Abstract DP396: The beneficial effect of repetitive transcranial cerebellar magnetic stimulation in the rehabilitation of post-stroke aphasia

Objective: Recent evidence shows transcranial magnetic stimulation (TMS) enhances language recovery in post-stroke aphasia (PSA), but optimal targets remain unclear. Studies show extensive neural connections between the cerebellum and frontal cortex. For PSA patients, non-invasive electrical stimulation of the contralateral cerebellum significantly improves language function. This study compares repetitive TMS (rTMS) effects between contralateral cerebellum and right Broca mirror area stimulation on language function, non-verbal cognition, and daily living skills in PSA patients to optimize rehabilitation strategies. Methods: Patients with PSA due to left hemisphere strokes were randomly assigned to three groups: one targeting the right hemisphere’s Broca mirror area, another targeting the contralateral cerebellum, and a control group. All received standard speech-language therapy; intervention groups additionally received 1Hz rTMS at respective targets pre-therapy. Assessments included: 1. Language: Western Aphasia Battery, Boston Naming Test, Word Fluency Test. 2. Cognition: Loewenstein Occupational Therapy Cognitive Assessment. 3. Daily living: Activity of Daily Living Scale. Results: Of the 77 PSA patients, 25 were assigned to the Broca mirror area group, 26 to the contralateral cerebellum group, and 26 to the control group. 1. Language function: Contralateral cerebellum group showed significant improvement vs baseline (P<0.05) and outperformed controls (P<0.05). 2. Non-verbal cognition: This group improved significantly in orientation, visual perception, visual motor organization, and thinking operations (P<0.05), exceeding both control and Broca mirror area groups (P<0.05). 3. Daily living ability: Contralateral cerebellum group demonstrated significant improvement (P<0.05), surpassing control and Broca mirror area groups (P<0.05). Conclusions: 1. Both right Broca mirror area and contralateral cerebellum rTMS enhance PSA language function with similar efficacy. 2. Contralateral cerebellum stimulation improves non-verbal cognition more effectively than Broca mirror area stimulation. 3. Cerebellar targeting yields greater daily living ability improvements compared to Broca mirror area stimulation.