in combination with language therapy, while the remaining 29 received language therapy alone. Microstructural changes in the bilateral neural pathways were assessed using diffusion tensor imaging (DTI). Correlation analyses were conducted to investigate the potential relationships between the DTI indices of tract integrity and improvements in language performance.
Results:
High-frequency rTMS significantly improved language performance across language domains (Δ: speech, 28.51%; comprehension, 25.08%; repetition, 24.25%; naming, 19.36%; and fluency, 28.48%). Notably, microstructural integrity was significantly enhanced specifically in the right-hemispheric tracts, including the arcuate fasciculus (Δ FA = 3.53%), the second branch of the superior longitudinal fasciculus (Δ FA = 5.60%), the inferior frontal-occipital fasciculus (Δ FA = 5.50%), the frontal aslant tract (Δ FA = 5.60%), and the extreme capsule (Δ FA = 5.58%), with no comparable changes in the left hemisphere. Moreover, multiple linear regression analyses revealed that these structural changes in the right tracts were significantly associated with language improvement.
Conclusions:
High-frequency rTMS applied to the right hemisphere facilitates the recovery of PSA, potentially driven by the involvement of right-hemispheric neural tracts, highlighting the therapeutic potential of right hemisphere-targeted rTMS as a viable rehabilitation strategy for PSA during the early stage of stroke.
