title: Repetitive transcranial magnetic stimulation for rehabilitation of poststroke dysphagia: A randomized, double-blind clinical trial.
abstract: OBJECTIVE
  This randomized, sham-controlled, double-blind study was conducted to investigate the effects of high-frequency versus low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with poststroke dysphagia during early rehabilitation.
  
  
  METHODS
  Forty patients with poststroke dysphagia were randomized to receive five daily sessions of sham, 3-Hz ipsilesional, or 1-Hz contralesional rTMS. Swallowing function, the severity of stroke and functional disability, and cortical excitability were examined before, immediately after five daily sessions, as well as the first, second, and third month after the last session.
  
  
  RESULTS
  At baseline, no significant differences between groups were observed in terms of demographic and clinical rating scales. However, a significantly greater improvement in swallowing function as well as functional disability was observed after real rTMS when compared with sham rTMS, which remained 3 months after the end of the treatment sessions. In addition, 1-Hz rTMS increased cortical excitability of the affected hemisphere and decreased that of the non-affected hemisphere; however, 3-Hz rTMS only increased cortical excitability of the affected hemisphere.
  
  
  CONCLUSIONS
  rTMS (both high and low frequency) improved swallowing recovery in patients with poststroke dysphagia, and the effects lasted for at least 3 months.
  
  
  CONCLUSIONS
  rTMS appears to be a beneficial therapeutic modality for patients with dysphagia during the early phase of stroke.
authors.affiliation: Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing 210002, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China. Electronic address: yangfang021011@163.com.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Jingze
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Biyang
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing 210002, China; Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China. Electronic address: xfliu2@vip.163.com.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Dysphagia; Ischemic stroke; Motor evoked potentials (MEPs); Rehabilitation; Repetitive transcranial magnetic stimulation (rTMS)