Long-Term Transcranial Magnetic Stimulation Combined with Language Therapy May Slow Progression of Aphasia

Recent research conducted at Hospital Clínico San Carlos in Madrid suggests that prolonged treatment using transcranial magnetic stimulation (TMS), specifically an intermittent theta-burst protocol, combined with targeted language therapy, can positively influence the progression of primary progressive aphasia (PPA). Over a period of six months, participants receiving active TMS alongside language therapy experienced less decline in brain metabolism and showed improvements in language skills, daily functioning, and neuropsychiatric symptoms.

Primary progressive aphasia is a neurodegenerative disorder characterized by an insidious onset of speech and language difficulties, often serving as an initial presentation of conditions such as Alzheimer's disease and other frontotemporal degenerations. It manifests in three variants: nonfluent/agrammatic, semantic, and logopenic. While speech-language therapy has demonstrated benefits, the potential of noninvasive brain stimulation techniques like TMS has garnered increasing interest.

The study, published in JAMA Network Open, involved 63 participants who were randomly assigned to either active TMS or sham stimulation. The participants underwent a two-week intensive phase with daily sessions, followed by weekly maintenance sessions over 22 weeks, immediately after which language therapy was administered. The TMS protocol employed consisted of 600 pulses at a frequency of 50 Hz, delivered across 20 cycles with specific parameters to ensure safety and efficacy.

Results showed that the group receiving active TMS had less reduction in brain metabolism, as indicated by the standardized uptake value ratio (SUVR), with a mean SUVR of 0.78 compared to 0.77 in the sham group at six months. Language assessments revealed significant improvements in lexical retrieval and naming ability, with trained item naming increasing notably in the active group. Functional measures indicated a decline in daily activities in the sham group but improvements in the active group, although speech rate did not significantly differ between groups.

Safety analysis reported two serious adverse events in the sham group, unrelated to the stimulation, emphasizing the safety profile of the TMS protocol. Researchers conclude that long-term TMS combined with language therapy offers a promising approach to slowing the neurodegenerative progression of PPA, providing new avenues for treatment of language impairments associated with neurodegenerative diseases.

This study underscores the potential of combining neuromodulation with behavioral therapy to improve clinical outcomes in neurodegenerative conditions, highlighting a significant step forward in personalized medicine for aphasia management.

source: https://medicalxpress.com/news/2025-08-term-transcranial-magnetic-language-therapy.html