Skip to main content
SpringerLink
Log in

Clinical effect of repetitive transcranial magnetic stimulation on dysphagia due to stroke

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Background

Repetitive transcranial magnetic stimulation (rT) could change the excitability of the cerebral cortex, and control the neurotransmitter release, with the therapeutic effect depending on stimulation intensity and position. In this study, we used 3 Hz rTMS to stimulate the pharyngeal cortical area of the lesioned hemisphere and to explore its clinical significance in the treatment of dysphagia after acute cerebral infarction.

Methods

A total of 61 in-patients with acute dysphagia caused by cerebral infarction hospitalized in the department of neurology of our hospital were included in this study and were assigned into the control and rTMS group. Patients in the control group only accepted the basic treatment of rehabilitation training, while patients in the rTMS group received additional rTMS (3 Hz) stimulation. The levels of the water swallowing test (WST) 14 days before and after the treatment of rTMS (3 Hz) would be recorded.

Results

After different therapies in two groups, 9 patients of the control group showed excellent curative effect, with a recovery rate of 31.0%. However, in the rTMS group, the swallowing function of 21 patients was significantly improved, with a recovery rate of 65.6%. Comparison results showed that the recovery rate of the rTMS group was much better than the control group (P < 0.05), indicating an effective therapeutic effect of 3 Hz rTMS on patients with dysphagia after acute cerebral infarction.

Conclusion

Stimulating the target cortical representation areas of pharyngeal of the lesioned hemisphere with cerebral infarction by the rTMS (3 Hz) could improve the patients’ function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Szu LY, Hsieh SI, Tseng SM, Huang TH (2017) [The determinants of dysphagia in patients with stroke during hospitalized rehabilitation].". Hu Li Za Zhi 64(3):43–55

    PubMed  Google Scholar 

  2. Martino R, Foley N, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R (2005) Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke 36(12):2756–2763

    Article  PubMed  Google Scholar 

  3. Altman KW, Yu GP, Schaefer SD (2010) Consequence of dysphagia in the hospitalized patient. Arch Otolaryngol Head Neck Surg 136(8):784

    Article  PubMed  Google Scholar 

  4. Martino R, Martin RE, Black S (2012) Dysphagia after stroke and its management. CMAJ 184(10):1127–1128

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rofes L, Vilardell N, Clavé P (2013) Post-stroke dysphagia: progress at last. Neurogastroenterol Motil 25(4):278–282

    Article  CAS  PubMed  Google Scholar 

  6. Suntrup S, Teismann I, Wollbrink A, Winkels M, Warnecke T, Flöel A et al (2013) Magnetoencephalographic evidence for the modulation of cortical swallowing processing by transcranial direct current stimulation. Neuroimage 83:346–354

    Article  PubMed  Google Scholar 

  7. Maeshima S, Osawa A, Hayashi T, Tanahashi N (2014) Elderly age, bilateral lesions, and severe neurological deficit are correlated with stroke-associated pneumonia. J Stroke Cerebrovasc Dis 23(3):484–489

    Article  PubMed  Google Scholar 

  8. Dziewas R, Ritter M, Schilling M, Konrad C, Oelenberg S, Nabavi DG et al (2004) Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatry 75(6):852–856

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Lanza G, Cantone M, Lanuzza B, Pennisi M, Bella R, Pennisi G et al (2015) Distinctive patterns of cortical excitability to transcranial magnetic stimulation in obstructive sleep apnea syndrome, restless legs syndrome, insomnia, and sleep deprivation. Sleep Med Rev 19:39–50

    Article  PubMed  Google Scholar 

  10. Fisicaro F, Lanza G, Grasso AA, Pennisi G, Bella R, Paulus W et al (2019) Repetitive transcranial magnetic stimulation in stroke rehabilitation: review of the current evidence and pitfalls. Ther Adv Neurol Disord 12:1756286419878317

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cheng IK, Chan KM, Wong CS, Cheung RT (2015) Preliminary evidence of the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on swallowing functions in post-stroke individuals with chronic dysphagia. Int J Lang Commun Disord 50(3):389–396

    Article  PubMed  Google Scholar 

  12. Lim KB, Lee HJ, Yoo J, Kwon YG (2014) Effect of low-frequency rTMS and NMES on subacute unilateral hemispheric stroke with dysphagia. Ann Rehabil Med 38(5):592–602

    Article  PubMed  PubMed Central  Google Scholar 

  13. Micho E, Raginis-Zborowska A, Watanabe M, Lodhi T, Hamdy S (2016) Repetitive transcranial magnetic stimulation: a novel approach for treating oropharyngeal dysphagia. Curr Gastroenterol Rep 18(2):10

    Article  Google Scholar 

  14. Momosaki R, Abo M, Watanabe S, Kakuda W, Yamada N, Kinoshita S (2015) Repetitive peripheral magnetic stimulation with intensive swallowing rehabilitation for poststroke dysphagia: an open-label case series. Neuromodulation 18(7):630–635

    Article  PubMed  Google Scholar 

  15. Fitzgerald PB, Fountain S, Daskalakis ZJ (2006) A comprehensive review of the effects of rTMS on motor cortical excitability and inhibition. Clin Neurophysiol 117(12):2584–2596

    Article  PubMed  Google Scholar 

  16. Shigemats T, Fujishima I, Ohno K (2013) Transcranial direct current stimulation improves swallowing function in stroke patients. Neurorehabil Neural Repair 27(4):363–369

    Article  Google Scholar 

  17. Terrà R, Panadés A, Mearin F (2013) Botulinum toxin treatment for oropharyngeal dysphagia in patients with stroke.". Neurogastroenterol Motil 25(11):896-e702

    Article  Google Scholar 

  18. Geeganage C, Beavan J, Ellender S, Bath PM (2012) Interventions for dysphagia and nutritional support in acute and subacute stroke. Cochrane Database Syst Rev. 10(10):CD000323

    PubMed  Google Scholar 

  19. Haiyan C, Ma B, Gao X, Gao H (2015) Tongue acupuncture in treatment of post-stroke dysphagia. Int J Clin Exp Med 8(8):14090–14094

    Google Scholar 

  20. Baker JM, Rorden C, Fridriksson J (2010) Using transcranial direct-current stimulation to treat stroke patients with aphasia. Stroke 41(6):1229–1236

    Article  PubMed  PubMed Central  Google Scholar 

  21. Camprodon JA, Martínez-Raga José, Alonso-Alonso M, Shih MC, Pascual-Leone A (2007) One session of high frequency repetitive transcranial magnetic stimulation (rtms) to the right prefrontal cortex transiently reduces cocaine craving. Drug Alcohol Depend 86(1) 0–94

  22. SBaohui, Zhai, Jingxuan, Fu, Shitong, & Xiang, et al. (2019). Repetitive transcranial magnetic stimulation ameliorates recognition memory impairment induced by hindlimb unloading in mice associated with bdnf/trkb signaling. Neuroscience Research

  23. Langguth B, Kleinjung T, Frank E, Landgrebe M, Sand P, Dvorakova J et al (2008) High-frequency priming stimulation does not enhance the effect of low-frequency rTMS in the treatment of tinnitus. Exp Brain Res 184(4):587–591

    Article  PubMed  Google Scholar 

  24. Verin E, Leroi AM (2009) Poststroke dysphagia rehabilitation by repetitive transcranial magnetic stimulation: a noncontrolled pilot study. Dysphagia 24(2):204–210

    Article  CAS  PubMed  Google Scholar 

  25. Du J, Yang F, Liu L, Hu J, Cai B, Liu W et al (2016) Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: a randomized, double-blind clinical trial. Clin Neurophysiol 127(3):1907–1913

    Article  PubMed  Google Scholar 

  26. Momosaki R, Abo M, Kakuda W (2014 Mar 20) (2014) Bilateral repetitive transcranial magnetic stimulation combined with intensive swallowing rehabilitation for chronic stroke dysphagia: a case series study. Case Rep Neurol 6(1):60–67

    Article  PubMed  PubMed Central  Google Scholar 

  27. Khedr EM, Abo-Elfetoh N (2010) Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. J Neurol Neurosurg Psychiatry 81(5):495–499

    Article  PubMed  Google Scholar 

  28. Ju F, Wang B, Mou X (2017) The effect of rtms on neuropathic pain and cerebral cortex excitability of the patients with spinal cord injury. Chinese J Rehabilitation Med 32(5):521–524

    Google Scholar 

  29. Jiao YG, Li GC, Chen JP, Wu ZH, Zhang HT (2013) Dopamine receptor 1 modulates the discharge activities of inspiratory and biphasic expiratory neurons via cAMP-dependent pathways. Cell Mol Neurobiol 33(2):155–160

    Article  CAS  PubMed  Google Scholar 

  30. Li GC, Zhang HT, Jiao YG, Wu ZH, Fang F, Cheng J (2010) Glial cells are involved in the exciting effects of doxapram on brainstem slices in vitro. Cell Mol Neurobiol 30(5):667–670

    Article  PubMed  Google Scholar 

  31. Kataoka S, Terasawa H, Touji H (2007) Cerebral peduncle infarction with pure dysarthria - Case report. Brain Nerve 59(8):877–879

    PubMed  Google Scholar 

  32. Chen RZ and Fang WB3. (2005). Early intervention for impaired swallowing in patients with unilateral acute cerebral infarction. Chinese J Clin Rehabilitation

  33. Association WM (2009) Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Indian Med Assoc. 14(1):233–238

    Google Scholar 

  34. Park JW, Oh JC, Lee JW, Yeo JS, Ryu KH (2013) The effect of 5hz high-frequency rtms over contralesional pharyngeal motor cortex in post-stroke oropharyngeal dysphagia: a randomized controlled study. Neurogastroenterol Motil 25(4):324-e250

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

This study was supported by Medical Science and Technology Foundation of Guangdong Province(A2018389).

Author information

Author notes

  1. Yonggang Jiao and Guocai Li contributed to this work equally.

Authors and Affiliations

  1. Department of Neurology, Guangdong Second Provincial General Hospital, Haizhu District, No. 466, Xingang Middle Road, Guangzhou, 510317, Guangdong, China

    Yonggang Jiao & Yingyi Dai

  2. Department of Anesthesiology, Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, 518034, Guangdong, China

    Guocai Li

Authors
  1. Yonggang Jiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guocai Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yingyi Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Y. Jiao designed the study, and Y. Jiao completed the draft. G. Li and Y. Dai took part in the study and revised the article. All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Yonggang Jiao.

Ethics declarations

Ethics approval

Ethical approval for this study (Ethical Committee No. 2016-SJNK-001) was provided by the Ethical Committee of Guangdong Second Provincial General Hospital, Guangzhou, China (Chairman Prof. Jun-Chang Tian) on Nov. 8, 2015. This study was performed in accordance with the ethical principles of the Declaration of Helsinki (Association 2009).

Informed consent

Informed consent was obtained from all the individual patients in this study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiao, Y., Li, G. & Dai, Y. Clinical effect of repetitive transcranial magnetic stimulation on dysphagia due to stroke. Neurol Sci 43, 3139–3144 (2022). https://doi.org/10.1007/s10072-021-05799-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-021-05799-7

Keywords

Search

Navigation