Ann Rehabil Med.  2011 Dec;35(6):765-771. 10.5535/arm.2011.35.6.765.

Effect of Repetitive Transcranial Magnetic Stimulation on Patients with Brain Injury and Dysphagia

• Kim L
• Chun MH
• Kim BR
• Lee SJ

• KMID: 2266801
• DOI: http://doi.org/10.5535/arm.2011.35.6.765

Abstract

OBJECTIVE
To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on recovery of the swallowing function in patients with a brain injury. METHOD: Patients with a brain injury and dysphagia were enrolled. Patients were randomly assigned to sham, and low and high frequency stimulation groups. We performed rTMS at 100% of motor evoked potential (MEP) threshold and a 5 Hz frequency for 10 seconds and then repeated this every minute in the high frequency group. In the low frequency group, magnetic stimulation was conducted at 100% of MEP threshold and a 1 Hz frequency. The sham group was treated using the same parameters as the high frequency group, but the coil was rotated 90degrees to create a stimulus noise. The treatment period was 2 weeks (5 days per week, 20 minutes per session). We evaluated the Functional Dysphagia Scale (FDS) and the Penetration Aspiration Scale (PAS) with a videofluoroscopic swallowing study before and after rTMS.
RESULTS
Thirty patients were enrolled, and mean patient age was 68.2 years. FDS and PAS scores improved significantly in the low frequency group after rTMS, and American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale scores improved in the sham and low frequency groups. FDS and PAS scores improved significantly in the low frequency group compared to those in the other groups.
CONCLUSION
We demonstrated that low frequency rTMS facilitated the recovery of swallowing function in patients with a brain injury, suggesting that rTMS is a useful modality to recover swallowing function.

Keyword

Dysphagia; Repetitive transcranial magnetic stimulation; Brain injury

MeSH Terms

Brain
Brain Injuries
Deglutition
Deglutition Disorders
Evoked Potentials, Motor
Hearing
Humans
Magnetics
Magnets
Noise
Salicylamides
Transcranial Magnetic Stimulation
Salicylamides

Figure

• 

  Fig. 1 Improvement in dysphagic parameters after repetitive transcranial magnetic stimulation (rTMS) treatment in each group. Functional Dysphagia Scale and Penetration Aspiration Scale scores improved only in the low-frequency stimulation group after rTMS (A, B). The American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale score improved in both the sham and low-frequency stimulation groups (C). Values represent mean±SD. FDS: Functional Dysphagia Scale, PAS: Penetration Aspiration Scale, ASHA NOMS: American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale. *p<0.05.

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