AUTHOR=Chou Ting-Yu , Wang Jia-Chi , Lin Mu-Yun , Tsai Po-Yi 

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

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2021.800377

DOI=10.3389/fnagi.2021.800377

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>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.</p></sec><sec><title>Purpose</title><p>We investigated the efficacy of intermittent theta burst stimulation (iTBS) in ameliorating chronic non-fluent aphasia and compared it with that of LF-rTMS.</p></sec><sec><title>Methods</title><p>We randomly assigned patients with poststroke non-fluent aphasia to an ipsilesional iTBS (<italic>n</italic> = 29), contralesional 1-Hz rTMS (<italic>n</italic> = 27), or sham (<italic>n</italic> = 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).</p></sec><sec><title>Results</title><p>Compared with the sham group, the iTBS group exhibited significant improvements in conversation, description, and expression scores (<italic>P</italic> = 0.0004–0.031), which characterize verbal production, as well as in auditory comprehension, reading comprehension, and matching scores (<italic>P</italic> &lt; 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 (<italic>P</italic> &lt; 0.05). The iTBS group had significantly superior results in CCAT total score, matching and auditory comprehension (<italic>P</italic> &lt; 0.05) relative to the 1-Hz group.</p></sec><sec><title>Conclusion</title><p>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.</p></sec><sec><title>Clinical Trial Registration:</title><p>[<ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>], identifier [NCT03059225].</p></sec>