Effect of Repetitive Transcranial Magnetic Stimulation According to the Stimulation Site in Stroke Patients With Dysphagia
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Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia.Methods This study was designed as a matched comparative study. Twenty-four patients who had dysphagia after ischemic stroke were recruited, and they were divided into two groups after matching for age and stroke lesion. The patients in group A received rTMS over the brain cortex where motor evoked potential (MEP) was obtained from the suprahyoid muscle. Group B received rTMS over the brain cortex where MEP was obtained from the abductor pollicis brevis muscle. rTMS was performed at 110% of MEP threshold, 10 Hz frequency for 10 seconds, and then repeated every minute for 10 minutes. Dysphagia status was measured by the Functional Dysphagia Scale (FDS), the Penetration-Aspiration Scale (PAS), and the Dysphagia Outcome and Severity Scale (DOSS) using the results of a videofluoroscopic swallowing study. These evaluations were measured before, immediately, and 4 weeks after rTMS.Results Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS. There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS.Conclusion rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.
Abstract
Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) according to the stimulation site in subacute stroke patients with dysphagia.Methods This study was designed as a matched comparative study. Twenty-four patients who had dysphagia after ischemic stroke were recruited, and they were divided into two groups after matching for age and stroke lesion. The patients in group A received rTMS over the brain cortex where motor evoked potential (MEP) was obtained from the suprahyoid muscle. Group B received rTMS over the brain cortex where MEP was obtained from the abductor pollicis brevis muscle. rTMS was performed at 110% of MEP threshold, 10 Hz frequency for 10 seconds, and then repeated every minute for 10 minutes. Dysphagia status was measured by the Functional Dysphagia Scale (FDS), the Penetration-Aspiration Scale (PAS), and the Dysphagia Outcome and Severity Scale (DOSS) using the results of a videofluoroscopic swallowing study. These evaluations were measured before, immediately, and 4 weeks after rTMS.Results Group A showed significant improvement compared to group B in the DOSS score immediately and 4 weeks after rTMS. There were no significant differences in the changes of FDS and PAS scores between groups A and B immediately and 4 weeks after rTMS.Conclusion rTMS over a hot spot for the suprahyoid muscle caused more improvement in swallowing function when compared to that over the interconnected site.
참고문헌 (29)
- Martino R, "Dysphagia after stroke: incidence, diagnosis, and pulmonary complications", Stroke, 36, pp.2756~2763 (2005)
- Finestone HM, "Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors", Arch Phys Med Rehabil, 76, pp.310~316 (1995)
- Gordon C, "Dysphagia in acute stroke", Br Med J (Clin Res Ed), 295, pp.411~414 (1987)
- Kidd D, "The natural history and clinical consequences of aspiration in acute stroke", QJM, 88, pp.409~413 (1995)
- Smithard DG, "Complications and outcome after acute stroke. Does dysphagia matter?", Stroke, 27, pp.1200~1204 (1996)
- Sharma JC, "What influences outcome of stroke: pyrexia or dysphagia?", Int J Clin Pract, 55, pp.17~20 (2001)
- Hamdy S, "Organization and reorganization of human swallowing motor cortex: implications for recovery after stroke", Clin Sci (Lond), 99, pp.151~157 (2000)
- Barwood CH, "rTMS as a treatment for neurogenic communication and swallowing disorders", Acta Neurol Scand, 127, pp.77~91 (2013)
- Khedr EM, "Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation", Acta Neurol Scand, 119, pp.155~161 (2009)
- Khedr EM, "Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction", J Neurol Neurosurg Psychiatry, 81, pp.495~499 (2010)
- Verin E, "Poststroke dysphagia rehabilitation by repetitive transcranial magnetic stimulation: a noncontrolled pilot study", Dysphagia, 24, pp.204~210 (2009)
- Hamdy S, "Cortical activation during human volitional swallowing: an event-related fMRI study", Am J Physiol, 277(1 Pt 1), pp.G219~G225 (1999)
- Zald DH, "The functional neuroanatomy of voluntary swallowing", Ann Neurol, 46, pp.281~286 (1999)
- Martin RE, "Menon RS. Cerebral cortical representation of automatic and volitional swallowing in humans", J Neurophysiol, 85, pp.938~950 (2001)
- Mosier K, "Parallel cortical networks for volitional control of swallowing in humans", Exp Brain Res, 140, pp.280~289 (2001)
- Bestmann S, "Subthreshold high-frequency TMS of human primary motor cortex modulates interconnected frontal motor areas as detected by interleaved fMRI-TMS", Neuroimage, 20, pp.1685~1696 (2003)
- Reithler J, "Multimodal transcranial magnetic stimulation: using concurrent neuroimaging to reveal the neural network dynamics of noninvasive brain stimulation", Prog Neurobiol, 94, pp.149~165 (2011)
- Triggs WJ, "Effects of left frontal transcranial magnetic stimulation on depressed mood, cognition, and corticomotor threshold", Biol Psychiatry, 45, pp.1440~1446 (1999)
- Jaewon Beom, "Electrical Stimulation of the Suprahyoid Muscles in Brain-injured Patients with Dysphagia: A Pilot Study", Annals of Rehabilitation Medicine, 35(3), pp.322~327 (2011), 대한재활의학회
- 박성희, "정상인에서 경두개 자기 자극을 이용한 삼킴근의 운동신경유발전위 특성", Annals of Rehabilitation Medicine, 33(2), pp.154~158 (2009), 대한재활의학회
- Han TR, "Quantifying swallowing function after stroke: a functional dysphagia scale based on videofluoroscopic studies", Arch Phys Med Rehabil, 82, pp.677~682 (2001)
- Rosenbek JC, "A penetration-aspiration scale", Dysphagia, 11, pp.93~98 (1996)
- O’Neil KH, "The dysphagia outcome and severity scale", Dysphagia, 14, pp.139~145 (1999)
- Ludlow CL, "Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal Dysphagia", Dysphagia, 22, pp.1~10 (2007)
- Humbert IA, "The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing", J Appl Physiol (1985), 101, pp.1657~1663 (2006)
- Kim SJ, "Effect of surface electrical stimulation of suprahyoid muscles on hyolaryngeal movement", Neuromodulation, 12, pp.134~140 (2009)
- 김정환, "연하 곤란을 동반한 뇌 병변 환자들에서 설골 상부 근육의 전기 자극 치료", 대한뇌졸중학회지, 9(2), pp.134~141 (2007), 대한뇌졸중학회
- Jang SH, "The motor cortex mapping using transcranial magnetic stimulation in normal subjects", J Korean Acd Rehab Med, 24, pp.219~224 (2000)
- Bestmann S, "BOLD MRI responses to repetitive TMS over human dorsal premotor cortex", Neuroimage, 28, pp.22~29 (2005)