AUTHOR=Liu Huiyu , Peng Yang , Liu Zicai , Wen Xin , Li Fang , Zhong Lida , Rao Jinzhu , Li Li , Wang Minghong , Wang Pu 

TITLE=Hemodynamic signal changes and swallowing improvement of repetitive transcranial magnetic stimulation on stroke patients with dysphagia: A randomized controlled study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.918974

DOI=10.3389/fneur.2022.918974

ISSN=1664-2295

ABSTRACT=METHODS: This study was a sham-controlled, single-blind, randomized controlled study with a blinded observer. A total 49 patients completed the study, which were randomized to rTMS group (n=23) and sham rTMS group (n=26) by random number table method. The rTMS group received 5 Hz rTMS stimulation to the affected mylohyoid cortical region of brain, the sham rTMS group underwent rTMS using the same parameters as rTMS group, except for the position of coil. Each patient received 2 weeks of stimulation followed by conventional swallowing therapy. Standardized Swallowing Assessment (SSA), Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration-Aspiration Scale (PAS), and functional oral intake status were assessed at two times: baseline (before treatment) and 2 weeks (after intervention). Meanwhile, we use fNIRS system to measurement the cerebral hemodynamic changes during experimental procedure.
CONCLUSIONS: The present study confirmed that a 5Hz rTMS is feasible at the affected mylohyoid cortical region in poststroke patients with dysphagia and rTMS therapy can alter cortical excitability. Based on previous studies that there is a dominant hemisphere in swallowing and the results of our fNIRS analysis seemed to show a better increase in cortical activation on the right side than on the left after rTMS of the affected mylohyoid cortical region. However, there was no difference between left and right hemisphere in the subgroup analysis. Nevertheless, present study provides a novel and feasible method of applying fNIRS to assessment in stroke patients with dysphagia.