Improved receptive and expressive language abilities in nonfluent aphasic stroke patients after application of rTMS: An open protocol case series

Evidence For the Use of Transcranial Magnetic Stimulation As An Effective Therapeutic Option For Aphasia

“…With this in mind, the direct manipulation of cortical brain activity by repetitive TMS (rTMS) is posited as an efficacious complimentary rehabilitatory treatment for patients with post-stroke aphasia. Prospectively, rTMS may aid in the alleviation of some language disturbances associated with post-stroke aphasia via the reorganization of neural language networks [1][2][3][4][5][6][7].…”

“…Nonetheless, evidence available to date mainly consists of case-based reports [3][4][5]7], complemented by a small number of placebo-controlled trials [1,2,6] and is thus still considered rudimentary and largely inadequate to draw decisive conclusions regarding its therapeutic efficacy. It is widely acknowledged, however, that TMS has a highly valuable clinical application to stroke, and potentially, to other brain injured populations with acquired language disorders and even motor speech disorders.…”

“…Both high-and low-frequency forms of rTMS, including theta burst stimulation, have been applied to patients with aphasia, with positive longitudinal reports for language outcomes [1][2][3][4][5][6][7]. Investigations range from chronically impaired aphasic patients (at least 6 months post-stroke) [1][2][3][4][5] to subacute populations (2-7 weeks poststroke) [6].…”

“…Investigations range from chronically impaired aphasic patients (at least 6 months post-stroke) [1][2][3][4][5] to subacute populations (2-7 weeks poststroke) [6]. The most promising language outcomes post-TMS reported to date report improvements in picture naming and expressive language function.…”

“…The most promising language outcomes post-TMS reported to date report improvements in picture naming and expressive language function. However, the suggestion of the 'wider reaching effects' of TMS to extend to other aspects of the impaired language system (e.g., receptive language) are consistently debated and have been reported in some investigations [3,10,11]. Functional imaging methods including functional MRI [12] and PET [6], and event-related brain potentials [13,14] have provided complimentary evidence regarding the neurophysiological influence of rTMS on neural language processing.…”