The effects of transcranial magnetic stimulations on non-fluent aphasia following stroke

Objective To explore the effects and mechanism of repetitive transcranial magnetic stimulation (rTMS) applied to the right Broca's homologue of stroke patients with non-fluent aphasia.Methods One stroke patient with non-fluent aphasia received rTMS at 1 Hz and another received the same treatment at 10 Hz.The western aphasia battery (WAB) and functional magnetic resonance imaging (fMRI) were used to evaluate their language function before and after the intervention.Results After treatment,language function in both patients had improved significantly.The aphasia quotient (AQ) score of patient 1 had improved from 37.2 to 66.6,and the AQ score of patient 2 had improved from 36.2 to 60.8.Before treatment,patient 1's activated brain areas during a vocabulary reading task were the left anterior central gyrus and the left gyrus frontalis medius.After the 1 Hz rTMS treatment the activated brain areas were the left medial surface of the lobus frontalis,the left gyrus frontalis inferior,the left prefrontal area,the left preinsula,the left lobulus parietalis inferior,and the left middle/inferior temporal gyrus.Before the 10 Hz rTMS treatment,patient 2's activated brain areas with the same vocabulary reading task were the bilateral medial surface of the temporal lobe,and the bilateral anterior central gyrus.After treatment the bilateral medial surface gyrus,the frontalis medius and lobus frontalis,the right gyrus frontalis inferior,the left prefrontal area,the bilateral lobulus parietalis superior,and the right superior/middle temporal gyrus were activated.Conclusion rTMS can significantly improve language function in stroke patients with non-fluent aphasia.Patients with smaller lesions in the left hemisphere language area can achieve hemisphere function restructuring.Larger lesions in the left hemisphere language area will probably yield bilateral restructuring in both hemispheres. Key words: Stroke;  Transcranial magnetic stimulation;  Non-fluent aphasia