The Effectiveness of Repetitive Transcranial Magnetic Stimulation for Post-stroke Dysphagia: A Systematic Review and Meta-Analysis

Xin Wen, Zicai Liu, Lida Zhong, Yang Peng, Jing Wang, Huiyu Liu, Xiaoqian Gong, Xin Wen, Zicai Liu, Lida Zhong, Yang Peng, Jing Wang, Huiyu Liu, Xiaoqian Gong

Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) applied to the mylohyoid cortical region has positive clinical effects on post-stroke. Therefore, we conducted a meta-analysis to investigate the efficacy of rTMS for patients with post-stroke dysphagia.

Methods: According to PRISMA guidelines, we searched the databases of MEDLINE (PubMed), Cochrane Library, Embase, Web of Science, CNKI, Wangfang. We searched for studies of randomized controlled trials (RCTs) of rTMS to treat dysphagia after stroke and screened by inclusion and exclusion criteria. Features of RCTs were extracted. The heterogeneity of the trials was measured by I 2 statistic.

Results: In total, 11 RCTs with 463 dysphagia patients fulfilled our inclusion criteria. In our analysis, rTMS demonstrated a great beneficial effect for post-stroke dysphagia when combined with traditional swallowing exercises. Moreover, a greatly significant difference (P = 0.008) was noted based on stimulation frequency (high frequency vs. low frequency). Additionally, no significant difference (P = 0.53) was observed based on stimulation site (affected vs. unaffected hemisphere).

Conclusions: Overall, rTMS can effectively accelerate the improvement of swallowing function in patients with post-stroke swallowing disorders.

Keywords: dysphagia; effectiveness; meta-analysis; repetitive transcranial magnetic stimulation; stroke.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Wen, Liu, Zhong, Peng, Wang, Liu and Gong.

Figures

Figure 1
Figure 1
PRISMA flow chart of study selection.
Figure 2
Figure 2
Risk of bias items shown as percentages across the included RCTs.
Figure 3
Figure 3
Risk of bias assessment for 11 RCTs.
Figure 4
Figure 4
Forest plot of the overall effect analysis of rTMS.
Figure 5
Figure 5
Forest plot for subgroup analysis according to the stimulation site.
Figure 6
Figure 6
Forest plot for subgroup analysis according to stimulation frequency.
Figure 7
Figure 7
Comparison of the effect size of 5, 3, and 1 Hz.

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