ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia.MethodsThis 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.ResultsGroup 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.ConclusionrTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.

Purpose: To compare the accuracy and efficacy of ultrasound (US)-guided versus blind pes anserinus bursa (PAB) injection in patients with pes anserinus tendinobursitis (PATB).Methods: Forty-seven patients with clinically diagnosed PATB were randomly assigned to a USguided group or a blind group of steroid injection. In the US-guided group, the injectate was delivered under sonographic visualization. In the blind group, the conventional technique was used without any visual guidance. After the PAB injection, the injectate location was identified using US in both groups. Treatment effects were assessed using the visual analogue scale (VAS) of knee tenderness. Outcomes were measured before, 1 week and 4 weeks after the injection.Results: Both groups showed pain relieving at 1 week and 4 weeks after the injection. The injectate in the US guided group were found to be accurately at the PAB in all subjects, whereas blind group were found to be just in 4 of 22 subjects. The US-guided group showed significant improvement of both of VAS scores compared to the blind group at 1 week and 4 weeks after the injection (P < .05). Conclusion:Our results suggest that US-guided PAB injection is more accurate and effective than blind injection in patients with PATB. K E Y W O R D Sbursa injection, pes anserinus tendinobursitis, ultrasound