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Updated: Sep 30, 2026
Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
Published on: July 2, 2013
Cerebellar Theta-Burst Stimulation Induces Distinct Functional Connectivity Patterns in Post-Stroke Aphasia: A
Xin Wang1, Xinlei Xu1, Daoran Wang1
1Department of Rehabilitation Medicine, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China.
Background:
Recent studies have identified the right cerebellar Crus I (rCrus I) as a promising target for rTMS in improving language rehabilitation. However, it remains unclear whether continuous theta burst stimulation (cTBS) over the rCrus I improves language outcomes in patients with subacute post-stroke aphasia (PSA).
Objective:
To determine whether inhibitory cTBS over rCrus I improves language recovery in PSA and to explore underlying functional connectivity (FC) mechanisms.
Methods:
Fifty-one PSA patients were randomized to receive either real cTBS (n = 25) or sham stimulation (n = 26) over rCrus I (10 sessions, 2 weeks) combined with speech-language therapy (SLT). Language assessments (WAB-AQ, BNT, BDAE) and resting-state fMRI were conducted before and after the intervention.
Results:
Both groups showed significant language improvement post-intervention. No significant interaction was found for WAB-AQ (P = .058), but a significant interaction was observed for repetition (P = .034), favoring cTBS. Resting-state fMRI showed altered connectivity between rCrus I and right temporo-occipital regions, with FC changes negatively correlated with language gains in the cTBS group. Exploratory subgroup analyses identified 2 distinct FC response patterns (FC-increase and FC-decrease), indicating heterogeneous cerebello-cortical and intra-cerebellar connectivity modulation across participants.
Conclusions:
Cerebellar cTBS did not confer a significant overall benefit on language recovery in PSA, but selectively improved repetition performance, suggesting domain-specific effects. Functional imaging indicated that rCrus I-centered connectivity changes were associated with behavioral outcomes, with marked inter-individual variability. These findings support a modulatory role of cerebellar cTBS on language networks, warranting further validation in larger, well-powered studies.
Trial Registration:
This trial was registered under the China Clinical Trial Registry (Registration No. ChiCTR2100049828).
