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低频重复经颅磁刺激对脑卒中后患者吞咽功能和生活质量的影响。

Effects of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Swallowing Function and Quality of Life of Post-stroke Patients.

机构信息

Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Yıldırım Beyazıt University, 06760, Çubuk, Ankara, Turkey.

Faculty of Medicine Neurology Department, Hacettepe University, 06100, Sıhhıye, Ankara, Turkey.

出版信息

Dysphagia. 2019 Jun;34(3):360-371. doi: 10.1007/s00455-018-09965-6. Epub 2019 Jan 2.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is one of the non-invasive techniques, which is used to modulate cortical regions in patients with stroke. The aim of this single blind, controlled study was to investigate the effect of rTMS on swallowing function and quality of life of mono-hemispheric post-stroke patients with dysphagia. Twenty-eight patients were randomized and split between study and control group. Each group received conventional dysphagia rehabilitation 3 days a week for 4 weeks, and study group also received 1 Hz rTMS to unaffected hemisphere in the final week. The descriptive information was noted. The clinical and radiological swallowing evaluation and quality of life assessment have been performed at four different times including before and after the treatment, 1 month and 3 months after the treatment. At baseline, no significant differences were observed between groups in terms of demographic and clinical features (p > 0.05). Swallowing function and quality of life of the patients were statistically improved in both groups towards the third month (p < 0.05). Swallowing function was comparable between two groups. However, a significant improvement was observed on appetite, fear of eating, and mental health parameters of quality of life assessment in the study group compared to the control group (p < 0.05). In conclusion, despite positive changes in some aspects of quality of life, rTMS did not enhance the swallowing function when compared conventional dysphagia rehabilitation. Therefore, the application of 1 Hz rTMS should be reconsidered to improve swallowing function in the chronic period.

摘要

重复经颅磁刺激(rTMS)是一种非侵入性技术,用于调节中风患者的皮质区域。本单盲对照研究的目的是调查 rTMS 对单侧半球性卒中后吞咽困难患者吞咽功能和生活质量的影响。将 28 名患者随机分为研究组和对照组。每组均接受每周 3 天的常规吞咽康复治疗 4 周,研究组在最后 1 周还接受 1Hz rTMS 治疗非受累半球。记录描述性信息。在治疗前、治疗后 1 个月和 3 个月,进行临床和放射学吞咽评估以及生活质量评估。在基线时,两组在人口统计学和临床特征方面无显著差异(p>0.05)。两组患者的吞咽功能和生活质量在第 3 个月均有统计学改善(p<0.05)。两组患者的吞咽功能无显著差异。然而,与对照组相比,研究组在食欲、进食恐惧和生活质量评估的心理健康参数方面有显著改善(p<0.05)。结论:尽管生活质量的某些方面有积极变化,但与常规吞咽康复相比,rTMS 并未增强吞咽功能。因此,应重新考虑应用 1Hz rTMS 来改善慢性期的吞咽功能。

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