Kmk Chan

Neuronavigated high-frequency repetitive transcranial magnetic stimulation for chronic post-stroke dysphagia: A randomized controlled study

OBJECTIVE There are potential benefits of repetitive transcranial magnetic stimulation (rTMS) in improving swallowing functions after stroke; however, few studies have been performed in the chronic stroke population. This study aims to distil the key effects of rTMS on swallowing functions and swallowing-related quality of life. METHODS Twenty-two participants with chronic post-stroke dysphagia were randomly assigned into active or sham rTMS groups. Seven participants withdrew from the study, thus data from 15 participants (mean age 64.6 years) were analysed. Participants received 3,000 pulses of 5 Hz rTMS (active: n = 11; sham: n = 4) on the tongue area of the motor cortex for 10 days over a period of 2 weeks. All participants were assessed 1 week before, and 2 months, 6 months and 12 months after stimulation. Outcomes were measured by a videofluoroscopic swallowing study, swallowing-related quality-of-life questionnaire and Iowa Oral Performance Instrument. RESULTS No statistically significant effects were identified for any outcome measures. CONCLUSION This study indicates that 5 Hz rTMS applied over the tongue area of the motor cortex is not effective for improving swallowing function in individuals with chronic post-stroke dysphagia. Possible explanations for these non-significant results are dis cussed. Future studies should explore the potential of the current protocol in conjunction with conventional dysphagia therapy.