The effects of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) on treating poststroke aphasia (PSA) remain inconclusive. We aimed to evaluate the efficacy and safety of LF-rTMS on language function poststroke and determine potential factors that may affect treatment effects. Electronic databases, including MEDLINE, EMBASE, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs) concerning the effects of LF-rTMS on language performance poststroke. We adopted fixed- and random-effects models to estimate intervention effects, which were represented by the Hedges’ g and 95% CIs. Subgroup analyses regarding several factors potentially influencing the effects of LF-rTMS on language recovery were also conducted. A total of 14 RCTs involving 374 participants were included in the meta-analysis. The pooled analysis showed the positive and significant effects of LF-rTMS on language function, both short-term (Hedges’ g = 0.65; P < .05) and long-term (Hedges’ g = 0.46; P < .05). Subgroup analyses demonstrated that LF-rTMS for 20 minutes per day over 10 days yielded the largest effect size (Hedges’ g = 1.02; P < .05) and that LF-rTMS significantly improved language performance in the chronic stage after stroke (Hedges’ g = 0.55; P < .05). Patients with different native languages might have diverse responses to LF-rTMS treatment efficacy. Additionally, there were significant improvements in language subtests, including naming, repetition, comprehension, and writing. Overall, this updated meta-analysis demonstrated that LF-rTMS has significant positive effects on PSA, with moderate treatment effects. It provides additional evidence to support LF-rTMS as a promising complementary therapy to promote language recovery in PSA.

低频重复经颅磁刺激 (LF-rTMS) 对治疗卒中后失语症 (PSA) 的影响尚无定论。我们旨在评估 LF-rTMS 对卒中后语言功能的有效性和安全性，并确定可能影响治疗效果的潜在因素。检索了包括 MEDLINE、EMBASE 和 Cochrane 图书馆在内的电子数据库，以确定有关 LF-rTMS 对中风后语言表现的影响的相关随机对照试验 (RCT)。我们采用固定和随机效应模型来估计干预效果，由 Hedges 的g和 95% CI。还对可能影响 LF-rTMS 对语言恢复的影响的几个因素进行了亚组分析。荟萃分析共纳入 14 项 RCT，涉及 374 名参与者。汇总分析显示 LF-rTMS 对语言功能的积极和显着影响，包括短期 (Hedges' g = 0.65; P < .05) 和长期 (Hedges' g = 0.46; P < .05)。亚组分析表明，在 10 天内每天 20 分钟的 LF-rTMS 产生了最大的效果（Hedges' g = 1.02；P < .05），并且 LF-rTMS 显着改善了中风后慢性阶段的语言表现（Hedges' G= 0.55; P < .05)。具有不同母语的患者可能对 LF-rTMS 治疗效果有不同的反应。此外，语言分项测试也有显着改进，包括命名、重复、理解和写作。总体而言，这项更新的荟萃分析表明，LF-rTMS 对 PSA 具有显着的积极作用，具有中等的治疗效果。它提供了额外的证据来支持 LF-rTMS 作为一种有前途的补充疗法，以促进 PSA 的语言恢复。