{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:08:08Z","timestamp":1775797688924,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-stroke language impairment and dysphagia frequently co-occur and can substantially hinder recovery, daily communication, and safe oral intake. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as an adjunct to conventional rehabilitation, yet evidence on coordinated improvement across both domains remains limited, particularly in studies using clinically interpretable outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this sham-controlled prospective study, 113 patients with post-stroke communication and swallowing impairment were enrolled and allocated to either active rTMS combined with conventional rehabilitation or sham stimulation plus the same rehabilitation program. The intervention lasted 2 weeks, with follow-up assessment after treatment completion. Clinical outcomes were evaluated at baseline, immediately after the intervention, and at follow-up using established measures of language performance, swallowing safety, and oral intake. Safety events and selected care-related indicators were also documented. Because no neurophysiological or neuroimaging markers were collected, mechanistic interpretation was limited to theory-informed inference based on observed clinical patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both groups improved over time. Compared with sham stimulation plus rehabilitation, the active rTMS group showed greater improvement in language-related and swallowing-related outcomes and maintained a more favorable recovery profile at follow-up. Directionally similar trends were observed across secondary clinical indicators, and no increase in safety risk was identified during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>rTMS administered before task-oriented rehabilitation was associated with improved short-term recovery in post-stroke language and swallowing function, with acceptable tolerability. These findings support further investigation of rTMS as an adjunct to multidisciplinary neurorehabilitation. Future randomized studies with longer follow-up and direct neurophysiological measures are needed to clarify mechanisms, durability of benefit, and patient-level heterogeneity in treatment response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1810365","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:26:51Z","timestamp":1775795211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes of rTMS-augmented rehabilitation for post-stroke language and swallowing dysfunction: a sham-controlled prospective study with theory-informed interpretation"],"prefix":"10.3389","volume":"17","author":[{"given":"Li","family":"Sun","sequence":"first","affiliation":[{"name":"Rehabilitation Medicine Department, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Gao","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Qiu","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Gu","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, Affiliated Hospital of Nantong University","place":["Nantong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.12786\/bn.2021.14.e6","article-title":"Safety review for clinical application of repetitive transcranial magnetic stimulation","volume":"14","author":"Kim","year":"2021","journal-title":"Brain Neurorehabil."},{"key":"B2","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.clinph.2020.10.003","article-title":"Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: expert guidelines","volume":"132","author":"Rossi","year":"2021","journal-title":"Clin Neurophysiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.clinph.2019.11.002","article-title":"Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014\u20132018)","volume":"131","author":"Lefaucheur","year":"2020","journal-title":"Clin Neurophysiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.clinph.2020.11.018","article-title":"Training in the practice of noninvasive brain stimulation: recommendations from an IFCN committee","volume":"132","author":"Fried","year":"2021","journal-title":"Clin Neurophysiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/j.clinph.2020.12.013","article-title":"Feasibility of TMS in patients with new generation cochlear implants","volume":"132","author":"Mandal\u00e0","year":"2021","journal-title":"Clin Neurophysiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e080289","DOI":"10.1136\/bmjopen-2023-080289","article-title":"Comparison of the efficacy and tolerability of different repetitive transcranial magnetic stimulation modalities for post-stroke dysphagia: a systematic review and Bayesian network meta-analysis protocol","volume":"14","author":"Chen","year":"2024","journal-title":"BMJ Open."},{"key":"B7","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1177\/15459683231166940","article-title":"Comparative effectiveness of combined and single neurostimulation and traditional dysphagia therapies for post-stroke dysphagia: a network meta-analysis","volume":"37","author":"Banda","year":"2023","journal-title":"Neurorehabil Neural Repair."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1355407","DOI":"10.3389\/fnhum.2024.1355407","article-title":"The effectiveness of transcranial magnetic stimulation for dysphagia in stroke patients: an umbrella review of systematic reviews and meta-analyses","volume":"18","author":"Georgiou","year":"2024","journal-title":"Front Hum Neurosci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1016\/j.apmr.2024.12.018","article-title":"Repetitive transcranial magnetic stimulation strategies for poststroke dysphagia: a systematic review and network meta-analysis","volume":"106","author":"Wu","year":"2025","journal-title":"Arch Phys Med Rehabil."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1586734","DOI":"10.3389\/fneur.2025.1586734","article-title":"Effect of repetitive transcranial magnetic stimulation with different stimulation parameters on post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Peng","year":"2025","journal-title":"Front Neurol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1177\/10538135251382914","article-title":"Comparative effects of repetitive transcranial magnetic stimulation and theta-burst stimulation on post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials","volume":"57","author":"Liu","year":"2025","journal-title":"Neurorehabilitation."},{"key":"B12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s00455-024-10757-4","article-title":"Evidence for intermittent theta burst transcranial magnetic stimulation for dysphagia after stroke: a systematic review and meta-analysis","volume":"40","author":"Han","year":"2025","journal-title":"Dysphagia."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.1007\/s00455-025-10842-2","article-title":"Repetitive transcranial magnetic stimulation over a different side of the cortex for rehabilitating poststroke dysphagia: a randomized, double-blind clinical trial","volume":"40","author":"Wang","year":"2025","journal-title":"Dysphagia."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1016\/j.brs.2023.05.023","article-title":"Effect of cerebellar transcranial magnetic stimulation with double-cone coil on dysphagia after subacute infratentorial stroke: a randomized, single-blinded, controlled trial","volume":"16","author":"Dai","year":"2023","journal-title":"Brain Stimul."},{"key":"B15","doi-asserted-by":"publisher","first-page":"4483","DOI":"10.1007\/s10072-025-08298-1","article-title":"Unilateral contralesional versus bilateral repetitive transcranial magnetic stimulation for patients with post-stroke dysphagia: a randomized controlled study","volume":"46","author":"Fouda","year":"2025","journal-title":"Neurol Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1650216","DOI":"10.3389\/fneur.2025.1650216","article-title":"Comparison of repetitive transcranial magnetic stimulation and intermittent theta burst stimulation efficacy in treating post-stroke dysphagia: a prospective, single-blind, randomized controlled study","volume":"16","author":"Li","year":"2025","journal-title":"Front Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/j.apmr.2023.11.006","article-title":"The therapeutic effect of transcranial magnetic stimulation on post-stroke aphasia and the optimal treatment parameters: a meta-analysis","volume":"105","author":"Wang","year":"2024","journal-title":"Arch Phys Med Rehabil."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1614586","DOI":"10.3389\/fneur.2025.1614586","article-title":"Efficacy and safety of repetitive transcranial magnetic therapy for post-stroke aphasia: a systematic review and meta-analysis of randomized controlled trials","volume":"16","author":"Xie","year":"2025","journal-title":"Front Neurol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1348695","DOI":"10.3389\/fneur.2024.1348695","article-title":"Repetitive transcranial magnetic stimulation for post-stroke non-fluent aphasia: a systematic review and meta-analysis of randomized controlled trials","volume":"15","author":"Cheng","year":"2024","journal-title":"Front Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"665","DOI":"10.3390\/brainsci14070665","article-title":"Repetitive transcranial magnetic stimulation for action naming in aphasia rehabilitation: a systematic review and meta-analysis","volume":"14","author":"Spigarelli","year":"2024","journal-title":"Brain Sci."},{"key":"B21","doi-asserted-by":"publisher","first-page":"105216","DOI":"10.1016\/j.bandl.2022.105216","article-title":"Repetitive transcranial magnetic stimulation combined with multi-modality aphasia therapy for chronic post-stroke non-fluent aphasia: a pilot randomized sham-controlled trial","volume":"236","author":"Low","year":"2023","journal-title":"Brain Lang."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e213424","DOI":"10.1212\/WNL.0000000000213424","article-title":"Transcranial magnetic stimulation combined with multimodality aphasia therapy for chronic poststroke aphasia: a randomized clinical trial","volume":"104","author":"Low","year":"2025","journal-title":"Neurology."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1473254","DOI":"10.3389\/fneur.2024.1473254","article-title":"Effects of low-frequency rTMS combined with speech and language therapy on Broca's aphasia in subacute stroke patients","volume":"15","author":"Gan","year":"2024","journal-title":"Front Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1016\/j.brs.2023.08.023","article-title":"Personalized functional imaging-guided rTMS on the superior frontal gyrus for post-stroke aphasia: a randomized sham-controlled trial","volume":"16","author":"Ren","year":"2023","journal-title":"Brain Stimul."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e70307","DOI":"10.1111\/ene.70307","article-title":"Gaps in guidelines on long-term management strategies for post-stroke dysphagia","volume":"32","author":"Karisik","year":"2025","journal-title":"Eur J Neurol."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1810365\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:26:51Z","timestamp":1775795211000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1810365\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":25,"alternative-id":["10.3389\/fneur.2026.1810365"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1810365","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1810365"}}