Factors associated with effective inhibitory repetitive transcranial magnetic stimulation (rTMS) to homologous language structures for persons with post-stroke aphasia
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The purpose of this report is to identify parameters associated with language improvement from inhibitory repetitive transcranial magnetic stimulation (rTMS) to homologous language structures in stroke survivors with aphasia. The communication outcomes documented in nine randomized controlled studies (RCTs) of diverse post-stroke aphasia patients receiving 1-Hz rTMS to one or more right homologous language structures, with or without adjunctive speech-language therapy, are reviewed within this report. Associations are drawn between treatment outcomes of reviewed inhibitory rTMS studies to region(s) of the right hemisphere and a) aphasia severity, b) aphasia type, c) aphasia duration, d) lesion site, and e) rTMS stimulation site. Findings of various RCTs suggest variations of 1-Hz rTMS to homologous language structures can give rise language improvements in a heterogenous population of aphasia patients. However, shortcomings in the design of the reviewed studies confounds understanding of conditions associated with improved language abilities for aphasia patients receiving inhibitory rTMS to right hemisphere regions. Future studies should not only further investigate general effectiveness of rTMS for post-stroke aphasia patients but also aim to shed light on the specific parameters underlying language gains for post-stroke aphasia patients receiving inhibitory rTMS to homologous language structures.