Legend box shows naming data for a single aphasia case, acquired immediately after suppression of 5 different RH cortical ROIs during exploratory Phase 1 TMS. Location of five frontal, RH ROIs are shown where each was suppressed in separate TMS sessions, with 1 Hz rTMS for 10 min. These five ROIs included R M1, mouth (orbicularis oris muscle, as verified with MEP), and four subregions within R Broca's area as defined in the text, using sulcal boundaries (arrows). A diagonal sulcus was present in the RH in this case. The PTr posterior ROI (green symbol), was the best-response ROI – i.e., the area associated with a naming score that reached at least 2 SD above baseline S&V naming ability (e.g., 15). During Phase 2 TMS, the PTr posterior ROI (green symbol) was used as the target for suppression with 1 Hz rTMS for ten, 20-min treatments in this case. Note that the number of pictures named correctly immediately post- rTMS decreased for any given ROI, as the distance from the best-response ROI increased by 1 or 2 cm, in an anterior or posterior direction. ROI, region of interest; PTr, pars triangularis; POp, pars opercularis; S&V, Snodgrass and Vanderwart. Reprinted with permission from Wolters Kluwer Health and authors' permission, Naeser, Martin, Lundgren, et al., Improved Language in a Chronic Nonfluent Aphasia Patient After Treatment with CPAP and TMS, J Cogn and Beh Neurol, 2009, 23(1), 29-38.

Significant improvement in Action naming test scores post- Intervention (TMS+CILT) for a severe nonfluent, global aphasia patient. Bargraph shows significant improvement (>2 SD) in BDAE verb Action Naming at 1 and 6 mo. post- TMS+CILT, compared to baseline testing pre- Intervention. Bargraph also displays previous scores, pre- and post- TMS alone, without CILT. Abbreviations: TMS = transcranial magnetic stimulation; CILT = constraint-induced language therapy; BDAE = Boston Diagnostic Aphasia Exam. Reprinted from Restorative Neurology and Neuroscience, 28(4), Naeser, Martin, Treglia et al., Research with rTMS in the treatment of aphasia, 511-529, Copyright (2010), with permission from IOS Press.

a and b: White matter pathways from horizontal, mid-portion of arcuate fasciculus (AF, green) connect primarily with pars opercularis (light blue), not posterior pars triangularis (yellow) or anterior pars triangularis (red), in the right hemisphere; a: axial view, and b: sagittal view. c: White matter pathways from horizontal, mid-portion of AF (orange) also connect with ventral premotor cortex (dark blue) in the right hemisphere; c: axial view. The R pars opercularis and the R ventral premotor cortical areas are regions that may be important for recovery of speech in chronic stroke patients with nonfluent aphasia. Pink area represents seed point in the horizontal, mid-portion of the AF in these DTI studies with normal controls.