Low-frequency repetitive transcranial magnetic stimulation for patients with aphasia after stoke: A meta-analysis.

Abstract

To perform a meta-analysis of studies investigating the effects of low-frequency repetitive transcranial magnetic stimulation on post-stroke aphasia. Studies were identified by performing a search of electronic databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Knowledge) for articles published until June 2014. Randomized controlled trials (RCTs) reporting treatments with low-frequency repetitive transcranial magnetic stimulation in patients with post-stroke aphasia were included. The outcomes included naming, repetition, comprehension, changes in brain excitability, and adverse events. Two independent reviewers extracted the data. Study quality was evaluated with the PEDro scale. Of the 879 articles identified, 4 RCTs were included in the final analysis. Data synthesis showed that low-frequency repetitive transcranial magnetic stimulation was beneficial for post-stroke patients in terms of naming (standard mean difference (SMD) 0.51; 95% confidence interval (95% CI) 0.16-0.86) and changes in brain excitability (7.6 ± 33.55; 95% CI -10.7-26.20). However, the changes in repetition (SMD 0.31; 95% CI -0.04-0.65) and comprehension (SMD 0.31; 95% CI -0.14-0.75) after stimulation were not significant. No adverse effects were reported. The included studies were of high methodological quality. These findings indicate that low-frequency repetitive transcranial magnetic stimulation is an effective treatment for recovery of naming. In addition, this treatment favours reorganization of the left-hemispheric language networks.