A pilot study of the effects of high‐frequency repetitive transcranial magnetic stimulation on dysphagia in the elderly

Background Swallowing difficulty is common in the geriatric population and is associated with brain activity alteration with advancing age. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach to stimulate cortical neurons and can produce changes in cortical excitability. Th...

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Published in:Neurogastroenterology and motility 2019-05, Vol.31 (5), p.e13561-n/a
Main Authors: Park, Jin‐Woo, Kim, Hyojun, Park, Taejune, Yeo, Jeong‐Seok, Hong, Ho‐Jin, Oh, Jin‐Young
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
aging
Cerebral Cortex - physiopathology
Cortex (motor)
Cortex (premotor)
deglutition
Deglutition Disorders - physiopathology
Deglutition Disorders - therapy
Dysphagia
Excitability
Female
Geriatrics
Hemispheric laterality
Humans
Magnetic fields
Male
Pharynx
Pilot Projects
Positron emission tomography
Prefrontal cortex
Swallowing
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
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Summary:Background Swallowing difficulty is common in the geriatric population and is associated with brain activity alteration with advancing age. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive approach to stimulate cortical neurons and can produce changes in cortical excitability. The objective of this study is to determine whether rTMS induces positive changes in the cortical areas and facilitates swallowing function in the elderly diagnosed with dysphagia. Methods Eight right‐handed elderly dysphagia patients without any neurologic deficits received 5 Hz rTMS to a pharyngeal motor hot spot in the right hemisphere for 10 minutes every weekday for 2 weeks. The intensity of the stimulation was set at 90% of the thenar motor threshold of the same hemisphere. They were all subjected to 18F‐labeled fluorodeoxyglucose‐PET scans at swallowing before and after rTMS. Differences between each patient's active image and control images on a voxel‐by‐voxel basis were examined to find significant increases in metabolism using statistical parametric mapping software. Videofluoroscopic swallowing study was also conducted before and after magnetic stimulation intervention. Penetration‐aspiration scale (PAS) and videofluoroscopic dysphagia scale (VDS) were compared to evaluate swallowing function. Key Results After 2 weeks of rTMS intervention, the VDS score was significantly reduced (from 43.6 ± 10.3 to 27.2 ± 14.5: P 
ISSN:1350-1925
1365-2982
DOI:10.1111/nmo.13561