Objective To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on activity in the intact motor cortex controlling the suprahyoid muscles and thus on dysphagia after an unilateral stroke.Methods Forty patients suffering dysphagia more than two weeks after a unilateral cerebral stroke were randomly divided into an experimental group and a control group,each of 20.Both groups were given traditional swallowing rehabilitation training,while the experimental group was additionally provided with 5 Hz rTMS for two weeks.Before and after the treatment,all of the patients were characterized using X-ray fluoroscopy,video fluoroscopic swallowing study (VFSS) and surface electromyography,and their swallowing was evaluated using a standardized swallowing assessment (SSA) and a penetration-aspiration scale (PAS).Results After the treatment,significant improvement was observed in both groups in the average swallowing time and in the maximum amplitude of sEMG,as well as the average SSA,PAS and VFSS scores (P＜0.05).The average values in the experimental group were in all cases significantly better than the control group's averages (P＜0.05).Conclusion Applying rTMS at 5 Hz to the motor cortex of the contralateral hemisphere controlling the suprahyoid muscles can effectively improve unilateral-hemisphere dysphagia after stroke.

Objective:To observe any effect of intermittent theta burst stimulation (iTBS) of a cerebellar hemisphere on the walking of stroke survivors with lower limb dysfunction, and to explore its possible mechanism.Methods:Thirty stroke survivors with walking dysfunction were randomly divided into an experimental group and a control group, each of 15. Before their daily routine rehabilitation, the control group received fake iTBS while the experimental group was given 600 pulses of iTBS over 200s. The experiment continued 5 days a week for 3 weeks. The Berg Balance Scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), the Modified Barthel Index (MBI) and Functional Ambulation Categories (FAC) were used before and after the treatment to evaluate the subjects′ balance, lower extremity motor function, walking and ability in the activities of daily living. Gait analysis was also performed. The amplitude of motor evoked potentials (MEPs) and the cortical silent period (CSP) were also noted to assess corticospinal excitability.Results:After the treatment, the average BBS, FMA-LE and MBI scores, FAC grading, stride length, stride speed, stride frequency, and the percentage of swing period in the walking cycle, as well as MEP amplitude and latency had improved significantly in the experimental group. All were then significantly better, on average, than in the control group. The control group also demonstrated significant improvement in all of the outcomes except the percentage of swing period in the walking cycle.Conclusion:iTBS of the cerebellum can improve the walking of stroke survivors with lower limb dysfunction. The mechanism may be related to the cerebellar regulation of spinal cord excitation of the cerebral cortex.