Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Eur Neurol. 2024;87(2):67-78. doi: 10.1159/000538130. Epub 2024 Mar 2.
This study aimed to comprehensively evaluate the therapeutic efficacy of cerebellar repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of post-stroke dysphagia (PSD).
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed, Cochrane Library, Embase, and Web of Science to identify relevant randomized controlled trials (RCTs) investigating the application of cerebellar rTMS in the treatment of PSD. Inclusion and exclusion criteria were rigorously applied during the screening process, and pertinent characteristics of the included RCTs were meticulously extracted. The I2 statistic was employed to assess heterogeneity, and meta-analysis was conducted using Stata 17 software. The Cochrane Risk of Bias 2 tool and PEDro scale were utilized to evaluate bias risk and literature quality.
Our analysis encompassed a total of 5 RCTs involving 673 patients with dysphagia who met the inclusion criteria. The findings indicated a significant positive impact of cerebellar rTMS when combined with traditional swallowing exercises on PSD, demonstrating superior efficacy compared to conventional swallowing exercises in isolation. Furthermore, the study revealed no statistically significant differences based on stimulation site (unilateral vs. bilateral cerebellum), stimulation mode (rTMS vs. intermittent theta-burst stimulation), and stimulation frequency (5 Hz vs. 10 Hz).
The amalgamation of cerebellar rTMS with conventional swallowing exercises demonstrates notable efficacy, surpassing the outcomes achievable with traditional exercises alone. The sustained effectiveness observed underscores the potential of cerebellar rTMS as an innovative avenue in the field of neurorehabilitation for PSD. This study contributes valuable insights into the prospect of utilizing cerebellar rTMS as an adjunctive therapeutic strategy in the management of PSD, emphasizing its relevance for further exploration and clinical application.
本研究旨在全面评估小脑重复经颅磁刺激(rTMS)在脑卒中后吞咽障碍(PSD)康复中的治疗效果。
根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,我们系统地检索了 PubMed、Cochrane 图书馆、Embase 和 Web of Science,以确定小脑 rTMS 应用于 PSD 治疗的相关随机对照试验(RCT)。在筛选过程中严格应用纳入和排除标准,并仔细提取纳入 RCT 的相关特征。采用 I2 统计量评估异质性,并使用 Stata 17 软件进行荟萃分析。采用 Cochrane 偏倚风险 2 工具和 PEDro 量表评估偏倚风险和文献质量。
我们的分析共纳入了 5 项 RCT,共纳入了 673 名符合纳入标准的吞咽障碍患者。研究结果表明,小脑 rTMS 联合传统吞咽训练对 PSD 具有显著的积极影响,其疗效优于单纯传统吞咽训练。此外,研究结果显示,刺激部位(单侧与双侧小脑)、刺激模式(rTMS 与间歇性经颅磁刺激)和刺激频率(5 Hz 与 10 Hz)之间无统计学差异。
小脑 rTMS 与传统吞咽训练相结合具有显著疗效,优于单纯传统训练。观察到的持续疗效突出了小脑 rTMS 在 PSD 神经康复领域作为一种创新方法的潜力。本研究为小脑 rTMS 作为 PSD 管理的辅助治疗策略提供了有价值的见解,强调了其进一步探索和临床应用的相关性。