Safety, Feasibility, and Preliminary Efficacy of Repetitive Transcranial Magnetic Stimulation for Stuttering in Children: A Randomized Sham-Controlled Pilot Trial

Background: Repetitive transcranial magnetic stimulation (rTMS) has shown preliminary promise for improving fluency in adults who stutter, but controlled studies in children are lacking. This pilot randomized placebo‐controlled trial evaluated safety and preliminary efficacy of 10 Hz rTMS applied to left pars opercularis (Broca’s area) and left supplementary motor area (SMA) in children aged 6–10 years with developmental stuttering. Methods: Forty‐four children were randomized to Broca rTMS (n = 19), SMA rTMS (n = 9), or placebo (n = 16). The protocol consisted of 10 daily sessions (1000–1500 pulses/session). Stuttering severity was assessed before and after treatment using a standardized clinical tool and a blinded speech‐language pathologist (SLP) rating. Results: In the Broca group, significant pre‐post improvements were observed for physical concomitants (p = 0.0038, r = 0.67), syllable repetitions (p = 0.0072, r = 0.62), raw composite score (p = 0.016, r = 0.55), and rank‐based index (p = 0.0038, r = 0.67). Compared to placebo, the Broca group showed significantly greater improvement in the rank‐based index (p = 0.040, r = 0.35). Younger age correlated with greater improvement (rₛ = 0.55, p = 0.014). The SMA group did not differ from placebo and was associated with fluency deterioration, leading to protocol suspension. Adverse events in the Broca group were mild. Conclusions: Low‐intensity 10 Hz rTMS over Broca’s area appears feasible and may improve stuttering severity in children aged 6–10 years. The SMA protocol was not effective. These preliminary findings require confirmation in larger trials.