| Objective:To assess the effectiveness of repetitive transcranial magnetic stimulation(rTMS)in patients with post stroke dysphagia,and attempt to find the most appropriate frequency and stimulus site.Methods:Potentially eligible randomized controlled trials(RCTs)were searched from Pub Med,Embase,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Sino Med Database and Wanfang Medical Database.Then evaluated the eligibility of retrieved articles and assessed the risk of bias of studies with the Revman5.3 software.Some swallowing related indicators evaluated before and after therapy were extracted to analyse.Results:From 11 articles,15 RCTs were analyzed.The Standardized Swallowing Assessment(SSA)and the Food Intake LEVEL Scale(FILS)showed that rTMS did effective with dysphagia after stroke.The Standardized Swallowing Assessment(SSA)was SMD=-0.95,95%CI=(-1.18,-0.72)P<0.00001,I~2=0%.The Food Intake LEVEL Scale(FILS)was SMD=1.14,95%CI=(0.76,1.51)P<0.00001,I~2=42%.The results of network meta-analysis showed that 5Hz was the best choice among the3 different frequencies,and the both hemispheres seemed much more effective.Conclusion:For patients with dysphagia after stroke,rTMS was statistically significant.Meanwhile,5 Hz rTMS and the both hemispheres may be the best therapeutic schedule according to the network meta-analysis. |
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