Transcranial Magnetic Stimulation Versus Transcutaneous Neuromuscular Electrical Stimulation in Post Stroke Dysphagia: A Clinical Randomized Controlled Trial

Hammad, Azza B.; Elhamrawy, Eman A.; Abdel-Tawab, Hayam; Shafik, Mohamed Ahmed; Sallam, Yossra; Elzomor, Hala Mohamed; Bahbah, Eshak I.

doi:10.1016/j.jstrokecerebrovasdis.2022.106554

Cited by 8 publications

(6 citation statements)

References 47 publications

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“…Both outcomes were more favourable than those of the control group, according to the results. However, high frequency transcranial magnetic stimulation produced greater results in swallowing disturbance questionnaire and PAS 48 …”

Section: Discussionmentioning

confidence: 91%

“…However, high frequency transcranial magnetic stimulation produced greater results in swallowing disturbance questionnaire and PAS. 48 The working mechanism behind SNMES has been a controversial subject of the treatment since its introduction, mainly because of a limited number of related studies. Sulica 29 and Teismann 30 demonstrated that the absence of sensory input from the oropharyngeal region resulted in difficulty swallowing, suggesting the involvement of its influence in the process.…”

Section: Discussionmentioning

confidence: 99%

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Sensory neuromuscular electrical stimulation for dysphagia rehabilitation: A literature review

Assoratgoon

Shiraishi

Tagaino

et al. 2022

J of Oral Rehabilitation

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Oropharyngeal dysphagia is a disorder categorised by the impaired function of the apparatus responsible for swallowing. 1 It is one of the most common complications among post-stroke patients. Occurring in 64% to 78% of patients recovering from a stroke, 2 this disorder is reported to be a major cause of malnutrition, dehydration, aspiration and respiratory complications. Usually, the conditions gradually improve during the first few weeks after the stroke, but 50% of the patient develop prolonged dysfunctionality lasting several months. 3 In severe cases, during the first year of the symptoms, up to 37%-78% of the patients suffer from aspiration pneumonia, 2,3 an infection that can lead to an increased mortality rate. 4 Conventional management strategies for dysphagia involve strengthening exercise, posture modification and diet replacement.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Sensory neuromuscular electrical stimulation for dysphagia rehabilitation: A literature review

Assoratgoon

Shiraishi

Tagaino

et al. 2022

J of Oral Rehabilitation

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“…Numerous studies have demonstrated the efficacy of rTMS in enhancing swallowing function. Both HF-rTMS and LF-rTMS interventions have shown positive outcomes in various studies targeting the ipsilateral or contralateral cerebral cortex of lesion ( Cheng et al., 2015 ; Lee et al., 2015 ; Park et al., 2017 ; Du et al., 2022 ; Hammad et al., 2022 ). Park et al.…”

Section: Discussionmentioning

confidence: 99%

“…Routine therapies such as postural substitution and adjustment of food texture do not have satisfactory effectiveness ( Reyes-Torres et al., 2019 ; Lin et al., 2021 ). However, recent studies have reported that noninvasive brain stimulation such as transcranial magnetic stimulation (TMS) is effective in improving swallow function ( Chiang et al., 2019 ; Du et al., 2022 ; Hammad et al., 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Comprehensive assessment of HF-rTMS treatment mechanism for post-stroke dysphagia in rats by integration of fecal metabolomics and 16S rRNA sequencing

Zhao,

Chen,

Shan

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundThe mechanism by which high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) improves swallowing function by regulating intestinal flora remains unexplored. We aimed to evaluate this using fecal metabolomics and 16S rRNA sequencing.MethodsA Post-stroke dysphagia (PSD) rat model was established by middle cerebral artery occlusion. The magnetic stimulation group received HF-rTMS from the 7th day post-operation up to 14th day post-surgery. Swallowing function was assessed using a videofluoroscopic swallowing study (VFSS). Hematoxylin-eosin (H&E) staining was used to assess histopathological changes in the intestinal tissue. Intestinal flora levels were evaluated by sequencing the 16S rRNA V3-V4 region. Metabolite changes within the intestinal flora were evaluated by fecal metabolomics using liquid chromatography-tandem mass spectrometry.ResultsVFSS showed that the bolus area and pharyngeal bolus speed were significantly decreased in PSD rats, while the bolus area increased and pharyngeal transit time decreased after HF-rTMS administration (p < 0.05). In the PSD groups, H&E staining revealed damaged surface epithelial cells and disrupted cryptal glands, whereas HF-rTMS reinforced the integrity of the intestinal epithelial cells. 16S rRNA sequencing indicated that PSD can disturb the intestinal flora and its associated metabolites, whereas HF-rTMS can significantly regulate the composition of the intestinal microflora. Firmicutes and Lactobacillus abundances were lower in the PSD group than in the baseline group at the phylum and genus levels, respectively; however, both increased after HF-rTMS administration. Levels of ceramides (Cer), free fatty acids (FA), phosphatidylethanolamine (PE), triacylglycerol (TAG), and sulfoquinovosyl diacylglycerol were increased in the PSD group. The Cer, FA, and DG levels decreased after HF-rTMS treatment, whereas the TAG levels increased. Peptococcaceae was negatively correlated with Cer, Streptococcus was negatively correlated with DG, and Acutalibacter was positively correlated with FA and Cer. However, these changes were effectively restored by HF-rTMS, resulting in recovery from dysphagia.ConclusionThese findings suggest a synergistic role for the gut microbiota and fecal metabolites in the development of PSD and the therapeutic mechanisms underlying HF-rTMS.

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“…Anyway, among the strengths of tDCS, there are greater accessibility to treatment and possibility of home therapy, thanks to portable devices. Hammad et al [107 ▪ ] compared the effects of rTMS with those of NMES and found the first treatment more effective in patients with poststroke dysphagia.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

Cosentino

Todisco

Giudice

et al. 2022

Current Opinion in Neurology

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Purpose of reviewNeurogenic dysphagia worsens quality of life and prognosis of patients with different neurological disorders. Management of neurogenic dysphagia can be challenging. This review provides a comprehensive overview of current evidence on screening, diagnosis, and treatment of neurogenic dysphagia in stroke and Parkinson's disease, suggesting clues for clinical practice.Recent findingsThe pros and cons of diagnostic techniques are discussed in the light of updated evidence. Findings from recent meta-analyses of different treatment approaches, including traditional dysphagia therapy, peripheral and central neurostimulation techniques, and treatment with botulinum toxin, are critically discussed, emphasizing inconsistencies and controversial issues.SummaryScreening tests and clinical swallow examination should be routinely performed in neurological patients at risk for dysphagia. In patients testing positive for dysphagia, first-line instrumental investigations, represented by fiberoptic endoscopic evaluation of swallowing or videofluoroscopic swallow study, should be performed to confirm the presence of dysphagia, to assess its severity, and to inform the treatment. Second-line and third-line instrumental methods can be used in selected patients to clarify specific pathophysiological aspects of oropharyngeal dysphagia. Treatment strategies should be personalized, and combination of traditional dysphagia therapy with innovative treatment approaches may increase the chance of restoring effective and safe swallowing.

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Transcranial Magnetic Stimulation Versus Transcutaneous Neuromuscular Electrical Stimulation in Post Stroke Dysphagia: A Clinical Randomized Controlled Trial

Cited by 8 publications

References 47 publications

Sensory neuromuscular electrical stimulation for dysphagia rehabilitation: A literature review

Sensory neuromuscular electrical stimulation for dysphagia rehabilitation: A literature review

Comprehensive assessment of HF-rTMS treatment mechanism for post-stroke dysphagia in rats by integration of fecal metabolomics and 16S rRNA sequencing

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

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