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Effect of Repetitive Transcranial Magnetic Stimulation According to the Stimulation Site in Stroke Patients With Dysphagia.

Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU - Ann Rehabil Med (2015)

Bottom Line: This study was designed as a matched comparative study.Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS.There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS. rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation and Regional Cardiocerebrovascular Center, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia.

Methods: This study was designed as a matched comparative study. Twenty-four patients who had dysphagia after ischemic stroke were recruited, and they were divided into two groups after matching for age and stroke lesion. The patients in group A received rTMS over the brain cortex where motor evoked potential (MEP) was obtained from the suprahyoid muscle. Group B received rTMS over the brain cortex where MEP was obtained from the abductor pollicis brevis muscle. rTMS was performed at 110% of MEP threshold, 10 Hz frequency for 10 seconds, and then repeated every minute for 10 minutes. Dysphagia status was measured by the Functional Dysphagia Scale (FDS), the Penetration-Aspiration Scale (PAS), and the Dysphagia Outcome and Severity Scale (DOSS) using the results of a videofluoroscopic swallowing study. These evaluations were measured before, immediately, and 4 weeks after rTMS.

Results: Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS. There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS.

Conclusion: rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.

No MeSH data available.


Related in: MedlinePlus

In repeated measures analysis of variance test, all dysphagia scores were improved over time up to 4 weeks after rTMS in group A and only FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores. FDS, Functional Dysphagia Scale; PAS, Penetration-Aspiration Scale; DOSS, Dysphagia Outcome and Severity Scale; rTMS, repetitive transcranial magnetic stimulation; group A, rTMS over the cortex representing the suprahyoid muscle; group B, rTMS over the cortex representing the abductor pollicis brevis. *p<0.05.
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Figure 2: In repeated measures analysis of variance test, all dysphagia scores were improved over time up to 4 weeks after rTMS in group A and only FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores. FDS, Functional Dysphagia Scale; PAS, Penetration-Aspiration Scale; DOSS, Dysphagia Outcome and Severity Scale; rTMS, repetitive transcranial magnetic stimulation; group A, rTMS over the cortex representing the suprahyoid muscle; group B, rTMS over the cortex representing the abductor pollicis brevis. *p<0.05.

Mentions: In repeated measures ANOVA test, all dysphagia scores (FDS, PAS, DOSS) were improved over time up to 4 weeks after rTMS in group A and only the FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores (FDS, PAS, DOSS) (Fig. 2). K-MBI was improved over time up to 4 weeks after rTMS, while there was no significant group-time interaction. The MMSE score was not significantly improved over time up to 4 weeks after rTMS, and there was no significant group-time interaction (Fig. 3).


Effect of Repetitive Transcranial Magnetic Stimulation According to the Stimulation Site in Stroke Patients With Dysphagia.

Lee JH, Kim SB, Lee KW, Lee SJ, Lee JU - Ann Rehabil Med (2015)

In repeated measures analysis of variance test, all dysphagia scores were improved over time up to 4 weeks after rTMS in group A and only FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores. FDS, Functional Dysphagia Scale; PAS, Penetration-Aspiration Scale; DOSS, Dysphagia Outcome and Severity Scale; rTMS, repetitive transcranial magnetic stimulation; group A, rTMS over the cortex representing the suprahyoid muscle; group B, rTMS over the cortex representing the abductor pollicis brevis. *p<0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496515&req=5

Figure 2: In repeated measures analysis of variance test, all dysphagia scores were improved over time up to 4 weeks after rTMS in group A and only FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores. FDS, Functional Dysphagia Scale; PAS, Penetration-Aspiration Scale; DOSS, Dysphagia Outcome and Severity Scale; rTMS, repetitive transcranial magnetic stimulation; group A, rTMS over the cortex representing the suprahyoid muscle; group B, rTMS over the cortex representing the abductor pollicis brevis. *p<0.05.
Mentions: In repeated measures ANOVA test, all dysphagia scores (FDS, PAS, DOSS) were improved over time up to 4 weeks after rTMS in group A and only the FDS score was improved in group B. There was no significant group-time interaction in all dysphagia scores (FDS, PAS, DOSS) (Fig. 2). K-MBI was improved over time up to 4 weeks after rTMS, while there was no significant group-time interaction. The MMSE score was not significantly improved over time up to 4 weeks after rTMS, and there was no significant group-time interaction (Fig. 3).

Bottom Line: This study was designed as a matched comparative study.Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS.There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS. rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation and Regional Cardiocerebrovascular Center, Dong-A University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia.

Methods: This study was designed as a matched comparative study. Twenty-four patients who had dysphagia after ischemic stroke were recruited, and they were divided into two groups after matching for age and stroke lesion. The patients in group A received rTMS over the brain cortex where motor evoked potential (MEP) was obtained from the suprahyoid muscle. Group B received rTMS over the brain cortex where MEP was obtained from the abductor pollicis brevis muscle. rTMS was performed at 110% of MEP threshold, 10 Hz frequency for 10 seconds, and then repeated every minute for 10 minutes. Dysphagia status was measured by the Functional Dysphagia Scale (FDS), the Penetration-Aspiration Scale (PAS), and the Dysphagia Outcome and Severity Scale (DOSS) using the results of a videofluoroscopic swallowing study. These evaluations were measured before, immediately, and 4 weeks after rTMS.

Results: Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS. There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS.

Conclusion: rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.

No MeSH data available.


Related in: MedlinePlus