Article

A meta-analysis and systematic review was conducted to investigate
the potential effects of repetitive transcranial magnetic stimulation on
dysphagia in patients with stroke, including different parameters of frequency
and stimulation site. METHODS: PubMed, Embase, MEDLINE databases and the Cochrane
Library, were searched for randomized controlled studies of repetitive
transcranial magnetic stimulation treatment of dysphagia published before March 2016. RESULTS: Six clinical randomized controlled studies of a total of 163
stroke patients were included in this meta-analysis. A significant effect size of
1.24 was found for dysphagic outcome (mean effect size, 1.24; 95% confidence
interval (CI), 0.67-1.81). A subgroup analysis based on frequency showed that the
clinical scores were significantly improved in dysphagic patients with low
frequency repetitive transcranial magnetic stimulation treatment
( P < 0.05) as
well as high frequency repetitive transcranial magnetic stimulation treatment ( P
< 0.05). A stimulation site stratified subgroup analysis implied significant
changes in stroke patients with dysphagia for the unaffected hemisphere ( P <
0.05) and the bilateral hemisphere stimulation
( P < 0.05), but not for the
affected hemisphere ( P > 0.05). The analysis of the follow-up data shows that
patients in the repetitive transcranial magnetic stimulation groups still
maintained the therapeutic benefit of repetitive transcranial magnetic
stimulation four weeks after the last session of repetitive transcranial magnetic
stimulation therapy ( P < 0.05). CONCLUSION: This meta-analysis indicates that
repetitive transcranial magnetic stimulation has a positive effect on dysphagia
after stroke. Compared with low-frequency repetitive transcranial magnetic
stimulation, high-frequency repetitive transcranial magnetic stimulation may be
more beneficial to the patients. This meta-analysis also supports that repetitive
transcranial magnetic stimulation on an unaffected - or bilateral - hemisphere
has a significant therapeutic effect on dysphagia.

Langue : ANGLAIS