Effect of Three Rehabilitation Methods Combined With Transcranial Electromagnetic Stimulation on Post-stroke Aphasia: A RCT Network Meta-Analysis

Frontiers in Neurology

Lin, X., Li, H., et al. (2025).

Frontiers in Neurology, 16, 1600065.

<div>This systematic review with network meta-analysis investigates the effects of combined speech and language treatments with transcranial electromagnetic stimulation on outcomes in individuals with post-stroke aphasia. The authors defined the rehabilitation methods as follows:</div> <div> <ul> <li>Traditional speech and language therapy (SLT) uses language training and rehabilitation exercises (e.g., phonation training, language comprehension or oral expression training) to improve language function.</li> <li>Comprehensive speech and language therapy (CSLT) incorporates advanced treatment methods (e.g., constraint-induced language therapy, multimodal aphasia therapy) with traditional speech therapy.</li> <li>Language cognitive therapy (LCT) adds cognitive training to traditional speech therapy (e.g., Behavioral Naming Therapy, Word Association Navigation Training).</li> </ul> </div>

No funding received

January 2000 to September 2024

<div>Randomized controlled trials</div>

14

<div>Combined speech and language treatments with transcranial electromagnetic stimulation (i.e., transcranial magnetic stimulation<br>[TMS] or transcranial direct current stimulation [tDCS]) demonstrated improved outcomes for individuals with post-stroke aphasia. SLT plus TMS or tDCS showed the greatest improvements in naming and repetition, and CSLT plus TMS or tDCS showed the greatest improvements in comprehension. Meta-analysis found the following standardized mean differences (SMD) for each type of treatment as compared to controls:</div> <div> <ul> <li>CSLT plus TMS or tDCS showed a non-significant effect on naming (SMD=0.88) and significant effects on comprehension (SMD=1.23) and repetition (SMD=1.22).</li> <li>LCT plus TMS or tDCS showed significant effects on naming (SMD=1.54), comprehension (SMD=0.81), and repetition (SMD=1.22).</li> <li>SLT plus TMS or tDCS showed a significant effect on naming (SMD=1.05) and non-significant effects on comprehension (SMD=0.62) and repetition (SMD=0.86).</li> </ul> </div> <div>Limitations of this review include heterogeneity in study designs, quality, and sample sizes. Additional large-scale research is needed to investigate personalizing treatment plans based on patient characteristics and the underlying mechanisms of combining treatments for individuals with post-stroke aphasia.</div>