Repetitive transcranial magnetic stimulation for post-stroke dysphagia: A meta-analysis

ABSTRACT

@#<p style="text-align justify;"><strong>BACKGROUND:</strong> Dysphagia is common among post-stroke patients,causing disability due to malnutrition and pneumonia. Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment modality to address this complication.</p><p style="text-align justify;"><strong>OBJECTIVE:</strong> The study aimed to compare real versus sham rTMS in treating post-stroke dysphagia.</p><p style="text-align justify;"><strong>METHODS:</strong> PubMed, Ovid, ClinicalKey, Herdin, and Google Scholar databases were searched from their earliest record to 31 July 2015 for randomized controlled trials that used rTMS to treat post-stroke dysphagia. The Jadad scale was used to assess the quality of the studies. The weighted mean difference (WMD) between baseline and post-treatment mean for Penetration Aspiration Scores (PAS) measured in the experimental and control groups were extracted for subsequent meta-analyses.</p><p style="text-align justify;"><strong>RESULTS:</strong> Three studies were analyzed. The WMD in PAS score between rTMS and control using liquid bolus two weeks after treatment in two good quality studies was -1.14 (95% confidence interval (CI) = -1.80 - -0.48, P = 0.001, I2 = 0.0%), and after four weeks was -1.83 (CI = -3.22 - -0.44, P = 0.010, I2 = 0.0%).</p><p style="text-align justify;"><strong>CONCLUSION:</strong> Treatment of post-stroke dysphagia with rTMS improved PAS on subgroup analyses of studies using liquid bolus after two weeks, and between real and sham treatment after four weeks.?</p>