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

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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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Acknowledgements

We are grateful to our co-workers at the Department of Rehabilitation Medicine of Yuebei People’s Hospital.

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The study did not receive any financial support.

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  1. Xin Wen and Quan Yang have contributed to the study with equal merit and should be acknowledged as co-first authors.

Authors and Affiliations

  1. Department of Rehabilitation Medicine, Yue Bei People’s Hospital, Shaoguan, Guangdong, China

    Xin Wen, Quan Yang, Yang Peng, Jing Wang, Huiyu Liu & Minghong Wang

  2. School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China

    Xin Wen, Zicai Liu, Xuejin Liu & Hao Hu

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  1. Xin Wen
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  2. Quan Yang
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  3. Zicai Liu
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Contributions

XW wrote the original draft. QY and ZL collected and analyzed the data. YP and JW performed the evaluation for patients. HH and XL performed the research. HL and MW involved in concept development and designed the study.

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Correspondence to Huiyu Liu or Minghong Wang.

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Wen, X., Yang, Q., Liu, Z. et al. The Effect of Repetitive Transcranial Magnetic Stimulation in Synchronization with Effortful Swallowing on Post-stroke Dysphagia. Dysphagia 38, 912–922 (2023). https://doi.org/10.1007/s00455-022-10515-4

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