Efficacy of intermittent theta burst stimulation in post-stroke Broca’s aphasia: a randomized controlled trial with multimodal neurophysiological assessment
Аннотация
Post-stroke Broca’s aphasia is a common and disabling condition, often resistant to conventional speech and language therapy (SLT). Intermittent theta burst stimulation (iTBS) is a neuromodulation technique with potential to promote neuroplasticity and improve language outcomes. Aim. To assess the clinical efficacy and neurophysiological effects of iTBS combined with SLT in patients with subacute post-stroke Broca’s aphasia. Materials and methods. In this randomized double-blind sham-controlled trial, 60 patients with subacute post-stroke Broca’s aphasia received active iTBS over the left inferior frontal gyrus (IFG) or sham stimulation alongside two weeks of standardized SLT. Language outcomes were assessed using the Western Aphasia Battery (WAB), alongside neuroimaging markers of cortical activation, EEG connectivity indices, functional independence (Barthel Index), and quality-of-life scales. Assessments were conducted at baseline, post-treatment, and at 1, 3, and 6 months. Results. The iTBS group showed significantly greater gains in WAB Aphasia Quotient (p<0.001; d=1.63). fMRI revealed increased BOLD activity in the left IFG, and EEG indicated enhanced alpha coherence and reduced interhemispheric asymmetry. Functional and quality of life scores improved significantly in the iTBS group compared to sham. Conclusions. iTBS combined with SLT significantly improves language recovery and cortical excitability in subacute post-stroke Broca’s aphasia.