Rewiring Speech: rTMS-enabled Recovery in Post-thrombolysis Aphasia

Despite timely thrombolysis, language recovery in post-stroke aphasia is highly variable. We report a patient with severe Broca’s aphasia following a left middle cerebral artery (MCA) infarct whose only verbal output for 6 weeks was the utterance “yani.” Introduction of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the right inferior frontal gyrus, combined with speech-language therapy, led to significant improvements, including production of 3-4-word length sentences with occasional paraphasia. This case highlights how neuromodulation may unlock recovery when conventional therapy alone stalls and provides a way forward. Informed consent was obtained for publication.