Low-Frequency vs. Theta Burst Transcranial Magnetic Stimulation for the Treatment of Chronic Non-fluent Aphasia in Stroke: A Proof-of-Concept Study.

Abstract

BACKGROUND:

Although low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) has shown promise in the treatment of poststroke aphasia, the efficacy of high-frequency rTMS (HF-rTMS) has yet to be determined.

PURPOSE:

We investigated the efficacy of intermittent theta burst stimulation (iTBS) in ameliorating chronic non-fluent aphasia and compared it with that of LF-rTMS.

METHODS:

We randomly assigned patients with poststroke non-fluent aphasia to an ipsilesional iTBS (n = 29), contralesional 1-Hz rTMS (n = 27), or sham (n = 29) group. Each group received the rTMS protocol executed in 10 daily sessions over 2 weeks. We evaluated language function before and after the intervention by using the Concise Chinese Aphasia Test (CCAT).

RESULTS:

Compared with the sham group, the iTBS group exhibited significant improvements in conversation, description, and expression scores (P = 0.0004-0.031), which characterize verbal production, as well as in auditory comprehension, reading comprehension, and matching scores (P < 0.01), which characterize language perception. The 1-Hz group exhibited superior improvements in expression, reading comprehension, and imitation writing scores compared with the sham group (P < 0.05). The iTBS group had significantly superior results in CCAT total score, matching and auditory comprehension (P < 0.05) relative to the 1-Hz group.

CONCLUSION:

Our study findings contribute to a growing body of evidence that ipsilesional iTBS enhances the language recovery of patients with non-fluent aphasia after a chronic stroke. Auditory comprehension was more preferentially enhanced by iTBS compared with the 1-Hz protocol. Our findings highlight the importance of ipsilesional modulation through excitatory rTMS for the recovery of non-fluent aphasia in patients with chronic stroke.

CLINICAL TRIAL REGISTRATION:

[www.ClinicalTrials.gov], identifier [NCT03059225].

• Authors: Ting-Yu Chou, Jia-Chi Wang, Mu-Yun Lin, Po-Yi Tsai
• Journal: Frontiers in aging neuroscience (Front Aging Neurosci) Vol. 13 Pg. 800377 ( 2021) ISSN: 1663-4365 [Print] Switzerland
• PMID: 35095477 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Chou, Wang, Lin and Tsai.