Imagine you’re a language superhero and someone called you in to help save the day. You’ve heard about this cool new tool that uses magnets to stimulate the brain, called repetitive transcranial magnetic stimulation (rTMS). It’s been showing promise in helping people with post-stroke aphasia recover their language skills, but the results have been mixed. Now, scientists are turning their attention to the cerebellum – that’s the part of the brain responsible for coordinating movements and, as it turns out, also plays a role in language functions. They want to see if a particular type of rTMS called continuous theta burst stimulation (cTBS) can make a difference. In this study, they’re inviting 40 individuals with chronic post-stroke aphasia to participate. Half will receive real cTBS while the other half will get sham cTBS (a placebo). Everyone will also receive speech-language therapy. To measure progress, they’ll use tests like the Western Aphasia Battery, Boston Diagnostic Aphasia Examination, and speech acoustic parameters. They’ll even look at changes in brain connectivity using resting-state functional MRI. If successful, this protocol could be a game-changer in aphasia rehabilitation.

BackgroundLanguage recovery is limited in moderate to severe post-stroke aphasia patients. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising tool in improving language dysfunctions caused by post-stroke aphasia, but the treatment outcome is as yet mixed. Considerable evidence has demonstrated the essential involvement of the cerebellum in a variety of language functions, suggesting that it may be a potential stimulation target of TMS for the treatment of post-stroke aphasia. Theta burst stimulation (TBS) is a specific pattern of rTMS with shorter stimulation times and better therapeutic effects. The effect of continuous TBS (cTBS) on the cerebellum in patients with aphasia with chronic stroke needs further exploration.MethodsIn this randomized, sham-controlled clinical trial, patients (n = 40) with chronic post-stroke aphasia received 10 sessions of real cTBS (n = 20) or sham cTBS (n = 20) over the right cerebellar Crus I+ a 30-min speech-language therapy. The Western Aphasia Battery (WAB) serves as the primary measure of the treatment outcome. The secondary outcome measures include the Boston Diagnostic Aphasia Examination, Boston Naming Test and speech acoustic parameters. Resting-state fMRI data were also obtained to examine treatment-induced changes in functional connectivity of the cerebro-cerebellar network. These outcome measures are assessed before, immediately after, and 12 weeks after cerebellar cTBS intervention.DiscussionThis protocol holds promise that cerebellar cTBS is a potential strategy to improve language functions in chronic post-stroke aphasia. The resting-state fMRI may explore the neural mechanism underlying the aphasia rehabilitation with cerebellar cTBS.

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