Personalized Transcranial Magnetic Stimulation and Constraint Induced Language Therapy to Treat Mild Post-Stroke Aphasia

Project Summary Although mild post-stroke aphasia is often disabling, there are no accepted treatments for this condition. Transcranial Magnetic Stimulation (TMS) in conjunction with Speech-Language Therapy, has been demonstrated to improve language function in subjects with moderate to severe chronic aphasia. We propose

to study the effects of continuous Theta Burst Stimulation (a type of TMS) combined with a modified form of Constraint Induced Language Therapy (mCILT) in 24 subjects with chronic, mild (operationally defined as Western Aphasia Battery – Revised Aphasia Quotient >85) post-stroke aphasia. Subjects will be randomized in

a 2:1 ratio to cTBS with mCILT or sham cTBS with mCILT. After pre-treatment evaluation, subjects will receive 10 days of treatment; post-treatment evaluations will be performed 3-5 days and again at 2 and 4 months after the completion of treatment. We will use electrical field modelling to personalize stimulation intensity for each

subject. Change from baseline to 4 months post-treatment on measures of language performance previously demonstrated to distinguish people with mild, post-stroke aphasia from neurotypical will serve as the primary outcome measure. A secondary aim is to explore the effects of the treatment on non-linguistic cognitive

functions and assess their role in the genesis of the communication impairment in mild aphasia.