Effects of different frequency repetitive transcranial magnetic stimulation combined with neuromuscular electrical stimulation on swallowing function and frailty in elderly patients with dysphagia after stroke
WANG Yan
ZHAO Dianlan
LIANG Xueqin
GUO Fengli
ZHANG Hongjun
DONG Mengtian
Abstract：Objective To investigate the application of repetitive transcranial magnetic stimulation(rTMS)combined with neuromuscular electrical stimulation(NMES)at different frequencies in elderly patients with post-stroke dysphagia(PSD).Methods A prospective study was conducted on 181 elderly PSD patients admitted to our hospital from February 2021 to June 2024.They were randomly divided into a NMES group(n=61),a low-frequency rTMS group(n=60,NMES+low-frequency rTMS),and a high-frequency rTMS group(n=60,NMES+high-frequency rTMS).The swallowing function[water swallowing test,clinical dysphagia score(CDS),and standard swallowing function assessment(SSA)]and nutritional status were compared among the three groups.The Edmond Frailty Scale(EFS)scores and incidence of adverse reactions were compared among the three groups.Results After 1 month of treatment,both the high-and the low-frequency rTMS groups obtained significantly lower scores of water swallow test,CDS,and SSA,and higher albumin and prealbumin levels than the NMES group(P＜0.05).Furthermore,the high-frequency rTMS group had more improved above indicators than the low-frequency rTMS group(P＜0.05).Compared with baseline,the EFS scores in all three groups were in a trend of initial increase followed by subsequent decrease at 2 weeks and 1 month after treatment and 1-and 3-month follow-ups.The reduction was most pronounced in the high-frequency rTMS group,with significant group × time interaction effects(P＜0.05).There was no statistical difference in the incidence of adverse events among the NMES,low-and high-frequency rTMS groups(3.3％vs 5.0％vs 10.0％,P＞0.05).Conclusion The combination of rTMS and NMES can effectively improve the swallowing function and nutritional status of elderly PSD patients,and reduce the frailty,and best efficacy is observed in high frequency rTMS.
Keywords：deglutition disordersstroketranscranial magnetic stimulationfrailty
Publication Date：2025-12-15
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：5( 1631-1635 )