Related Experiment Video
Updated: Sep 8, 2026
Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
Published on: July 2, 2013
Sex-Specific Differences in Response to Non-Invasive Brain Stimulation for Recovery From Post-Stroke Aphasia: A
Donguk Jo1,2, Franziska E Hildesheim3,4, Numa Dancause5
1University of Ottawa Heart Institute, Ottawa, Canada.
Background And Aim:
There are limited clinical trial data examining sex differences in response to non-invasive brain stimulation interventions for language recovery in individuals with post-stroke aphasia. The primary aim of this analysis was to retrospectively assess sex differences in longitudinal language recovery and neuromodulation in a subset of the international NORTHSTAR clinical trial cohort.
Methods:
A cohort of 76 adults with post-stroke aphasia (31 females and 45 males) was ascertained from the NORTHSTAR trial data for the present analysis. In NORTHSTAR, patients were randomly allocated to receive 15-minute repetitive transcranial magnetic stimulation, cathodal transcranial direct current stimulation, or sham stimulation, paired with 45-minute speech-language therapy for 10 sessions. In the present analysis, random coefficient mixed-effects models were used to estimate sex differences in longitudinal language recovery (naming, verbal fluency, and comprehension) over the 30-day follow-up both overall and in subacute patients only. Secondary analyses examined change in contralesional resting motor threshold over the 10 sessions in subacute patients only. All models were adjusted for variables that differed by sex at baseline (Montreal Cognitive Assessment (MoCA) scores, stroke severity, age, and education).
Results:
Females had a significantly greater increases in the ability of naming compared to males over the follow-up period in the overall cohort, with significant contributions from MoCA-visuospatial and language to sex-specific naming recovery. In contrast, no sex differences were observed in changes in verbal fluency or language comprehension during the recovery period.
Conclusions:
The greater recovery of the naming function in females compared to males may be mainly associated with sex differences in visuospatial cognitive function, given the characteristics of MoCA-language that heavily weight on aphasia-related language deficits. However, this should be interpreted cautiously, given the lack of sex differences in comprehension and semantic fluency.NORTHSTAR trial registration (#NCT02020421): https://clinicaltrials.gov/ct2/show/NCT02020421.
