Speech and Language Therapy Plus Electroacupuncture or Non-Invasive Brain Stimulation for Post-Stroke Aphasia: A Systematic Review and Network Meta-Analysis.

This article systematically evaluates the therapeutic effectiveness of speech and language therapy (SLT)-based combination treatments for post-stroke aphasia (PSA) through a network meta-analysis (NMA) of 66 randomized controlled trials involving 4,607 participants. The study compares SLT alone with SLT combined with acupuncture, electroacupuncture, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and sham controls, assessing outcomes across language function dimensions including the Aphasia Quotient (AQ), naming, repetition, listening comprehension, and speaking. Results indicate that all SLT-based combination therapies outperform SLT alone, with SLT plus electroacupuncture showing the highest likelihood of improving AQ, naming, repetition, and speaking scores, while SLT plus tDCS is most effective for listening comprehension. The analysis also highlights significant benefits of SLT combined with non-invasive brain stimulation (NIBS) for specific aphasia types such as Broca's and non-fluent aphasia. Limitations include heterogeneity among studies, cultural context bias due to the predominance of Chinese populations, and uneven sample sizes across intervention types. The findings provide evidence supporting the integration of electroacupuncture and non-invasive brain stimulation with SLT to enhance language recovery in PSA patients.