Efficacy Of Transcranial Magnetic Stimulation Combined With Biofeedback In The Treatment Of Post-stroke Dysphagia

Objective: To discuss the effect of rTMS combined with EMG-BF in the treatment of post-stroke dysphagia,and to expose its mechanism.Methods: 60 patients were screeninged and randomly divided into 4 groups:Group A(spurious-stimulation group),Group B(high-frequency group),group C(low-frequency group),and group D(high-frequency + lowfrequency stimulus).All patients were given EMG-BF and conventional drug therapy.Group A received bilateral sham stimulation;Group B received 5Hz rTMS in the affected hemisphere and sham stimulation in the healthy hemisphere.Group C received 1Hz rTMS in the healthy hemisphere and sham stimulation in the affected hemisphere.Group D received 5Hz rTMS in the affected hemisphere and 1Hz rTMS in the healthy hemisphere.These treatments mentioned above were given once a day,5 days every week,lasted for 2 weeks.Before and after the treatment,Evaluation scales and the nutritional status(serum albumin)were used to evaluate the swallowing function of the patients.Results: A total of 60 patients were enrolled in this study,and no one gave up halfway.(1)The Water swallow test grading,SSA and serum albumin index of4 groups after treatment were better than before treatment(P < 0.05);(2)After treatment,the efficacy of Water swallow test,SSA after treatment,SSA difference before and after treatment,albumin difference before and after treatment,and MBI difference before and after treatment in groups B,C and D were better than those in group A(P<0.05).(3)After treatment,the difference of SSA before and after treatment in group D was greater than that in groups B and C(P<0.05),but there was no significant difference between groups B and C(P>0.05);(4)There was no significant difference in the efficacy of Water swallow test,albumin after treatment,albumin difference before and after treatment,MBI difference before and after treatment in group B,C and D(P>0.05).Conclusions: rTMS combined with EMG-BF was more effective than single EMG-BF,and bilateral combination therapy was more effective than unilateral combination therapy,while there was no significant difference between high-frequency rTMS in the affected side and low-frequency rTMS in the healthy side.