RESUMO
Objective:To observe the effect of applying repetitive transcranial magnetic stimulation (rTMS) on swallowing function and auditory evoked potentials in the brain-stems of stroke survivors with dysphagia.Methods:Sixty stroke survivors with dysphagia were randomly assigned to an observation group and a control group, each of 30. Both groups were given 30 minutes of routine swallowing training 6 times a week for 5 weeks, while the observation group was additionally provided with two-second bursts of rTMS on the left and right brain hemispheres alternately for 20 minutes daily. The frequency was 3.0Hz and the strength was 80% of the resting motor threshold (RMT), with an interval of 10 seconds between bursts. Before and after the treatment, both groups′ swallowing was assessed using the functional communication measure (FCM) and the modified Mann swallowing capacity evaluation scale (MMASA). Brainstem auditory evoked potentials (BAEP) were recorded to detect any changes in the peak latency (PL) and inter-peak latency (IPL). The clinical efficacy was also observed.Results:After the treatment, the average FCM results of both groups had improved significantly, but the observation group had improved significantly more. The average MMASA total scores and the average scores on all the sub-items had improved significantly more in the observation group except for the expressive speech disorder and anarthria scores. After the treatment, improvement was observed in respiration, anarthria, range of motion of the tongue muscles, strength of the tongue muscles, gag reflex and soft palate movement compared with before the intervention. Peak and inter-peak latencies had also improved significantly more in the observation than in the control group, on average.Conclusions:rTMS combined with conventional swallowing training can significantly improve the swallowing of dysphagic stroke survivors, and shorten the PL of the BAEP so as to better regulate deglutition.
RESUMO
Objective To observe any therapeutic effect of transcutaneous electric nerve stimulation (TENS) on patients with shoulder-hand syndrome after stroke (SHSAS) and to examine the influence of TENS on sympathetic skin response (SSR).Methods Sixty-eight patients with SHSAS were randomly divided into a treatment group (35 cases) treated with routine rehabilitation training and TENS therapy and a control group (33 cases)treated with routine rehabilitation training only.The therapy for both groups lasted 3 weeks.The severity of pain and edema of the affected upper limb was assessed with a visual analogue scale (VAS) while sympathetic skin response was recorded from the affected upper limb before and after treatment.Results VAS scores improved significantly in the treatment group,and significantly more than in the control group.There was no significant difference in the SSR latencies,amplitudes or abnormality rates between the two groups before treatment.The latencies and abnormality rates of both groups improved significantly after treatment,but the improvement in the treatment group was more obvious.The SSR amplitudes did not change significantly after treatment in either group.There was a positive correlation between the SSR latencies and abnormality rates and the VAS scores,but no significant correlation between SSR amplitude and the VAS scores.Conclusions TENS therapy combined with routine rehabilitation training showed not only good clinical results,but also significant changes in SSR among patients with SHSAS.This indicates that SSR could be used to evaluate therapeutic effects in SHSAS patients.
RESUMO
Objective To evaluate the diagnostic value of sympathetic skin response(SSR)in patients with vestibular vertigo.Methods SSR tests were performed on 1 20 patients with acute vestibular system vertigo,including 70 cases of central vertigo and 50 eases of peripherM vertigo.60 healthy subjects were also examined to serve as controls.Results In those with central vertigo,the abnormality rate in the SSR results was 87.1%(61/70).SSR latency was longer and its amplitude wag lower than in those with peripheral vertigo and in the heMthy controls.In those with peripheral vertigo the abnormality rate was 18.0%(9/50),but the average latency and amplitude were not significantly different from those of the healthy controls.Conclusion Persons with acute central vestibular vertigo may have sympathetic nerve dysfunction.SSR test results can be used as an electrophysiological index to distinguish central from peripheral vestibular vertigo.