ClinicalTrials.gg
RecruitingNCT05303649Updated Mar 31, 2026

Effects of Neuronavigated Theta Burst Stimulation in Therapy of Post-stroke Aphasia

An interventional study of Noninvasive transcranial brain stimulation: excitatory iTBS and Noninvasive transcranial brain stimulation: inhibitory cTBS in Stroke, Ischemic and Aphasia Non Fluent, sponsored by Institute of Psychiatry and Neurology, Warsaw. Recruiting at 1 site in Poland. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-03-31.

Sponsored by Institute of Psychiatry and Neurology, Warsaw · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2022; still recruiting 4 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
45
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Aphasia is an impairment in the ability to express and/or understand language, commonly observed after stroke to the language dominant (left) hemisphere. Despite natural tendency to spontaneous functional recovery in the first months post stroke and language improvement due to application of behavioral speech and language therapy (SLT), many aphasic patients do not achieve satisfactory level of verbal communication. The aim of the planned study is to explore the potential of the noninvasive repetitive Transcranial Magnetic Stimulation (rTMS) as a therapeutic tool for aphasia in addition to traditional behavioral therapy. In case of aphasia, studies on therapeutic effectiveness of rTMS aim to increase the activity of the language-dominant left cerebral hemisphere, which may be achieved in an indirect manner by inhibiting the activity of the opposite (right) hemisphere or in a direct manner by increasing the excitability of preserved language areas in the left hemisphere. In our study, we plan to administer the newest form of rTMS called Theta Burst Stimulation (TBS), which is safer than the conventional rTMS, even when used in the perilesional area. Computer-based neuronavigation system will be implemented to precisely localize stimulation targets, control administration of stimuli during rTMS sessions, and evaluate differences between participants regarding deviations from established stimulation points. 45 patients (all right-handed, polish native speakers, aged 18-75 years, diagnosed with non-fluent aphasia) will be enrolled in a randomized, double-blind, sham-controlled trial. Subjects will be randomly assigned to one of the three groups: 1) a group with excitatory intermittent TBS of the left hemisphere (iTBS group), 2) a group with inhibitory continuous TBS of the right hemisphere (cTBS group), 3) a group with sham TBS (sTBS group as a control group). Specific forms of stimulation will be carried out for three consecutive weeks (Monday to Friday; a total of 15 stimulation sessions). Immediately after each session of the stimulation, patients will undergo individual SLT. Assessment of language functioning will be carried out three times: before and after the therapy period, and 3 months after its completion. Results of the study will broaden knowledge about hemispherical mechanisms of language and speech recovery after stroke and provide insight into possibilities of their modulation for the purpose of post-stroke rehabilitation.

02

Conditions studied

  • Stroke, Ischemic
  • Aphasia Non Fluent

Keywords

  • Aphasia
  • Stroke
  • Theta Burst Stimulation
  • Therapy
  • Rehabilitation
  • Noninvasive Transcranial Brain Stimulation
03

In context

Ischemic Stroke

2,612 studies on the registry are indexed under Ischemic Stroke; 971 are open to participants now.

This study's planned enrollment of 45 is below the median of 120 across 1,776 interventional studies indexed under Ischemic Stroke.

Browse Ischemic Stroke studies →

Lead sponsor

Institute of Psychiatry and Neurology, Warsaw is the lead sponsor of 5 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • First-ever left middle cerebral artery ischemic stroke (brain damage localization confirmed by magnetic resonance imaging, MRI)
  • 3 or more months from the onset of stroke
  • Non-fluent aphasia (confirmed in the BDAE test) with functional communication difficulties ranging from mild to significant (grades from 2 to 4 in ASRS), marked difficulties in naming, and relatively preserved everyday speech comprehension
  • Native Polish speaker
  • Right-handedness prior to stroke
  • Signing of the for the participation in the study.

Exclusion criteria

Exclusion Criteria:

  • Psychiatric and/or neurological comorbidity (e. g. dementia, depressive disorder, alcohol dependence)
  • Diagnose of epilepsy or epileptic changes in EEG, also frequent losses of consciousness of unclear etiology which might suggest epileptic seizures
  • History of any neurosurgical procedure around the head area
  • 1.5 T MRI examination (metal elements in the body, e. g. implantable cardioverter-defibrillator, deep brain stimulation devices; claustrophobia)
  • Regular intake of medication that could affect cortical excitability (e. g. antiepileptic or antipsychotic drugs, antidepressants, benzodiazepines) or medication influencing neuroplastic processes (e. g. dopamine)
  • Significant cognitive impairment limiting patient's cooperation during assessment and behavioral aphasia therapy
  • Visual deficits significantly hindering the perception of therapeutic tasks presented visually on a computer's screen
  • New neurological episode (e. g. another brain stroke) or somatic illness (e. g. COVID-19) during the cycle of the therapy, requiring its interruption.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
45 participants (estimated)

Study arms

  • Experimental
    Intermittent TBS (iTBS) of the left hemisphere plus behavioral aphasia therapy

    15 sessions of 200-second of iTBS over the pars triangularis of Broca's area in the left hemisphere (BA 45), preceding 45-minutes of behavioral aphasia therapy.

    Device: Noninvasive transcranial brain stimulation: excitatory iTBS · Behavioral: Individual speech-language therapy (SLT)

  • Experimental
    Continuous TBS (cTBS) of the right hemisphere plus behavioral aphasia therapy

    15 sessions of 40 seconds of cTBS over the pars triangularis of the right inferior frontal gyrus (BA 45 homologue), preceding 45-minutes of behavioral aphasia therapy.

    Device: Noninvasive transcranial brain stimulation: inhibitory cTBS · Behavioral: Individual speech-language therapy (SLT)

  • Sham comparator
    Sham TBS (sTBS) of the left hemisphere plus behavioral aphasia therapy

    15 sessions of sham TBS over the pars triangularis of Broca's area in the left hemisphere (BA 45), preceding 45-minutes of behavioral aphasia therapy.

    Behavioral: Individual speech-language therapy (SLT) · Device: Sham TBS simulating left hemispheric iTBS

Interventions

  • DeviceNoninvasive transcranial brain stimulation: excitatory iTBS

    600 pulses (3 pulses at 50 Hz given every 200 milliseconds in 2-second trains at 10-second intervals, delivered at 80% of active motor threshold) generated by Magstim Super Rapid2 stimulator equipped with a figure-of-eight coil applied over BA 45 Device: Magstim Co., Wales, UK.

    Also known as: Magstim Super Rapid2

  • DeviceNoninvasive transcranial brain stimulation: inhibitory cTBS

    600 pulses (3 pulses at 50 Hz, repeated at 5 Hz, delivered at 80% of active motor threshold) generated by Magstim Super Rapid2 stimulator equipped with a figure-of-eight coil applied over BA 45 homologue Device: Magstim Co., Wales, UK.

    Also known as: Magstim Super Rapid2

  • BehavioralIndividual speech-language therapy (SLT)

    45 minutes training tailored to every patient's deficits, abilities and needs. Exercises used during each therapeutic session include: expressions tasks (naming and sentence building), complex utterances comprehension tasks, reading and writing exercises. Training is administered using paper-and-pencil tasks and computerized aphasia therapy program AfaSystem (Harpo sp.zoo, Poznań, Poland).

  • DeviceSham TBS simulating left hemispheric iTBS

    Sham TMS coil positioned exactly like an active TMS coil resulting in a very good approximation of the auditory effects Device: Magstim Co., Wales, UK.

    Also known as: Magstim Super Rapid2

06

What researchers measure

Primary outcomes

  1. Change from pre-treatment assessment in the performance on a picture naming task

    Total number of correctly named items (assessed: accuracy and speed of naming) from a set of 250 visually presented objects (200 noun names and 50 verb names; stimuli included in the set are diversified with regard to the articulation difficulty of corresponding words and their usage frequency in everyday speech).

    Time frame: Pre-treatment assessment (within 2 days before starting the intervention), post-treatment assessment (within 2 days of completing the 15 days intervention)

  2. Change from pre-treatment in the performance on the picture naming task at 3 months post-therapy (follow up assessment)

    Total number of correctly named items from a set of 250 visually presented objects.

    Time frame: Pre-treatment and 3 months follow-up (post-treatment) assessment

  3. Change from post-treatment in the performance on the picture naming task at 3 months post-therapy

    Total number of correctly named items from a set of 250 visually presented objects.

    Time frame: Post-treatment and 3 months follow-up assessment

  4. Change from pre-treatment assessment in the performance on a scene description task of three visually presented scenes

    (assessed: length and correctness of utterances).

    Time frame: Pre-treatment assessment, post-treatment assessment (within 2 days of completing the 15 days intervention)

  5. Change from pre-treatment in the scene description task at 3 months post-therapy

    Oral description of three visually presented scenes (assessed: length and correctness of utterances).

    Time frame: Pre-treatment and 3 months follow-up

  6. Change from post-treatment in the scene description task at 3 months post-therapy

    Oral description of three visually presented scenes (assessed: length and correctness of utterances).

    Time frame: Post-treatment and 3 months follow-up

  7. Change from pre-treatment on the semantic fluency task

    Producing within a minute as many words as possible from 3 semantic categories: animals, fruit, clothes; assessed: total number of correctly generated items.

    Time frame: Pre-treatment and post-treatment (within 2 days of completing the 15 days intervention)

  8. Change from pre-treatment on the semantic fluency task at 3 months post-therapy

    Total number of correctly generated items such as animals, fruits, clothes.

    Time frame: Pre-treatment and 3 months follow-up

  9. Change from post-treatment on the semantic fluency task at 3 months post-therapy

    Total number of correctly generated items such as animals, fruits, clothes.

    Time frame: Post-treatment and 3 months follow-up

Secondary outcomes

  1. Modified Communication Effectiveness Index (CETI)

    A questionnaire to complete by researcher and family member/caregiver. Contains descriptions of ten communication situations, patients' performance in each of them is assessed on a Likert-type scale (from 0 to 7). Higher score means better functional communication.

    Time frame: Pre-treatment, post-treatment (within 2 days of completing the 15 day intervention) and on 3-month follow-up

Other outcomes

  1. The Polish version of short form of the Boston Diagnostic Aphasia Examination (BDAE)

    Assesses the linguistic skills of adults with aphasia. This provides information for the diagnosis of the type of aphasia. Includes the six-point Goodglass and Kaplan's Aphasia Severity Rating Scale (ASRS; 0-5 points - lower score means more severe language impairment).

    Time frame: Screening appointment (pre-enrollment assessment)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Harvey DY, Mass JA, Shah-Basak PP, Wurzman R, Faseyitan O, Sacchetti DL, DeLoretta L, Hamilton RH. Continuous theta burst stimulation over right pars triangularis facilitates naming abilities in chronic post-stroke aphasia by enhancing phonological access. Brain Lang. 2019 May;192:25-34. doi: 10.1016/j.bandl.2019.02.005. Epub 2019 Mar 11. PubMed 30870740 ↗
  • Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta burst stimulation of the human motor cortex. Neuron. 2005 Jan 20;45(2):201-6. doi: 10.1016/j.neuron.2004.12.033. PubMed 15664172 ↗
  • Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, Filipovic SR, Grefkes C, Hasan A, Hummel FC, Jaaskelainen SK, Langguth B, Leocani L, Londero A, Nardone R, Nguyen JP, Nyffeler T, Oliveira-Maia AJ, Oliviero A, Padberg F, Palm U, Paulus W, Poulet E, Quartarone A, Rachid F, Rektorova I, Rossi S, Sahlsten H, Schecklmann M, Szekely D, Ziemann U. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol. 2020 Feb;131(2):474-528. doi: 10.1016/j.clinph.2019.11.002. Epub 2020 Jan 1. PubMed 31901449 ↗
  • Oberman L, Edwards D, Eldaief M, Pascual-Leone A. Safety of theta burst transcranial magnetic stimulation: a systematic review of the literature. J Clin Neurophysiol. 2011 Feb;28(1):67-74. doi: 10.1097/WNP.0b013e318205135f. PubMed 21221011 ↗
  • Rossi S, Hallett M, Rossini PM, Pascual-Leone A. Screening questionnaire before TMS: an update. Clin Neurophysiol. 2011 Aug;122(8):1686. doi: 10.1016/j.clinph.2010.12.037. Epub 2011 Jan 11. No abstract available. PubMed 21227747 ↗
  • Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008-2039. doi: 10.1016/j.clinph.2009.08.016. Epub 2009 Oct 14. PubMed 19833552 ↗
  • Shah PP, Szaflarski JP, Allendorfer J, Hamilton RH. Induction of neuroplasticity and recovery in post-stroke aphasia by non-invasive brain stimulation. Front Hum Neurosci. 2013 Dec 24;7:888. doi: 10.3389/fnhum.2013.00888. PubMed 24399952 ↗
  • Schlaug G, Marchina S, Wan CY. The use of non-invasive brain stimulation techniques to facilitate recovery from post-stroke aphasia. Neuropsychol Rev. 2011 Sep;21(3):288-301. doi: 10.1007/s11065-011-9181-y. Epub 2011 Aug 14. PubMed 21842404 ↗
  • Szaflarski JP, Griffis J, Vannest J, Allendorfer JB, Nenert R, Amara AW, Sung V, Walker HC, Martin AN, Mark VW, Zhou X. A feasibility study of combined intermittent theta burst stimulation and modified constraint-induced aphasia therapy in chronic post-stroke aphasia. Restor Neurol Neurosci. 2018;36(4):503-518. doi: 10.3233/RNN-180812. PubMed 29889086 ↗
  • Szaflarski JP, Vannest J, Wu SW, DiFrancesco MW, Banks C, Gilbert DL. Excitatory repetitive transcranial magnetic stimulation induces improvements in chronic post-stroke aphasia. Med Sci Monit. 2011 Feb 25;17(3):CR132-9. doi: 10.12659/msm.881446. PubMed 21358599 ↗
  • Ball LJ, Beukelman DR, Pattee GL. Communication effectiveness of individuals with amyotrophic lateral sclerosis. J Commun Disord. 2004 May-Jun;37(3):197-215. doi: 10.1016/j.jcomdis.2003.09.002. PubMed 15063143 ↗

Individual participant data

Plan to share: Undecided

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Sep 2022 (actual). Primary completion is estimated for Dec 2027, 63 months after the start.

Of 572 non-industry interventional studies with no phase under Ischemic Stroke, half reached primary completion within 28 months of starting (the median), counting those still running; a quarter within 14 and three quarters within 48. This study's planned 63 months is above that.

Counting every sponsor, half of 653 studies reached it within 27 months; a quarter within 14 and three quarters within 48.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 22, 2022
First posted
Mar 31, 2022
StartActual
Sep 2, 2022
Primary completionEst.
Dec 2027
CompletionEst.
Dec 2027
Last update
Mar 31, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 31, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05303649
Lead sponsor
Institute of Psychiatry and Neurology, Warsaw
Responsible party
Katarzyna Polanowska (Principal Investigator, Institute of Psychiatry and Neurology, Warsaw) — Principal investigator
First posted
Mar 31, 2022
Start date
Sep 2, 2022
Primary completion
Dec 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Mar 31, 2026

Study contacts

Katarzyna E Polanowska, PhD
Contact
kpolanowska@ipin.edu.pl
+48224582870
Szczepan Iwański, PhD
Contact
iwanski@ipin.edu.pl
+48224582870
Katarzyna E Polanowska, PhD
principal investigator · Institute of Psychiatry and Neurology, Warsaw, Poland

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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