Effect of High Frequency Transcranial Magnetic Stimulation on Recovery of Chronic Post-Stroke Aphasia

•Repetitive TMS has some potential to be an adjuvant therapy for chronic post-stroke expressive nonfluent aphasia.•This study provided a preliminary evidence that excitatory rTMS applied to the affected Broca's area improves language skills in patients with chronic post-stroke aphasia in short and long term.•Excitatory rTMS protocol appeared to be a safe modality, thus it should be further tested in blinded studies on larger sample size assessing its safety and efficacy for post-stroke aphasia rehabilitation. Both hemispheres have role in post-stroke aphasia recovery but better recovery is expected with the restoration of function by the left hemisphere. Transcranial stimulation has been used to favor recruitment of left-hemispheric language networks and increase activity of the left hemisphere, thus helps aphasia recovery The aim of this study is to evaluate the effect of excitatory repetitive transcranial magnetic stimulation (rTMS) on recovery of post stroke aphasic patients Twenty patients with post stroke chronic aphasia were enrolled in the study. Aphasia severity was assessed using Aphasia Severity Rating Scale (ASRS). Linguistic deficits were assessed using Kasr Al-Aini Arabic Aphasia test (KAAT). Real rTMS was applied three for 10 sessions of 10-Hz stimulation, positioned over the left Broca's area of the affected hemisphere. All patients were evaluated before, after the end of treatment sessions and one month later There was a significant improvement in the mean total score and mean scores of components of KAAT scale before, immediately after and after one month of rTMS (P< 0.05). Moreover, there was a significant improvement in mean scores of ASRS before, immediately after and after one month of rTMS (P= 0.000). There was a significant difference in mean scores of ASRS and KAAT before, immediately after the last session and after one month between small, medium and large brain infarcts. (P< 0.05). Excitatory rTMS is a beneficial adjuvant therapy that improves language skills in patients with chronic post-stroke non-fluent aphasia in short and long term. The protocol of this observational study was registered in clinical trial registration: www.ClinicalTrials.gov, identifier: NCT04708197