Repetitive Transcranial Magnetic Stimulation at Different Sites for Dysphagia After Stroke: A Randomized, Observer-Blind Clinical Trial

作者：Lida Zhong, Jinzhu Rao, Jing Wang, Fang Li, Yang Peng, Huiyu Liu, Yan Zhang, Pu Wang · 发表于：Frontiers in Neurology · 年份：2021 · DOI：10.3389/fneur.2021.625683 · 被引用次数：60 · 研究领域：Dysphagia Assessment and Management、Voice and Speech Disorders、Tracheal and airway disorders

Background: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) protocols on patients with poststroke dysphagia is still unclear. Objective: This trial aimed to explore and analyze the effectiveness of 5 Hz rTMS on the unaffected hemisphere, affected hemisphere, and cerebellum in stroke patients with dysphagia. Methods: This observer-blind and randomized controlled trial included a total of 147 patients with stroke. Patients were divided into four treatment groups: the unaffected hemispheric group, the affected hemispheric group, the cerebellum group and the control group. Each group received traditional dysphagia treatment 5 days a week for 2 weeks. All recruited patients except for those in the control group underwent 10 consecutive rTMS sessions for 2 weeks. For the affected hemispheric group and unaffected hemispheric group, 5 Hz rTMS was applied to the affected mylohyoid cortical region or to the unaffected mylohyoid cortical region. For the cerebellum group, 5 Hz rTMS was applied to the mylohyoid cortical representation of the cerebellum (4.3 cm lateral and 2.4 cm below the inion). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Gugging Swallowing Screen (GUSS), and Standardized Swallowing Assessment (SSA) were used to evaluate clinical swallowing function before the intervention (baseline), immediately after the intervention and 2 weeks after the intervention. Results: There were significant time ...