title: Effect of Repetitive Transcranial Magnetic Stimulation on Patients With Dysarthria After Subacute Stroke.
abstract: OBJECTIVE
  To evaluate whether repetitive transcranial magnetic stimulation (rTMS) could improve dysarthria in stroke patients at the subacute stage.
  
  
  METHODS
  This study was a prospective, randomized, double-blind controlled trial. Patients who had unilateral middle cerebral artery infarction were enrolled. In patients in the rTMS group, we found hot spots by searching for the evoked motor potential of the orbicularis oris on the non-affected side. We performed rTMS at a low frequency (1 Hz), 1,500 stimulations/day, 5 days a week for 2 weeks on the hotspots. We used the same protocol in the sham stimulation group patients as that in the rTMS group, except that the angle of the coil was perpendicular to the skull rather than tangential to it. The patients in both groups received speech therapy for 30 minutes, 5 days a week from a skilled speech therapist. The speech therapist measured the Urimal Test of Articulation and Phonology, alternative motion rates, sequential motion rates, and maximal phonation time before and after intervention sessions.
  
  
  RESULTS
  Forty-two patients were enrolled in this study and 20 completed the study. Statistical analysis revealed significant improvements on the dysarthria scales in both groups. The sequential motion rate (SMR)-PǝTǝKǝ showed significantly greater improvement in the rTMS group patients than in the sham stimulation group.
  
  
  CONCLUSIONS
  Patients in the rTMS group showed greater improvement in articulation than did patients in the sham rTMS group. Therefore, rTMS can have a synergistic effect with speech therapy in treating dysarthria after stroke.
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yong Gyu
authors.initials: YG
authors.lastname: Kwon
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Do
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sung Jong
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Rehabilitation Center, Union Hospital, Daegu, Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Chang
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Chun
keywords: Dysarthria; Orbicularis oris; Repetitive transcranial magnetic stimulation; Stroke