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High-frequency repetitive transcranial magnetic stimulation combined with neuromuscular electrical stimulation for the treatment of poststroke dysphagia: a randomized controlled trial
Author(s): 
Pages: 39-43
Year: Issue:  1
Journal: International Journal of Cerebrovascular Diseases

Keyword:  StrokeDeglutition DisordersTranscranial Magnetic StimulationElectric Stimulation TherapyTreatment Outcome;
Abstract: Objective To assess the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) on poststroke dysphagia.Methods A total of 90 patients with poststroke dysphagia were enrolled.They were randomly divided into either a NMES + rTMS group or a NMES + sham rTMS group (n =45 in each group).The Kuhota water drinking test and Standardized Swallowing Assessment (SSA) were used to assess the swallowing function.Results The scores of Kuhota water drinking test (F=82.001,P<0.001) and the SSA (F =33.743,P <0.001) before treatment,treatment of one course,treatment of two courses,and at 3 months after treatment in the NMES + rTMS group had significant differences.Compared with before treatment,they were improved significantly for treatment of one course (P <0.01 and P <0.05,respectively),two courses (all P<0.01),and at 3 months (all P<0.01) after treatment.The scores of Kuhota water drinking test (F =53.647,P<0.001) and the SSA (F=19.178,P<0.001) in the NMES + sham rTMS group also had significant difference.Compared with before treatment,they had significant improvement for treatment of one course (all P <0.05),two courses (P <0.05 and P <0.01,respectively) and at 3 months (all P<0.01)after treatment.The scores of Kuhota water drinking test for treatment of one course,two courses,and at 3 months after treatment (treatment of one course:t=2.217,P=0.02;treatment of two courses:t =2.406,P =0.019;at 3 months after treatment:t =2.128,P =0.037) and the SSA (treatment of one course:t =2.196,P =0.030,treatment of two courses:t =2.425,P =0.016;at 3 months after treatment:t =2.512,P=0.013) in the NMES + rTMS group were significantly better than those in the NMES + sham rTMS group.Conclusions High-frequency rTMS combined with NMES may significantly improve the swallowing function in patients with stroke.Its efficacy is superior to NMES.
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