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Dysphagia
Published in: Dysphagia 3/2023

10-09-2022 | Stroke | Original Article

The Effect of Repetitive Transcranial Magnetic Stimulation in Synchronization with Effortful Swallowing on Post-stroke Dysphagia

Authors: Xin Wen, Quan Yang, Zicai Liu, Yang Peng, Jing Wang, Xuejin Liu, Hao Hu, Huiyu Liu, Minghong Wang

Published in: Dysphagia | Issue 3/2023

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Abstract

Either effortful swallowing exercise or repetitive transcranial magnetic stimulation (rTMS) is considered as an effective method to treat dysphagia after stroke. Thus, synchronizing these two interventions may improve the efficiency of treatment. This trial intended to explore the effects of rTMS and effortful swallowing exercise on the recovery of swallowing function in patients after stroke. A total of 56 patients with post-stroke dysphagia who were able to actively cooperate with the training were analyzed in this study. We experimented with different intervention effects of rTMS synchronization with effortful swallowing training (group 1), rTMS (group 2), and traditional swallowing training alone (group 3). Every patient completed conventional swallowing training 5 days a week for 2 weeks. Patients in group 1 and group 2 underwent 10 consecutive sessions of 5 Hz rTMS over the affected mylohyoid cortical region. Fiberoptic endoscopic dysphagia severity scale (FEDSS), penetration/aspiration scale (PAS), standardized swallowing assessment (SSA), and functional oral intake scale (FOIS) were assessed and compared across the groups. No significant difference in FEDSS, PAS, SSA, or FOIS scores was found at baseline among the three groups. The mean change values of the FEDSS score, PAS score, SSA score, and FOIS score between baseline and post-intervention of the three groups (H = 16.05, P < 0.001; H = 21.70, P < 0.001; F (2, 53) = 9.68, P < 0.001; H = 18.26, P < 0.001; respectively) were statistically significant. In addition, the mean change values of FEDSS, PAS, SSA, and FOIS scores in participants in group 1 (all P < 0.001) and group 2 (P = 0.046; P = 0.045; P = 0.028; P = 0.032; respectively) were significantly higher than in group 3. Similarly, the mean change values of FEDSS, PAS, SSA, and FOIS scores were significantly higher in participants in group 1 than in group 2 (P = 0.046; P = 0.038; P = 0.042; P = 0.044; respectively). The results revealed that the conjunction of rTMS and effortful swallowing training was an effective method to facilitate the recovery of swallowing function in stroke patients. The present clinical trial provided a new treatment method for the functional restoration of swallowing in stroke patients, which may further facilitate the recovery of swallowing function in stroke patients with swallowing disorders.
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Metadata
Title
The Effect of Repetitive Transcranial Magnetic Stimulation in Synchronization with Effortful Swallowing on Post-stroke Dysphagia
Authors
Xin Wen
Quan Yang
Zicai Liu
Yang Peng
Jing Wang
Xuejin Liu
Hao Hu
Huiyu Liu
Minghong Wang
Publication date
10-09-2022
Publisher
Springer US
Published in
Dysphagia / Issue 3/2023
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-022-10515-4

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