Effect of Theta Burst Transcranial Magnetic Stimulation on Post-Stroke Aphasia Based on Different Stimulation Targets in the Cerebral Cortex

Currently, the population affected by post-stroke aphasia (PSA) is increasing steadily and clinically these patients present with speech impairments of varying degrees. As a unique core cognitive and social function specific to humans, speech ability is crucial across multiple dimensions, including physical and mental health as well as cultural inheritance. However, the cerebral mechanisms underlying the onset and recovery of PSA remain unclear, and traditional treatments yield suboptimal results, prompting researchers to continuously explore new therapeutic approaches. Transcranial magnetic stimulation (TMS) is a non-invasive, safe brain stimulation technique. <italic>Theta</italic> burst transcranial magnetic stimulation (TBS), a specialized TMS mode, offers advantages such as short treatment duration, low intensity, strong efficacy, and minimal side effects, leading to its growing clinical application in recent years. This article reviews the characteristics, common parameters, and safety of TBS; notably, therapeutic effects on PSA patients vary with different TBS parameters, and more research is needed to identify the optimal parameters. Existing studies suggest that the therapeutic mechanisms for PSA include regulating cerebral metabolism, improving functional network connectivity, and promoting interhemispheric excitatory balance. Current domestic and international research results indicate that when TBS acts on cerebral cortical regions, such as the inferior frontal gyrus, primary motor cortex, Wernicke's area, and dorsolateral prefrontal cortex, it can improve one or more of the subdomains of speech function, including spontaneous speech, auditory comprehension, repetition, and naming, which suggests that TBS has potential clinical significance for the recovery of speech function in PSA patients. In addition, therapeutic regimens combining bilateral or unilateral multi-target TBS stimulation with speech training can achieve functional complementarity, and due to the short duration of TBS, multi-target stimulation is highly feasible. Currently, research has limitations such as focusing mainly on short-term effects and lacking of long-term data. In the future, it is necessary to explore more potential targets such as the cerebellum, combine neuropsychological scales with imaging techniques to evaluate long-term efficacy and further explore cerebral mechanisms, so as to provide a basis for precise treatment of PSA.