Functional Network Changes After High-Frequency rTMS Over the Most Activated Speech-Related Area Combined With Speech Therapy in Chronic Stroke With Non-fluent Aphasia

• Published in: Frontiers in neurology 2022-02, Vol.13, p.690048
• Main Authors: Chang, Won Kee, Park, Jihong, Lee, Ji-Young, Cho, Sungmin, Lee, Jongseung, Kim, Won-Seok, Paik, Nam-Jong
• Format: Article
• Language: English
• Subjects: aphasia; functional neuroimaging; Neurology; neuronal plasticity; stroke; transcranial magnetic stimulation
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2022.690048

High-frequency repetitive transcranial magnetic stimulation (HF-rTMS) to the lesional hemisphere requires prudence in selecting the appropriate stimulation spot. Functional near-IR spectroscopy (fNIRS) can be used in both selecting the stimulation spot and assessing the changes of the brain network. This study aimed to evaluate the effect of HF-rTMS on the most activated spot identified with fNIRS and assess the changes of brain functional network in the patients with poststroke aphasia. A total of five patients received HF-rTMS to the most activated area on the lesional hemisphere, followed by 30 min of speech therapy for 10 days. The Korean version of the Western aphasia battery (K-WAB) and fNIRS evaluation were done 1 day before the treatment, 1 day and 1 month after the last treatment session. Changes of K-WAB and paired cortical interaction and brain network analysis using graph theory were assessed. Aphasia quotient in K-WAB significantly increased after the treatment ( = 0.043). The correlation analysis of cortical interactions showed increased connectivity between language production and processing areas. Clustering coefficients of the left hemisphere were increased over a sparsity range between 0.45 and 0.58 (0.015 < < 0.031), whereas the clustering coefficients of the right hemisphere, decreased over a sparsity range 0.15-0.87 (0.063 < < 0.095). The global efficiency became lower over a network sparsity range between 0.47 and 0.75 (0.015 < < 0.063). Improvement of language function and changes of corticocortical interaction between language-related cortical areas were observed after HF-rTMS on the most activated area identified by fNIRS with combined speech therapy in the patients with poststroke aphasia.