Effects of Repetitive Transcranial Magnetic Stimulation on Patients With Dysphagia in Stroke Observed Based on Functional Near-infrared Spectroscopic
Condition: Stroke; Deglutition Disorders
MeSH terms: Deglutition Disorders; Stroke
Study type: Interventional

Summary: 
      This trial was a randomized, double-blind, sham-controlled trial.Thirty patients with
      post-stroke dysphagia were randomly assigned to the repetitive transcranial magnetic
      stimulation(rTMS) group (n=15) or sham rTMS group (n=15). Both groups received conventional
      swallowing rehabilitation, and in addition, the rTMS group received 5hz repetitive
      transcranial magnetic stimulation on the healthy side. Swallowing function was assessed at
      admission and after two weeks of treatment using the the Standardized Swallowing Assessment
      (SSA), the Penetration-Aspiration Scale (PAS), the Fiberoptic Endoscopic Dysphagia Severity
      Scale(FEDSS), the Functional Oral Intake Scale (FOIS), and the functional near-infrared
      spectroscopic(fNIRS).
    

Detailed description: 
      Stroke is the leading cause of death and disability worldwide, and dysphagia is one of the
      common complications of stroke.Dysphagia after stroke can lead to serious complications such
      as aspiration, pneumonia, and malnutrition, which greatly reduces the quality of life of
      patients.Transcranial magnetic stimulation(TMS), a non-invasive central nervous system
      stimulation that is safe, non-invasive, and does not require active patient participation,
      has been gradually applied to stroke rehabilitation in recent years.Although there have been
      studies on the improvement of post stroke dysphagia(PSD) by healthy-side high-frequency rTMS,
      there have been no studies assessing the activation of relevant brain regions before and
      after its treatment by fNIRS and exploring the possible mechanisms involved. The aim of this
      study was to observe the effect of high-frequency rTMS stimulation of the healthy mandibular
      hyoid cortical area at 5 hz on PSD, and to explore the possible mechanisms by assessing it
      with fNIRS, so as to provide a theoretical basis for the clinical use of rTMS in the
      treatment of patients with PSD.
    

Intervention name(s): routine swallowing rehabilitation; real repetitive transcranial magnetic stimulation; sham repetitive transcranial magnetic stimulation
Intervention type(s): Other; Device; Device
Intervention description(s): Routine swallowing rehabilitation training mainly included oral and facial muscle training, ice stimulation therapy, Mendelssohn maneuver training, and tongue root resistance training. The subjects were treated twice a day, Monday through Saturday, for 20 min each time for 2 weeks. All operations were performed by the same trained and qualified professional rehabilitation therapist.; In the rTMS group, 5 Hz rTMS was applied to the hot spot of the supraglottic motor cortex of the affected hemisphere at a treatment intensity of 80% resting motor threshold for 10 min, with a total of 250 pulses (with an interval of 11 s for every 1 s of continuous stimulation), and the treatment was performed once a day for 6 d per week for 2 weeks.; The sham rTMS group supplemented pseudomagnetic stimulation at the hotspot of the representative area, tilted the magnetic stimulation coil at 90°, and the same noise was emitted by the instrument during the treatment, but no stimulation was performed, and the group was treated once a day, 6d per week, for 2 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment