Transcranial Magnetic Stimulation Clinical Trial
Official title:
Neuromodulation With rTMS in Dysphagic Patients With Stroke
The patients with chronic dysphagia secondary to first-ever stroke were randomly assigned to 2 groups: Group A: sham stimulation for 10 minutes , Group B: real rTMS for 10 minutes. rTMS conditioning: daily rTMS 10 min for 10 days. Assessments: 1. videofluoroscopy,2.Functional outcome swallowing scale (3 scales). 3. MEP measurements
While the reflex component of swallowing depends on swallowing centres in the brainstem,
initiation of swallowing is a voluntary action that involves the integrity of motor areas of
the cerebral cortex. Oropharyngeal dysphagia occurs in more than 50% of stroke patients.
Aspiration pneumonia occurs in up to 20% of acute stroke patients and is a major cause of
mortality after discharge. Oropharyngeal dysphagia is both underestimated and underdiagnosed
as a cause of major nutritional and respiratory complications in stroke patients. Recently,
transcranial magnetic stimulation (TMS) has been used to study the cortical input to
swallowing control and has revealed that the topographic representation of esophageal motor
function in the human cerebral cortex is bilateral but with consistent interhemispheric
asymmetry unrelated to handedness.
In a number of recent studies, poststroke motor and dysphagia performance has been improved
after daily treatment sessions with repetitive TMS (rTMS) using an excitatory frequency in
patients with hemispheric ischaemic stroke due to occlusion of territories of the middle
cerebral artery. Our hypothesis was that rTMS would facilitate dysphagia recovery.
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