Improved receptive and expressive language abilities in nonfluent aphasic stroke patients after application of rTMS: An open protocol case series Caroline H.S. Barwood, a Bruce E. Murdoch, a Brooke-Mai Whelan, a David Lloyd, a,b Stephan Riek, b John D. O’Sullivan, c Alan Coulthard, d Andrew Wong c a Centre for Neurogenic Communication Disorders Research, School of Health and Rehabilitation Sciences, University of Queensland, Australia b School of Human Movement Studies, University of Queensland, Australia c Department of Neurology Royal Brisbane and Women’s Hospital, Queensland, Australia d Department of Medical Imaging, Royal Brisbane and Women’s Hospital, Queensland, Australia Background Repetitive transcranial magnetic stimulation (rTMS) has been identified as a potentially valuable tool for the rehabilitation of language impairment after left hemisphere (LH) stroke, in populations of persons with chronic aphasia. Applied to a homologue to Broca’s area, rTMS is posited to modulate bilateral language networks, promoting measurable behavioral language change, in accordance with theories of transcallosal disinhibition arising from the damaged LH. Objective/Hypothesis The current investigation is an open-label study, presenting detailed case and group presentations on a population of seven nonfluent aphasic participants. Behavioral language performance is presented on expressive and receptive language measures up to 8 months after a 10-day protocol of 1 Hz stimulation. This research aims to provide longitudinal behavioral language outcomes for persons with aphasia, subsequent to rTMS and supplement previous studies to inform the clinical efficacy of rTMS. Results In accordance with previous investigations, significant improvements in picture naming, spontaneous elicited speech and auditory comprehension were found. Time of testing was identified as a significant main effect. Significant improvements in picture naming accuracy and decreases in picture naming latency were also identified. The results demonstrate sustained language improvements up to 8 months subsequent to TMS application. Correspondence: Caroline H.S. Barwood, Centre for Neurogenic Communication Disorders Research, School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia 4072. E-mail address: c.barwood@uq.edu.au Submitted November 23, 2010; revised March 14, 2011. Accepted for publication March 15, 2011. 1935-861X/$ - see front matter Ó 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.brs.2011.03.005 Brain Stimulation (2012) 5, 274–86 www.brainstimjrnl.com