Effectiveness of intermittent theta burst stimulation (iTBS) for managing post-stroke dysphagia: systematic review and meta-analysis.

Autor:	Mehdi Zaidi SM; Dow Medical College, Dow University of Health Science, Karachi, Pakistan., Alvi MH; Department of Internal Medicine, University of Nevada, Reno, USA., Fatmi SAA; Dow Medical College, Dow University of Health Science, Karachi, Pakistan., Abbasi L; Dow Medical College, Dow University of Health Science, Karachi, Pakistan., Hayat A; Dow Medical College, Dow University of Health Science, Karachi, Pakistan., Irfan Q; Dow Medical College, Dow University of Health Science, Karachi, Pakistan., Zehra S; Department of Internal Medicine, University of Nevada, Reno, USA., Abbas Z; Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan., Zaidi SMA; Dow Medical College, Dow University of Health Science, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	Topics in stroke rehabilitation [Top Stroke Rehabil] 2024 Dec 08, pp. 1-10. Date of Electronic Publication: 2024 Dec 08.
DOI:	10.1080/10749357.2024.2437325
Abstrakt:	Background: Post-Stroke Dysphagia (PSD) is a common complication that significantly affects the quality of life and health outcomes of stroke survivors. Traditional treatments often have limitations, necessitating the exploration of new therapeutic approaches. This systematic review and meta-analysis aimed to evaluate the efficacy of intermittent Theta Burst Stimulation (iTBS) as an innovative treatment for PSD. Methods: Following the PRISMA guidelines, a comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library up to July 2024. Studies included were randomized controlled trials (RCTs) involving stroke patients with confirmed dysphagia, comparing iTBS to control treatments. Data extraction and quality assessment were performed independently by two reviewers using the Cochrane RoB 2 tool. Primary outcomes were changes in the Penetration-Aspiration Scale (PAS) and Swallowing Severity Scale (SSA). Meta-analyses were conducted using Review Manager (RevMan) 5.4. Results: Four RCTs with a total of 199 participants were included. iTBS significantly improved SSA (MD = -3.26, 95% CI [-4.66, -1.86], p < 0.001) and PAS (MD = -1.67, 95% CI [-2.49, -0.86], p < 0.001) immediately after treatment compared to sham stimulation. No significant adverse events were reported. Conclusion: iTBS appears to have a positive immediate effect on improving swallowing function and reducing aspiration risk in PSD patients compared to sham stimulation. However, these effects may not persist in the long term, and further large-scale RCTs are needed to confirm these findings and establish standardized treatment protocols.
Databáze:	MEDLINE
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