Xia Jiayi, Chen Yeping, Pei Song, Shan Chunlei, Zhang Jingjing, Zhou Zhiqing, Wu Jiali, Lu Yao, Chen Yiyi, Chen Yunjia
Clinical Research Centre, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.
Department of Rehabilitation Medicine, Renhe Hospital of Baoshan District, Shanghai, China.
Med Sci Monit. 2025 Jul 9;31:e947213. doi: 10.12659/MSM.947213.
Aphasia, a language impairment resulting from stroke or neurodegenerative disease, presents complex rehabilitation challenges. Recently, neuromodulation techniques such as transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and mirror neuron system (MNS) therapy have emerged as promising adjuncts to traditional speech-language therapy. This narrative review summarizes current advances in these 3 modalities. tDCS involves low-intensity electrical stimulation to modulate cortical excitability, with evidence supporting its use in post-stroke aphasia (PSA) and primary progressive aphasia (PPA). TMS, a magnetic stimulation technique, provides more precise cortical targeting through low- or high-frequency protocols and emerging paradigms such as intermittent theta-burst stimulation (iTBS). MNS therapy employs behavioral strategies like action observation and imitation to enhance motor-language pathways. The review also discusses the neural mechanisms underlying aphasia recovery, such as cortical reorganization and interhemispheric compensation, and examines the role of advanced tools such as functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) in guiding personalized treatment. Future directions include closed-loop stimulation, multimodal integration, and individualized protocols. This article aims to review recent developments in neuromodulation techniques for rehabilitating patients with aphasia, including transcranial direct current stimulation, transcranial magnetic stimulation, and mirror neuron system therapy.
失语症是由中风或神经退行性疾病导致的语言障碍,带来了复杂的康复挑战。最近,诸如经颅直流电刺激(tDCS)、经颅磁刺激(TMS)和镜像神经元系统(MNS)疗法等神经调节技术已成为传统言语治疗的有前景的辅助手段。这篇叙述性综述总结了这三种治疗方式的当前进展。tDCS涉及低强度电刺激以调节皮质兴奋性,有证据支持其在中风后失语症(PSA)和原发性进行性失语症(PPA)中的应用。TMS是一种磁刺激技术,通过低频或高频方案以及诸如间歇性theta爆发刺激(iTBS)等新兴模式提供更精确的皮质靶向。MNS疗法采用动作观察和模仿等行为策略来增强运动 - 语言通路。该综述还讨论了失语症恢复的神经机制,如皮质重组和半球间补偿,并研究了功能磁共振成像(fMRI)和扩散张量成像(DTI)等先进工具在指导个性化治疗中的作用。未来的方向包括闭环刺激、多模态整合和个性化方案。本文旨在综述用于失语症患者康复的神经调节技术的最新进展,包括经颅直流电刺激、经颅磁刺激和镜像神经元系统疗法。