Recovery From Post-Stroke Aphasia With rTMS Targeting Left or Right Anterior Temporal Lobe
ATLAS
2 other identifiers
interventional
45
1 country
1
Brief Summary
This project aims to tailor repetitive Transcranial Magnetic Stimulation (rTMS) target to the clinical profile of post-stroke aphasia, specifically focusing on lexicosemantic impairments, to enhance recovery. Functional Magnetic Resonance Imaging (fMRI) will provide critical insights into the effects of facilitatory versus inhibitory stimulation on interhemispheric balance. Additionally, this study will generate new data on how lesion localization and brain connectivity influence individual responses to rTMS, explaining variability in treatment efficacy.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable stroke
Started May 2026
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
April 22, 2026
CompletedStudy Start
First participant enrolled
May 15, 2026
CompletedFirst Posted
Study publicly available on registry
May 27, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 30, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
July 30, 2027
May 29, 2026
May 1, 2026
1.2 years
April 22, 2026
May 26, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Picture Naming task accuracy
The primary outcome is improvement in accuracy of the a Picture Naming task. Participants will complete a Picture Naming tasks based on the Older Adult Naming Test. Participants will name items from pictures as quickly and accurately as possible. Items will include mid-frequency words and 10 pictures of middle-to-late age-of-acquisition words (mean = 10.01 years, SD = 1.16).
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
Secondary Outcomes (12)
Picture Naming Reaction time
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
Auditory Description Naming accuracy
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
Auditory Description Naming reaction time
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
Comprehensive Aphasia Test - cognitive screening
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
Comprehensive Aphasia Test - language score
Baseline assessment conducted within 7 days prior to intervention Post-intervention assessment conducted within 3 days after the final intervention session Follow-up assessment conducted 1 month after the end of the intervention
- +7 more secondary outcomes
Study Arms (3)
Inhibitory rTMS
EXPERIMENTALParticipants will receive inhibitory continuous Theta Burst Stimulation (cTBS) targeting the right ATL 5 times a week for 2 weeks. Each stimulation session will be followed by 30-min of Speech and Language Therapy using the Semantic Feature Analysis protocol.
Facilitatory rTMS
EXPERIMENTALParticipants will receive facilitatory intermittent Theta Burst Stimulation (iTBS) targeting the left ATL 5 times a week for 2 weeks. Each stimulation session will be followed by 30-min of Speech and Language Therapy using the Semantic Feature Analysis protocol.
Sham rTMS
SHAM COMPARATORParticipants will receive sham stimulation targeting either the left or right ATL with allocation balanced across participants, 5 times a week for 2 weeks. Each stimulation session will be followed by 30-min of Speech and Language Therapy using the Semantic Feature Analysis protocol.
Interventions
We will use continuous Theta Burst Stimulation (600 pulses, burst frequency at 5 Hz, burst of three pulses at 50Hz) targeting the right ATL
We will use intermittent Theta Burst Stimulation (600 pulses, burst frequency at 5 Hz, burst of three pulses at 50Hz, interval intertrain of 8 sec, 10 pulses in train) targeting the left ATL
We will use sham stimulation using the same coil but flipped over, with the left ATL targeted in half of the participant and the right ATL in the other half. The placebo coil will replicate the auditory sensations produced by active stimulation. In addition, we will use electrical stimulation of the scalp (via electrodes placed over specific muscles) in the Sham group to mimic the sensory effects of active stimulation. Participants will have no prior rTMS experience before inclusion in the protocol.
Participants will receive 30 minutes of Semantic Feature Analysis therapy administered by a Speech and Language Pathologist. On a computer screen, participants will see an image of an object and will be cued to retrieve the object's name by describing various features of the object, including its physical properties, typical location, personal associations, category, use and actions involving the object (Quique et al., 2019).
Eligibility Criteria
You may qualify if:
- Right-handedness (assesed using the Edinburgh Handedness Inventory)
- Native English speakers
- Single left hemispheric stroke
- Diagnosis of aphasia and lexicosemantic impairments (e.g., anomia, semantic errors in picture naming or spontaneous speech) confirmed by a Speech and Language Pathologist or Physician
You may not qualify if:
- Severely impaired auditory comprehension (WAB Comprehension score of 0 or 1)
- Major phonological impairments (defined as \> 2 errors in non-word repetition of one- and two-syllable items on the PALPA, 2)
- Contraindications to rTMS (e.g., uncontrolled epilepsy, history of seizures, intracranial ferromagnetic body, cochlear implant, or factors that lower seizure threshold (see Rossi et al., 2021)
- Contraindication to MRI
- Stroke involving the left ATL
- Severe depression or psychiatric history
- Illiteracy
- Known neurodegenerative disorders
- Severe uncorrected visual or hearing impairments
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
McCausland Center
Columbia, South Carolina, 29203, United States
Related Publications (6)
Quique YM, Evans WS, Dickey MW. Acquisition and Generalization Responses in Aphasia Naming Treatment: A Meta-Analysis of Semantic Feature Analysis Outcomes. Am J Speech Lang Pathol. 2019 Mar 11;28(1S):230-246. doi: 10.1044/2018_AJSLP-17-0155.
PMID: 30208415BACKGROUNDArheix-Parras S, Barrios C, Python G, Cogne M, Sibon I, Engelhardt M, Dehail P, Cassoudesalle H, Moucheboeuf G, Glize B. A systematic review of repetitive transcranial magnetic stimulation in aphasia rehabilitation: Leads for future studies. Neurosci Biobehav Rev. 2021 Aug;127:212-241. doi: 10.1016/j.neubiorev.2021.04.008. Epub 2021 Apr 20.
PMID: 33862065BACKGROUNDHilari K, Byng S, Lamping DL, Smith SC. Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39): evaluation of acceptability, reliability, and validity. Stroke. 2003 Aug;34(8):1944-50. doi: 10.1161/01.STR.0000081987.46660.ED. Epub 2003 Jul 10.
PMID: 12855827BACKGROUNDNippold MA, Mansfield TC, Billow JL. Peer conflict explanations in children, adolescents, and adults: examining the development of complex syntax. Am J Speech Lang Pathol. 2007 May;16(2):179-88. doi: 10.1044/1058-0360(2007/022).
PMID: 17456896BACKGROUNDRossi S, Antal A, Bestmann S, Bikson M, Brewer C, Brockmoller J, Carpenter LL, Cincotta M, Chen R, Daskalakis JD, Di Lazzaro V, Fox MD, George MS, Gilbert D, Kimiskidis VK, Koch G, Ilmoniemi RJ, Lefaucheur JP, Leocani L, Lisanby SH, Miniussi C, Padberg F, Pascual-Leone A, Paulus W, Peterchev AV, Quartarone A, Rotenberg A, Rothwell J, Rossini PM, Santarnecchi E, Shafi MM, Siebner HR, Ugawa Y, Wassermann EM, Zangen A, Ziemann U, Hallett M; basis of this article began with a Consensus Statement from the IFCN Workshop on "Present, Future of TMS: Safety, Ethical Guidelines", Siena, October 17-20, 2018, updating through April 2020. Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clin Neurophysiol. 2021 Jan;132(1):269-306. doi: 10.1016/j.clinph.2020.10.003. Epub 2020 Oct 24.
PMID: 33243615BACKGROUNDArheix-Parras S, Moore SR, Desai RH. Improving Lexicosemantic Impairments in Post-Stroke Aphasia Using rTMS Targeting the Right Anterior Temporal Lobe. Brain Sci. 2026 Jan 22;16(1):117. doi: 10.3390/brainsci16010117.
PMID: 41594838BACKGROUND
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Postdoctoral Fellow
Study Record Dates
First Submitted
April 22, 2026
First Posted
May 27, 2026
Study Start
May 15, 2026
Primary Completion (Estimated)
July 30, 2027
Study Completion (Estimated)
July 30, 2027
Last Updated
May 29, 2026
Record last verified: 2026-05
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
- Time Frame
- Data will be made available upon publication of the respective study. Data will remain accessible for at least 10 years post-publication.
- Access Criteria
- Interested research will be able to access the following data : - De-identified behavioral data (reaction time, accuracy, transcription) at be shared publicly using OSF * Audio recordings will not be shared due to confidentiality risks * Neuroimaging data (structural and functional MRI) will be shared after de-identification (face removal) in OpenNeuro * Aggregate results will be disseminated via peer-reviewed publications and conference presentations. * Study protocol, task descriptions, and analysis pipelines will be documented in manuscripts * Metadata describing participant demographics (e.g., age, gender, stroke type, lesion location) will be included in shared dataset and available in manuscripts * Documentation will be provided upon request to facilitate data interpretation
The expected data types include: * Behavioral data: Accuracy and reaction times measures for cognitive and language tasks. * Neuroimaging data: Structural MRI (T1 and T2 weighted) and functional MRI (resting state and task-based, for around 15 minutes per session)