Khedr, E. M., Mohamed, K. O., Soliman, R. K., Hassan, A. M., & Rothwell, J. C. (2019). The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Advancing Parkinson’s Disease With Dysphagia: Double Blind Randomized Clinical Trial. Neurorehabilitation and neural repair, 33(6), 442-452.
This double-blind, randomized clinical trial investigated whether repetitive transcranial magnetic stimulation (rTMS) has efficacy in reducing dysphagia in patients with Parkinson’s Disease (PD). Thirty-three patients with PD and dysphagia were randomized to receive either active (n=22) or sham (n-11) rTMS. The active rTMS protocol applied high-frequency pulses over the hand area of each motor cortex. rTMS was applied 5 days per week for 10 sessions, followed by 5 booster sessions each month for 3 months. Response was assessed using the Unified Parkinson’s Disease Rating Scale part III (UPDRS), Arabic–Dysphagia Handicap Index (A-DHI), and Instrumental Activities of Daily Living (IADL) before the first session, after the last session, and 3 months later. In nine patients in the active rTMS group and six patients in the sham group, video-fluoroscopy measures of pharyngeal transit time (PTT) and time to maximal hyoid elevation (H1-H2) were taken before and after each session.
At baseline, there were no significant differences between groups regarding age, sex, duration of illness, and measures of dysphagia. Only active rTMS was a significant improvement on all rating scales with a significant time × group interaction. Similarly, only active rTMS demonstrated a significant and durable (3 months) effect of time on all subitems of the A-DHI: functional (P = .0001); physical (P = .0001), and emotional (P = .02). This was associated with significant improvement in PTT (P = .01) and H1-H2 (P = .03) during swallowing of solids in the active rTMS group. The authors concluded that active rTMS improved dysphagia in PD patients, as demonstrated improvements in A-DHI scores and by video-fluoroscopy.
*For original abstract/publication see the link below.
Publication link: The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Advancing Parkinson’s Disease With Dysphagia: Double Blind Randomized Clinical Trial – Eman M. Khedr, Khaled O. Mohamed, Radwa Kamel Soliman, Asmaa M. M. Hassan, John C. Rothwell, 2019 (sagepub.com)