Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation

Khedr, Eman M.; El-Fetoh, Noha Abo; Rothwell, John C.

doi:10.1111/j.1600-0404.2008.01093.x

Cited by 182 publications

(184 citation statements)

References 19 publications

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“…Compared to the standard therapy group, the study group had better scores in all tests used, and the gains remained at 10 days after the end of treatment. The same group has reported beneficial effects of rTMS on dysphagia in the subacute stage (70). The first study on long-term follow-up of patients treated 5-15 days after stroke with 5 daily stimulations and followed for 1 year demonstrated a lasting benefit (71).…”

Section: Electrical Brain Stimulationmentioning

confidence: 99%

Current trends in stroke rehabilitation. A review with focus on brain plasticity

Johansson

2010

Acta Neurologica Scandinavica

245

157

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Section: Electrical Brain Stimulationmentioning

confidence: 99%

Current trends in stroke rehabilitation. A review with focus on brain plasticity

Johansson

2010

Acta Neurologica Scandinavica

245

157

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“…Dysphagia is a life threatening symptom of a brain injury. It is caused by pseudobulbar paralysis or a lesion in the brain stem which was improved after rTMS [40,41]. In addition to the wide therapeutic application of rTMS the spasticity can also be decreased by rTMS with low and high frequency stimulation [25,42].…”

Section: Influence On Different Symptoms Of Stroke With Noninvasive Bmentioning

confidence: 99%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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Two non-invasive brain stimulations have spread all over the world: repetitive trasncranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). TMS is based on the current induction with a changing electromagnetic field in the nervous system [1] while tDCS changes the polarity of cell membranes [2]. General Aspects of TMS and tDCSTMS is widely used in research and daily medical practice. It was introduced as a diagnostic tool about thirty years ago to test functioning of motor pathways [3]. The motor evoked potential (MEP) and the measurement of the central motor conduction time (CMCT) has entered into daily practice. The other parameters of the electrophysiological examination assessed by TMS are mainly used in scientific work [4]. TMS aids the diagnosis of multiple sclerosis, furthermore the prognosis of stroke can be indicated by TMS [5]. Different paired pulse stimulations with TMS give a new insight into the function of the brain. In recent years, sophisticated brain plasticity can be detected by the measurement of intracortical excitability [6,7]. We learnt from these studies how different conditions can modify brain plasticity. It can be changed by different diseases, altered by drugs [8] and strongly influenced by non-invasive stimulations [2,9]. The single TMS and one session of repetitive stimulation have a short after-effect. However the effect of repeated stimulation for days exceeds the stimulation period and many times it lasts for months. This effect of rTMS has made it useful for therapy for the last 20 years. The low and high frequency stimulation, continuous theta burst stimulation (cTBS), intermittent theta burst stimulation (iTBS), anodal or cathodal stimulation are used for therapy. The intensity of rTMS was around the motor threshold and the duration of stimulation was 7-10 days. This paper reviews the most frequently studied symptoms of Parkinson's diseases and stroke although rTMS has been tried to treat all disorders of the central nervous system (CNS). Parkinson's Disease (PD)The first protocol was low frequency, low intensity monophasic stimulation for 7 days which improved the Parkinsonian symptoms and its results were maintained for several months after the stimulation [10,11]. The authors performed a "dose (intensity) response" curve with 1 Hz stimulation and they indicated that there is an optimal intensity using 1 Hz [12]. We learned from these studies that the therapeutic effect of rTMS develops after a delay in time of a few weeks. The improvement can be maintained for several months. The later studies confirmed these observations not only in PD but other diseases. Although, the high frequency stimulations over the primary motor cortex [13,14] had the same effect on the Parkinsonian scores but the after-effect lasted for a shorter time. iTBS over the dorsolateral prefrontal area improved the depression without effecting on bradykinesia [15]. The studies concentrated on varying the frequency which was applied but they did not try to find the optimal in...

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“…Four trials (15,16,20,22) used DOSS and 3 trials (17 -19) used PAS for assessment of outcome. Other reported outcome measures included Functional Dysphagia Scale : FDS (23), American Speech-Language -Hearing Association National Outcome Measurement System swallowing scale : ASHS NOMS swallowing scale (24), Videofluoroscopic Dysphagia Scale : VDS (25) and Pharyngeal Transit Time : PTT (26).…”

Section: Outcome Measuresmentioning

confidence: 99%

Noninvasive brain stimulation for dysphagia after acquired brain injury: a systematic review

et al. 2016

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: The purpose of this study was to review the best available evidence of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) for dysphagia after acquired brain injury. We searched randomized controlled trials that compared noninvasive brain stimulation with control used to improve dysphagia after acquired brain injury. We assessed dysphagia severity rating scales and penetration-aspiration scale as outcomes immediately after intervention. We calculated the pooled estimate of the standardized mean difference (SMD) to combine individual results. We included 8 published studies. Two heterogenous trials of 48 patients showed that rTMS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 2.95). Three homogeneous trials of 88 patients showed a significant effect of rTMS on the penetration -aspiration scale score (SMD 0.77). Two homogeneous trials of 34 patients showed that tDCS was associated with a significant improvement in the dysphagia severity rating scale score (SMD 1.20). The review provided low-quality evidence for the effectiveness of noninvasive brain stimulation in improving dysphagia after acquired brain injury. Further trials of larger sample sizes are needed to determine the most appropriate noninvasive brain stimulation protocol. J. Med. Invest. 63 : 153-158, August, 2016

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Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation

Abstract: rTMS may be a useful adjunct to conventional therapy for dysphagia after stroke.

Cited by 182 publications

References 19 publications

Current trends in stroke rehabilitation. A review with focus on brain plasticity

Current trends in stroke rehabilitation. A review with focus on brain plasticity

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

Noninvasive brain stimulation for dysphagia after acquired brain injury: a systematic review

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