The Clinical Study Of Bilateral Combined Repetitive Transcranial Magnetic Stimulation In The Treatment Of Dysphagia After Stroke

Objective:To explore the effect of bilateral combined repetitive transcranial magnetic stimulation on dysphagia after stroke and the effect on motor evoked potential of the mylohyoid muscle.Methods: Fiftytwo patients with poststroke dysphagia were randomly divided into four groups: the sham stimulation group,the contralesional stimulation group,the ipsilesional stimulation group and the bilateral stimulation group.All patients were all treated with routine swallowing training.The r TMS stimulation parameters were 1 Hz for the unaffected side stimulation frequency and 3 Hz for the affected side,five consecutive days per week,totally two weeks.Swallowing function including the water swallow test,the degree of dysphagia,and the standard swallowing assessment were assessed and the latency and amplitude of motor evoked potential of the mylohyoid muscle were measured before as well as immediately after treatment.The changes of swallowing function scale score and MEP were compared in the four groups.Results:1.In the sham stimulation group,only the difference of the SSA score was statistically significant.2.The difference ofthe contralesional stimulation group,the ipsilesional stimulation group and the bilateral stimulation group in the water swallow test,the degree of dysphagia,and the SSA scorewas statistically significant.And there was no statistically significant difference among the three groups.3.The difference of the latency and amplitude of MEP in bilateral mylohyoid muscle was no difference in the sham group.There were significant differences in the bilateral MEP of the contralesional stimulation group and the bilateral stimulation group.And there was no statistically significant difference between the two groups.Conclusion:1.The rTMS of 1 Hz on the unaffected side,3 Hz on the affected side and bilateral combined can improve the dysphagia after stroke,but the improvement was no difference among the three groups.2.The r TMS of 1 Hz on the unaffected side and bilateral combinednot only can prolong the MEP latency and decrease the amplitude of the unaffected side,but also can shorten the MEP latency and increase the amplitude of the affected side.And there was no significant difference between the two groups.3.The r TMS of 3 Hz on the affected side only can shorten the MEP latency and increase the amplitude of the affected side.