The effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on patients with swallowing disorders after cerebral infarction

2021 ◽  
pp. 1-8
Author(s):  
Yupeng Du ◽  
Li Wei ◽  
Ying Lu ◽  
Hong Gao

BACKGROUND: Swallowing disorders represent one of the most common complications after cerebral infarction. OBJECTIVE: To study the effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on swallowing disorders after cerebral infarction. METHODS: Ninety patients with swallowing disorder after cerebral infarction were enrolled and randomly assigned to three groups: the 10 Hz frequency rTMS group (30 patients), the 5 Hz frequency rTMS group (30 patients), and the 1 Hz frequency rTMS group (30 patients); another 90 healthy persons without swallowing disorders were included as the control group. The Kubota’s water-swallow test, the video fluoroscopic swallow study (VFSS), and the Electroencephalograph (EEG) were analyzed before and after treatment; the EEG of the control group was detected as the baseline. RESULTS: The Kubota’s water-swallow test scores were significantly decreased while the scores of pharynx period and the aspiration degree of VFSS significantly increased in 10 Hz frequency rTMS group than before treatment (P≤0.05); the amplitudes of C3 of the EEG significantly increased in three frequency groups than before treatment (P≤0.05). CONCLUSIONS: 10 Hz frequency of rTMS is effective for the treatment of swallowing disorder after cerebral infarction, the excitement of C3 area maybe the therapeutic target of rTMS on swallowing disorder after cerebral infarction.

Author(s):  
Yupeng Du ◽  
Li Wei ◽  
Huangwei Jiang

Abstract Objective To study the improvements and mechanism of repetitive transcranial magnetic stimulation (rTMS) on swallowing disorders after cerebral infarction. Methods A total of 60 patients with swallowing disorders were randomly assigned to receive high/low-frequency rTMS treatment, another 30 patients without rTMS treatment were included in the control group. The Kubota’s water-swallowing test, video fluoroscopic swallowing study (VFSS), and major intracranial neurotransmitters were analyzed before and after treatment. Results No significant difference was observed in the Kubota’s water-swallowing test scores, the VFSS scores, or the levels of intracranial neurotransmitters between the three groups before treatment. The Kubota’s water-swallowing test scores were significantly reduced after high-frequency rTMS treatment than in the control group; the aspiration degree was significantly increased after high-frequency rTMS treatment than in the control group; the levels of glutamate and dopamine were significantly increased after high-frequency rTMS treatment than in the control group; Moreover, the Kubota’s water-swallowing test scores were significantly reduced after high-frequency rTMS treatment than after low-frequency rTMS treatment; the levels of glutamate and dopamine were significantly increased after high-frequency rTMS treatment than after low-frequency rTMS treatment. Conclusions High-frequency rTMS was effective for swallowing disorders, which may be related to increased levels of intracranial glutamate and dopamine.


2020 ◽  
Vol 10 (2) ◽  
pp. 87
Author(s):  
Jae-Hong Kim ◽  
Jae-Young Han ◽  
Min-Keun Song ◽  
Gwang-Cheon Park ◽  
Jeong-Soon Lee

This study investigated the synergistic effects of scalp acupuncture (SA) and repetitive transcranial magnetic stimulation (rTMS), known to be effective for cerebral infarction. This outcome-assessor-blinded, randomized controlled clinical trial included a per-protocol analysis to compare the efficacy of SA and electromagnetic convergence stimulation (SAEM-CS) and single or no stimulation. The trial was conducted with 42 cerebral infarction patients (control group, 12; SA group, 11; rTMS group, 8; SAEM-CS group, 11). All patient groups underwent two sessions of CSRT per day. SA, rTMS, and SAEM-CS were conducted once per day, 5 days per week, for 3 weeks. The primary outcome was evaluated using the Fugl–Mayer assessment (FMA). FMA Upper Extremity, FMA total, MBI, and FIM scores significantly increased in the rTMS group compared with the control group. Additionally, FMA Upper Extremity, FMA total, MBI and FIM scores significantly increased in the rTMS group compared with the SAEM-CS group. However, there were no significant changes in the SA or SAEM-CS groups. In conclusion, low-frequency rTMS in the contralesional hemisphere may have long-term therapeutic effects on upper extremity motor function recovery and improvements in activities of daily living. SAEM-CS did not show positive synergistic effects of SA and rTMS.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1143-1143
Author(s):  
M. He ◽  
Z. Gu ◽  
X. Wang ◽  
X. Tian

ObjectiveTo investigate the effects of sleep electroencephalogram-modulated repetitive transcranial magnetic stimulation (SEM-rTMS) and conventional rTMS (C-rTMS) on the activity of hypothalamic-pituitary-adrenal (HPA) axis in patients with depression.MethodsIn a double-blind, randomized controlled trial, 164 patients diagnosed with depression were randomized to treatment with SEM-rTMS (n = 57), C-rTMS (n = 55) or sham rTMS (n = 52) for 30 min every day for 10 d. Before and after treatment plasma concentrations of adrenocorticotropic hormone (ACTH) and cortisol (CORT) were measured, and the 24-item Hamilton Depression Rating Scale (HAMD-24) was used for assessment.ResultsThe HAMD-24 scores and plasma ACTH and CORT concentrations of these depressive patients before treatment were significantly different from those of the normal control group (P < 0.05). The HAMD-24 scores and plasma ACTH and CORT concentrations in the SEM-r TMS group and conventional rTMS group were decreased significantly (P < 0.05). There was a significant positive correlation between the HAMD-24 scores and plasma ACTH (n = 240, r = 0.105, P = 0.048) and CORT concentrations (n = 240, r = 0.126, P = 0.023) in the patients with depression before and after treatment.ConclusionThe antidepressant effect of rTMS, including SEM-rTMS, may be related to its decreasing HPA axis activity. (This trail was registered. No: ChiCTR-TRC-00000465).


Author(s):  
Azza B. Hammad ◽  
Rasha E. Elsharkawy ◽  
Ghada S. Abdel Azim

Abstract Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.


2018 ◽  
Vol 74 (9) ◽  
pp. 1341-1350 ◽  
Author(s):  
Fei Wang ◽  
Chi Zhang ◽  
Siyuan Hou ◽  
Xin Geng

Abstract Repetitive transcranial magnetic stimulation (rTMS) and mesenchymal stem cells (MSCs) transplantation both showed therapeutic effects on cognition impairment in vascular dementia (VD) model rats. However, whether these two therapies have synergistic effects and the molecular mechanisms remain unclear. In our present study, rats were randomly divided into six groups: control group, sham operation group, VD group, MSC group, rTMS group, and MSC+rTMS group. The VD model rats were prepared using a modified 2VO method. rTMS treatment was implemented at a frequency of 5 Hz, the stimulation intensity for 0.5 Tesla, 20 strings every day with 10 pulses per string and six treatment courses. The results of the Morris water maze test showed that the learning and memory abilities of the MSC group, rTMS group, and MSC+rTMS group were better than that of the VD group, and the MSC+rTMS group showed the most significant effect. The protein expression levels of brain-derived neurotrophic factor, NR1, LC3-II, and Beclin-1 were the highest and p62 protein was the lowest in the MSC+rTMS group. Our findings demonstrated that rTMS could further enhance the effect of MSC transplantation on VD rats and provided an important basis for the combined application of MSC transplantation and rTMS to treat VD or other neurological diseases.


2020 ◽  
Vol 32 (3) ◽  
pp. 128-134 ◽  
Author(s):  
Masachika Niimi ◽  
Yuko Fujita ◽  
Tamaki Ishima ◽  
Kenji Hashimoto ◽  
Nobuyuki Sasaki ◽  
...  

AbstractObjective:Abnormalities in neurotransmission via N-methyl-d-aspartic acid receptor (NMDAR) play a role in the pathophysiology of neuropsychiatric disorders. The impact of repetitive transcranial magnetic stimulation (rTMS) on NMDAR-related amino acids remains unknown. We aim to investigate the effects of rTMS on NMDAR-related amino acids in serum of post-stroke patients.Methods:Ninety-five consecutive post-stroke patients with upper limb hemiparesis were recruited. In 27 patients, the Beck Depression Inventory (BDI) score was 10 or higher. Twelve depressed patients underwent rehabilitation in combination with rTMS and 15 non-depressed patients underwent rehabilitation only without rTMS for 14 days. 1 Hz rTMS was applied to the primary motor area in the non-lesional hemisphere. BDI was conducted before and after treatment. Serum glutamine, glutamate, glycine, l-serine, and d-serine levels were measured before and after treatment.Results:There were no differences between depressed patients and non-depressed patients in clinical characteristics, levels of the five amino acids in serum, and the ratio of amino acids. However, in 27 depressed patients, there was a significant correlation between levels of glutamate in serum and BDI (ρ = 0.428, p = 0.026). BDI decreased significantly in depressed patients after treatment with or without rTMS. d-serine decreased in the rehabilitation with rTMS group, but increased in the rehabilitation without rTMS group. l-serine increased in the rehabilitation with rTMS group, but decreased in the rehabilitation without rTMS group.Conclusion:The results suggest that rTMS can modulate NMDAR-related amino acids in blood, producing beneficial effects.


2009 ◽  
Vol 106 (5) ◽  
pp. 1593-1603 ◽  
Author(s):  
Gabrielle Todd ◽  
Nigel C. Rogasch ◽  
Stanley C. Flavel ◽  
Michael C. Ridding

Repetitive transcranial magnetic stimulation (rTMS) can induce short-term reorganization of human motor cortex. Here, we investigated the effect of rTMS during relaxation and weak voluntary muscle contraction on motor cortex excitability and hand function. Subjects ( n = 60) participated in one of four studies. Single transcranial magnetic stimuli were delivered over the motor area of the first dorsal interosseus for measurement of motor evoked potential (MEP) size before and after real or sham rTMS delivered at an intensity of 80% of active motor threshold. rTMS involved trains of stimuli applied at 6 Hz for 5 s and repeated every 30 s for 10 min. Resting MEP size was suppressed for 15 min after rTMS during relaxation. However, MEP suppression was abolished when additional brief voluntary contractions were performed before and after rTMS ( study 1). Resting MEP size was suppressed for 30 min after rTMS during weak voluntary contraction. MEP suppression was present even though voluntary contractions were performed before and after rTMS ( study 2). The MEP suppression most likely reflects a decrease in motor cortical excitability. Surprisingly, rTMS during voluntary contraction did not alter maximal finger tapping speed or performance on a grooved pegboard test, object grip and lift task ( study 3), and visuomotor tracking task ( study 4). These studies document the complex relationship between voluntary movement and rTMS-induced plasticity in motor cortex. This work has implications for the optimization of rTMS parameters for improved efficacy and potential therapeutic applications.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lida Zhong ◽  
Jinzhu Rao ◽  
Jing Wang ◽  
Fang Li ◽  
Yang Peng ◽  
...  

Background: The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) protocols on patients with poststroke dysphagia is still unclear.Objective: This trial aimed to explore and analyze the effectiveness of 5 Hz rTMS on the unaffected hemisphere, affected hemisphere, and cerebellum in stroke patients with dysphagia.Methods: This observer-blind and randomized controlled trial included a total of 147 patients with stroke. Patients were divided into four treatment groups: the unaffected hemispheric group, the affected hemispheric group, the cerebellum group and the control group. Each group received traditional dysphagia treatment 5 days a week for 2 weeks. All recruited patients except for those in the control group underwent 10 consecutive rTMS sessions for 2 weeks. For the affected hemispheric group and unaffected hemispheric group, 5 Hz rTMS was applied to the affected mylohyoid cortical region or to the unaffected mylohyoid cortical region. For the cerebellum group, 5 Hz rTMS was applied to the mylohyoid cortical representation of the cerebellum (4.3 cm lateral and 2.4 cm below the inion). The Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), Penetration/Aspiration Scale (PAS), Gugging Swallowing Screen (GUSS), and Standardized Swallowing Assessment (SSA) were used to evaluate clinical swallowing function before the intervention (baseline), immediately after the intervention and 2 weeks after the intervention.Results: There were significant time and intervention interaction effects on the FEDSS, PAS, SSA, and GUSS scores (p &lt; 0.05). In a direct comparison of the swallowing parameters of the four groups, the changes in FEDSS, PAS, SSA, and GUSS scores showed a significantly greater improvement in the unaffected hemispheric group, the affected hemispheric group and cerebellum group than in the control group (p &lt; 0.05).Conclusions: Whether stimulating the unaffected hemisphere or the affected hemisphere, 5 Hz high-frequency rTMS on mylohyoid cortical tissue might have a positive effect on poststroke patients with dysphagia. In addition, cerebellar rTMS is a safe method that represents a potential treatment for poststroke dysphagia, and more clinical trials are needed to develop this technique further.Clinical Trial Registration:chictr.org.cn, identifier: ChiCTR2000032255.


Sign in / Sign up

Export Citation Format

Share Document