Rehabilitation interventions for Wernicke's aphasia and related fluent aphasia: A systematic review of randomized controlled trials.

BACKGROUND: Wernicke's aphasia is a fluent aphasia syndrome characterized by impaired auditory comprehension and paraphasic speech, typically resulting from lesions affecting temporo-parietal language networks. Evidence regarding effective therapeutic approaches for Wernicke's aphasia remains relatively limited. OBJECTIVE: To systematically review randomized controlled trials evaluating rehabilitation interventions for individuals with Wernicke's aphasia or related fluent aphasia syndromes associated with auditory comprehension impairment. METHODS: A systematic literature search was conducted in PubMed, Cochrane Library, and Google Scholar for randomized controlled trials published between 2011 and December 2025. Studies were included if they investigated behavioral, technological, or neuromodulatory interventions aimed at improving language or communication outcomes in adults with Wernicke's or fluent aphasia. Study selection followed PRISMA guidelines. Methodological quality was assessed using the Cochrane Risk of Bias 2 tool. RESULTS: Six randomized controlled trials involving 105 participants met the inclusion criteria. Interventions included intensive behavioral language therapy, phonological or semantic training, and adjunctive neuromodulatory approaches such as transcranial direct current stimulation. Overall, most studies reported improvements in auditory comprehension, lexical processing, and language performance following rehabilitation interventions. However, considerable heterogeneity in intervention protocols, outcome measures, and sample characteristics limited direct comparability across trials. CONCLUSIONS: Available evidence suggests that both intensive language therapy and neuromodulatory interventions may support language recovery in Wernicke's aphasia. Nevertheless, larger and methodologically robust trials are needed to establish optimal rehabilitation strategies and clarify predictors of treatment response.