Improvement of Post-stroke Dysphagia by Intermittent Theta Burst Stimulation

Abstract

The present study aims to investigate the efficacy of intermittent theta burst stimulation (iTBS) on post-stroke dysphagia and its effect on the motor cortical excitability of the suprahyoid muscle. A total of 40 patients with post-stroke dysphagia were randomly divided into the iTBS and the sham stimulation groups, with the conduction of motor cortical iTBS and sham stimulation of the supraglottal muscle on the affected side, respectively. Swallowing function was assessed before (T0), immediately after (T1), and two weeks after (T2) cessation of the intervention using the water-swallowing test (WST), standard swallowing assessment (SSA), Murray secretion scale (MSS), and Penetration’Aspiration Scale (PAS). The bilateral motor evoked potentials (MEP) of the suprahyoid muscle were recorded. After the intervention, the PAS, WST, SSA, and MSS scores were significantly improved in both groups (p < 0.05). The iTBS group showed a greater change in the PAS score than the sham stimulation group at T1 (p < 0.05) and a greater change in the WST and MSS scores at T2 (p < 0.05). The amplitude of the MEP wave of the suprahyoid muscle in the affected hemisphere was significantly higher in the iTBS group at T1 and in the healthy hemisphere at T2 (p < 0.05). The feasibility of applying iTBS to the affected hemisphere for the treatment of post-stroke dysphagia was directly analyzed for the first time. ITBS combined with conventional swallowing therapy could be adopted as a rehabilitation strategy to improve post-stroke dysphagia.