The effects of low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) and sham condition rTMS on behavioural language in chronic non-fluent aphasia: Short term outcomes

Introduction: The application of low frequency (1 Hz) Repetitive Transcranial Magnetic Stimulation (rTMS) to right hemisphere (RH) language homologues in non-fluent aphasic populations has yielded improvements in behavioural language function, up to 43 months post stimulation 32. Functional imaging studies have demonstrated RH language homologue "overactivation" post left inferior frontal gyrus (IFG) damage, in chronic non-fluent aphasia. The effects of low frequency (inhibitory) rTMS are postulated to be as a result of a reduction of overactivation in RH language homologues, facilitating the reorganisation of neural language networks. Methods: Low frequency (1 Hz) rTMS was applied to the anterior portion of a Broca's area homologue (pars triangularis), for 20 minutes per day for 10 days, using a stereotactic neuronavigational system. Twelve non-fluent aphasic patients (six real stimulation and six sham), 2-10 years post stroke were stimulated. Behavioural language outcome measures were taken at baseline and 1 week post rTMS. Results: Comparisons between the real stimulation and sham conditions indicated significant main effects between the stimulation and sham groups to 1 week post stimulation for naming accuracy, latency and repetition. Conclusions: This study indicates that rTMS has the capacity to modulate neural language networks, to facilitate improvements in behavioural language function, 1 week post TMS.