Abstract TP175: Changes in Brain Network After High Frequency Repetitive Transcranial Magnetic Stimulation Based on Brain Activation During Language Performance in Chronic Stroke Patients With Non-Fluent Aphasia

Abstract

Introduction: In post-stroke aphasia rehabilitation, repetitive transcranial stimulation (rTMS) aimed to reinforce the activity of the brain regions in the left hemisphere. In the present study, we performed functional near-infrared spectroscopy (fNIRS) with excitatory rTMS treatment for selection of the most appropriate application of stimulation and detection of the changes in cortical brain network. The purpose of this study is to assess the changes in brain network after high frequency rTMS in post-stroke non-fluent aphasia patients. Methods: Five right-handed patients with post-stroke non-fluent aphasia were included in this study. The most activated area of left hemisphere in fNIRS analysis was selected for stimulation. 34 channels were set by arranging 12 sensors and detectors at intervals of 3cm covering Broca and Wernicke areas. Excitatory rTMS (10Hz, 800 stimuli, 100% of resting motor threshold, tangential to scalp) at the most activated area with navigation system was done in combination with 30 minutes’ speech therapy for 10 consecutive days. Western aphasia battery (WAB) and fNIRS evaluation before (T0), right after 10 sessions of treatment (T1) and 2 months after the last treatment session (T2) were done. The changes in brain network were analyzed by the graph theoretical approach. Results: The scores from subtests in WAB have increased after excitatory rTMS combined with speech therapy in all subjects (Figure 1). The thresholded correlation in the area of stimulation became higher in all patients. The changes of network parameters such as global efficiency and small-worldness in Broca and Wernicke area was significant after rTMS in all patients. Conclusion: Aphasia quotient and scores from all subtests in WAB have increased significantly after targeted excitatory rTMS combined with speech therapy in all subjects. The efficiency in brain language network has been changed after excitatory rTMS.