Background Repetitive transcranial magnetic stimulation (rTMS) is a novel technology for the treatment of post-stroke aphasia, but its inaccurate positioning affects the treatment effect. Recently, little research has been performed focusing on the clinical efficacy of neuronavigational rTMS in post-stroke aphasia.
Objective To analyze and evaluate the safety and efficacy of neuronavigational rTMS in the treatment of subacute post-stroke non-fluent aphasia.
Methods This study was a randomized, double-blind, prospective clinical trial. From October 2020 to April 2022, patients with post-stroke non-fluent aphasia who were hospitalized in the Rehabilitation Medicine Department of the First Medical Center of Chinese PLA General Hospital were selected and randomly divided into neuronavigationed rTMS group (nTMS, n=15) and conventional international 10-20 EEG system guided rTMS group (cTMS, n=14). The regimens of both groups were low-frequency rTMS targeting right hemisphere pars triangularis (PTr). Before treatment and after 10 days of treatment, the safety of treatment was assessed by the Adverse Event Scoring Scale, and the language function was evaluated by Aphasia Battery of Chinese (ABC) within and between the groups.
Results There were 15 cases in the nTMS group, and 14 cases in the cTMS group, and no significant differences existed between the two groups in general data such as gender, age, and onset (P＞0.05). No adverse events occurred during the treatment. Before treatment, there was no significant difference in speech scores between the two groups (P＞0.05). After treatment, the spontaneous speech, comprehension, repetition, naming, reading, space and structure, and application of the nTMS group were significantly improved compared with those before treatment (P＜0.05); the comprehension, naming, and reading of the cTMS group were significantly improved compared with those before treatment (P＜0.05). Compared with cTMS group, the nTMS group had more significant improvement in repetition and naming scores (P＜0.05).
Conclusion Compared with conventional rTMS treatment, the neuronavigational low-frequency rTMS of the right inferior frontal gyrus triangle can significantly improve the naming and repetition functions of patients with subacute post-stroke non-fluent aphasia.
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