Post-Stroke Aphasia TMS

In this project, the investigator will use functional neuroimaging and inhibitory TMS to determine precise therapy-responsive targets for excitatory TMS therapy with SFA. One group of stroke survivors will receive SFA + TMS targeting the precision site, and another group will receive SFA + TMS targeting a control site. The primary outcome will be changes in picture naming accuracy. We expect that excitatory TMS targeting a precision site would result in larger improvements in naming accuracy than TMS targeting a control site. Results will provide the efficacy of precision TMS in post-stroke aphasia.

Inclusion criteria

• Diagnosed with left hemisphere stroke
• Consent date >= 1 month after stroke onset
• Fluent in English
• 18 years of age or older

Exclusion criteria

• Severe cognitive, auditory or visual impairments that would preclude cognitive and language testing
• Presence of major untreated or unstable psychiatric disease (e.g. schizophrenia, bipolar disease)
• A chronic medical condition that is not treated or is unstable
• The presence of cardiac stimulators or pacemakers or intracardiac lines, neurostimulators, medication infusion device, any other implants near the scalp (e.g., cochlear implants) or in the eye, metal in the body (e.g., splinters, fragments, clips)
• Pregnancy
• History of skull fractures, or skin diseases
• History of ongoing or unmanaged seizures
• Presence of factors that potentially decrease seizure thresholds: on pro-convulsant medications, untreated sleep deprivation or insomnia, ongoing alcoholism or illegal drug abuse (e.g., cocaine or MDMA users)
• History of dyslexia or other developmental learning disabilities