The effect of 5Hz high‐frequency rTMS over contralesional pharyngeal motor cortex in post‐stroke oropharyngeal dysphagia: a randomized controlled study

Park, Jin-Woo; Oh, Jong-Chi; Lee, J.-W.; Yeo, Jun Sang; Ryu, Kyu Hyung

doi:10.1111/nmo.12063

Cited by 128 publications

(157 citation statements)

References 23 publications

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“…1). We included a total of 10 studies, 5 about aphasia [9,11,26,27,28], 3 related to dysphagia [10,14,15], 1 about hypokinetic dysarthria in PD [7], and another one regarding a language deficit that was a consequence of AD [8]. Posteriorly, an aphasia study [28] was excluded because of a low JADAD score [25].…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, high-frequency rTMS can stimulate the recovery of perilesional areas related to language in the affected, left hemisphere [13]. For dysphagia, previous studies used high-frequency rTMS over the motor cortex but with divergence on the stimulated side [10,14,15]. Deglutition representation is bilateral but asymmetric.…”

Section: Introductionmentioning

confidence: 99%

“…Hence, when the stroke occurs in the dominant hemisphere, it causes dysphagia [16,17]. Nevertheless, the nonaffected side seems to restore the function [10,14]. …”

Section: Introductionmentioning

confidence: 99%

“…Low-frequency rTMS causes an inhibitory effect on the targeted region, whereas high-frequency rTMS increases local brain activity. These mechanisms promote neuroplastic changes and can lead to clinical benefits [2,6], including communication and deglutition disorders of individuals affected by neurological diseases [7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

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Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials

Gadenz¹,

Moreira²,

Capobianco³

et al. 2015

Folia Phoniatr Logop

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Objective: To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related to communication and swallowing functions. Methods: A search was conducted on PubMed, Clinical Trials, Cochrane Library, and ASHA electronic databases. Studies were judged according to the eligibility criteria and analyzed by 2 independent and blinded researchers. Results: We analyzed 9 studies: 4 about aphasia, 3 about dysphagia, 1 about dysarthria in Parkinson's disease and 1 about linguistic deficits in Alzheimer's disease. All aphasia studies used low-frequency rTMS to stimulate Broca's homologous area. High-frequency rTMS was applied over the pharyngoesophageal cortex from the left and/or right hemisphere in the dysphagia studies and over the left dorsolateral prefrontal cortex in the Parkinson's and Alzheimer's studies. Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. The other 2 studies related to aphasia found a benefit restricted to subgroups with a severe case or injury on the anterior portion of the language cortical area, respectively, whereas the Alzheimer's study demonstrated positive effects specific to auditory comprehension. There were no changes for vocal function in the Parkinson's study. Conclusion: The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still uncertain. Therefore, other randomized controlled trials are needed to clarify the optimal stimulation protocol for each disorder studied and its real effects.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Hence, when the stroke occurs in the dominant hemisphere, it causes dysphagia [16,17]. Nevertheless, the nonaffected side seems to restore the function [10,14]. …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials

Gadenz¹,

Moreira²,

Capobianco³

et al. 2015

Folia Phoniatr Logop

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“…Changes in excitability of cortical projections to various swallowing muscles have been documented in response to treatments with TMS induced motor evoked potentials (MEPs). Beneficial effects of 5 Hz rTMS on swallowing motor cortex were observed following a repeated application of the technique over a period of weeks (21), (22).…”

Section: Assessment Of Swallowing Disorders Includes Clinical and Parmentioning

confidence: 99%

Swallowing Disorders in Clinical Practice: Functional Anatomy, Assessment and Rehabilitation Strategies

Ioana¹,

Gabriela²,

Hațieganu³

2014

BALNEO

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Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle.Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition.

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Swallowing therapy for dysphagia in acute and subacute stroke

Bath

Lee

Everton

2018

Cochrane Database of Systematic Reviews

137

145

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Background Dysphagia (swallowing problems), which is common a er stroke, is associated with increased risk of death or dependency, occurrence of pneumonia, poor quality of life, and longer hospital stay. Treatments provided to improve dysphagia are aimed at accelerating recovery of swallowing function and reducing these risks. This is an update of the review first published in 1999 and updated in 2012. Objectives To assess the e ects of swallowing therapy on death or dependency among stroke survivors with dysphagia within six months of stroke onset.

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The effect of 5Hz high‐frequency rTMS over contralesional pharyngeal motor cortex in post‐stroke oropharyngeal dysphagia: a randomized controlled study

Abstract: A 5Hz high-frequency rTMS on contra-lesional pharyngeal motor cortex might be beneficial for post-stroke dysphagic patients. This intervention can be used as a new treatment method in post-stroke patients with dysphagia.

Cited by 128 publications

References 23 publications

Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials

Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials

Swallowing Disorders in Clinical Practice: Functional Anatomy, Assessment and Rehabilitation Strategies

Swallowing therapy for dysphagia in acute and subacute stroke

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