The Effect of Repetitive Transcranial Magnetic Stimulation in Poststroke Dysphagia: A Systemic Review with Meta-analysis

• Main Authors: YU, CHUN-YAO, 游鈞堯
• Other Authors: LAN, SHOU-JEN
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/e433gj

碩士 === 亞洲大學 === 健康產業管理學系長期照護組碩士在職專班 === 105 === Background There are multiple complications after a stroke, one of which is poststroke dysphagia, resulting in choking, aspiration, malnutrition, and even the death. There are some interventions for poststroke dysphagia, such as modification of the environment, posture adjustment of the body and head, modification of food and drink, behavioral swallowing therapy, medications, non-oral feeding like the nasogastric feeding or gastrostomy feeding, and surgery. In the past years, many studies focused on the effect of non-invasive brain stimulation on poststroke dysphagia, including repetitive transcranial magnetic stimulation(rTMS). Since rTMS is safe and less uncomfortable, should it be considered as a conventional or alternative treatment of poststroke dysphagia? Objective To investigate the effect of repetitive transcranial magnetic stimulation on poststroke dysphagia, with systemic review and meta-analysis. Methods This study uses systematic review and meta-analysis. The electric database PubMed, ProQuest, CINAHL Complete, EBSCOhost Medline complete, Science Direct and airiti library, were searched up to May 15th, 2017. The inclusion criteria are (1) English and Chinese published articles; (2) Patients with Poststroke dysphagia. The parameters of rTMS were not restricted. Results Eight controlled studies of a total 220 patients with poststroke dysphagia were included in the meta-anatlysis. A significant effect of -0.79 (95% confidence interval(CI), -1.13，-0.44) was found, and the effect may last 8 weeks (P < 0.05). When taking frequency of rTMS and the stimulation hemisphere into account, “high frequency rTMS on the bilateral hemisphere” (SMD = -1.22，95% CI, -1.88，-0.56) and “low frequency rTMS on the unaffected hemisphere” (SMD = -0.76，95% CI, -1.14，-0.44) were significantly effective。 Conclusions rTMS is noninvasive and leads to little side effect, and is effective in patients with poststroke dysphagia. rTMS could be an alternative treatment for poststroke dysphagia.