IMR Press / JIN / Volume 22 / Issue 1 / DOI: 10.31083/j.jin2201024
Open Access Original Research
Effects of the Left M1 iTBS on Brain Semantic Network Plasticity in Patients with Post-Stroke Aphasia: A Preliminary Study
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1 Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, 200040 Shanghai, China
2 Department of Rehabilitation Medicine, Jingan District Central Hospital Affiliated to Fudan University, 200040 Shanghai, China
3 Department of Rehabilitation Medicine, Changzhou Dean Hospital, 213000 Changzhou, Jiangsu, China
4 Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, 610075 Chengdu, Sichuan, China
5 Faculty of Sport and Science, Shanghai University of Sport, 200438 Shanghai, China
6 The Third Affiliated Hospital of Xinxiang Medical University, 453003 Xinxiang, Henan, China
7 Departmentof Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, 350122 Fuzhou, Fujian, China
*Correspondence: (Jie Jia)
These authors contributed equally.
Academic Editor: Hongmin Wang
J. Integr. Neurosci. 2023, 22(1), 24;
Submitted: 22 April 2022 | Revised: 13 June 2022 | Accepted: 14 June 2022 | Published: 17 January 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: The left primary motor area (M1) stimulation has recently been revealed to promote post-stroke aphasia (PSA) recovery, of which a plausible mechanism might be the semantic and/or the mirror neuron system reorganization, but the direct evidence is still scarce. The aim of this study was to explore the functional connectivity (FC) alterations induced by the left M1 intermittent theta burst stimulation (iTBS), a new transcranial magnetic stimulation paradigm, in the semantic and mirror neuron systems of PSA patients. Methods: Sixteen PSA patients accepted the left M1 iTBS and underwent a resting-state functional magnetic resonance image (fMRI) scanning before and immediately after the first session of iTBS, of which six underwent another fMRI scanning after twenty sessions of iTBS. Three brain networks covering the semantic and the mirror neuron systems were constructed using the fMRI data, and the FC alterations following one-session iTBS were investigated in the networks. Additional seed-based FC analyses were conducted to explore the longitudinal FC patterns changes during the course of multi-session iTBS. The Aphasia quotient of the Chinese version of the western aphasia battery (WAB-AQ) was used to assess the severity of the language impairments of the participants. The relationship between the longitudinal WAB-AQ and network FC changes was analyzed by Spearman’s correlation coefficients in the multi-session iTBS sub-group. Results: Decreased FCs were noted in the bilateral semantic rather than in the mirror neuron networks following one-session of iTBS (p < 0.05, network based statistical corrected). Longitudinal seed-based FC analyses revealed changing FC ranges along the multi-session iTBS course, extending beyond the semantic networks. No significant relationship was found between the longitudinal WAB-AQ and network FC changes in the multi-session iTBS sub-group. Conclusions: The left M1 iTBS might induce FC changes in the semantic system of PSA patients. Clinical Trial Registration: This research was registered on the Chinese Clinical Trial Registry website (, and the registration number is ChiCTR2100041936.

intermittent theta burst stimulation (iTBS)
resting-state functional connectivity (FC)
2018YFC2002300/National Key Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China
2018YFC2002301/National Key Research and Development Program of the Ministry of Science and Technology of the People’s Republic of China
91948302/National Natural Science Foundation of China
82021002/Innovative Research Group Project of National Natural Science Foundation of China
19YF1405200/Shanghai Sailing Program
Fig. 1.
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