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Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study.
Neurogastroenterol Motil. 2019 07; 31(7):e13609.NM

Abstract

INTRODUCTION

The cerebellum has been showed by numerous studies to be active during the process of swallowing. Cortically targeted repetitive transcranial magnetic stimulation (rTMS) is a technique which has been shown to result in beneficial electrophysiological and behavioral changes in healthy participants and patients with post stroke dysphagia. Cerebellar rTMS is a relatively unstudied area of this emerging field. Here we apply cerebellar targeted rTMS to a patient with post stroke dysphagia in an attempt to improve their swallowing.

METHODS

A 67-year-old woman with post stroke dysphagia was recruited to undergo a crossover active rTMS vs sham rTMS study. Outcome measures were pharyngeal motor evoked potential (PMEP) amplitude and cumulative penetration-aspiration score (cPAS). The patient attended the laboratory on two occasions. During each attendance, baseline PMEP and cPAS measurements were acquired followed by either active or sham rTMS. Following this, PMEP and cPAS measurements were repeated at 30 minutes.

RESULTS

Active cerebellar rTMS was able to increase both PMEP amplitude (55% over baseline) and improve swallowing safety (17% below baseline). Sham rTMS did not result in any beneficial PMEP or cPAS changes.

CONCLUSION

Our results suggest that cerebellar rTMS has plausible therapeutic potential for post stroke dysphagia.

Authors+Show Affiliations

Neurogastroenterology, Manchester University Foundation Trust, Wythenshawe Hospital, Manchester, UK.Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), University of Manchester, Salford, UK.Department of Speech and Language Therapy, Technological Educational Institute of Western Greece, Patras, Greece.Manchester Centre for Clinical Neurosciences, Division of Cardiovascular Sciences, University of Manchester, Salford Royal Hospital, Manchester Academic Health Sciences Centre (MAHSC), Salford, UK.Gastrointestinal (GI) Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Salford Royal Hospital (part of the Manchester Academic Health Sciences Center (MAHSC)), University of Manchester, Salford, UK.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31025451

Citation

Vasant, Dipesh H., et al. "Rapid Improvement in Brain and Swallowing Behavior Induced By Cerebellar Repetitive Transcranial Magnetic Stimulation in Poststroke Dysphagia: a Single Patient Case-controlled Study." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 31, no. 7, 2019, pp. e13609.
Vasant DH, Sasegbon A, Michou E, et al. Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study. Neurogastroenterol Motil. 2019;31(7):e13609.
Vasant, D. H., Sasegbon, A., Michou, E., Smith, C., & Hamdy, S. (2019). Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 31(7), e13609. https://doi.org/10.1111/nmo.13609
Vasant DH, et al. Rapid Improvement in Brain and Swallowing Behavior Induced By Cerebellar Repetitive Transcranial Magnetic Stimulation in Poststroke Dysphagia: a Single Patient Case-controlled Study. Neurogastroenterol Motil. 2019;31(7):e13609. PubMed PMID: 31025451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid improvement in brain and swallowing behavior induced by cerebellar repetitive transcranial magnetic stimulation in poststroke dysphagia: A single patient case-controlled study. AU - Vasant,Dipesh H, AU - Sasegbon,Ayodele, AU - Michou,Emilia, AU - Smith,Craig, AU - Hamdy,Shaheen, Y1 - 2019/04/26/ PY - 2019/01/23/received PY - 2019/03/13/revised PY - 2019/04/09/accepted PY - 2019/4/27/pubmed PY - 2020/4/10/medline PY - 2019/4/27/entrez KW - cerebellar rTMS KW - dysphagia KW - stroke SP - e13609 EP - e13609 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol Motil VL - 31 IS - 7 N2 - INTRODUCTION: The cerebellum has been showed by numerous studies to be active during the process of swallowing. Cortically targeted repetitive transcranial magnetic stimulation (rTMS) is a technique which has been shown to result in beneficial electrophysiological and behavioral changes in healthy participants and patients with post stroke dysphagia. Cerebellar rTMS is a relatively unstudied area of this emerging field. Here we apply cerebellar targeted rTMS to a patient with post stroke dysphagia in an attempt to improve their swallowing. METHODS: A 67-year-old woman with post stroke dysphagia was recruited to undergo a crossover active rTMS vs sham rTMS study. Outcome measures were pharyngeal motor evoked potential (PMEP) amplitude and cumulative penetration-aspiration score (cPAS). The patient attended the laboratory on two occasions. During each attendance, baseline PMEP and cPAS measurements were acquired followed by either active or sham rTMS. Following this, PMEP and cPAS measurements were repeated at 30 minutes. RESULTS: Active cerebellar rTMS was able to increase both PMEP amplitude (55% over baseline) and improve swallowing safety (17% below baseline). Sham rTMS did not result in any beneficial PMEP or cPAS changes. CONCLUSION: Our results suggest that cerebellar rTMS has plausible therapeutic potential for post stroke dysphagia. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/31025451/Rapid_improvement_in_brain_and_swallowing_behavior_induced_by_cerebellar_repetitive_transcranial_magnetic_stimulation_in_poststroke_dysphagia:_A_single_patient_case_controlled_study_ L2 - https://doi.org/10.1111/nmo.13609 DB - PRIME DP - Unbound Medicine ER -