Transl Stroke Res. 2026 Jul 24;17(4):89. doi: 10.1007/s12975-026-01482-1.
ABSTRACT
BACKGROUND: Combined central-peripheral magnetic stimulation shows promise for post-stroke dysphagia (PSD), but its neural mechanisms remain unclear. We evaluated the its efficacy and cortical mechanisms in PSD patients.
METHODS: In this single-blind, parallel-controlled trial, 44 PSD patients were randomized to four groups: active-rTMS + active-rPMS, active-rTMS + sham-rPMS, sham-rTMS + active-rPMS, or sham-rTMS + sham-rPMS. Clinical scales, such as functional oral intake scale (FOIS) and Penetration-Aspiration Scale (PAS), and Videofluoroscopic Swallowing Study (VFSS) were accessed before, after intervention. Cortical activation during rest and swallowing task was measured by functional near-infrared spectroscopy (fNIRS).
RESULTS: Significant interaction effects (time × intervention) were found for FOIS (Wald χ2 = 39.816, p < 0.001) and PAS scores (Wald χ2 = 45.433, p < 0.001), with the active-rTMS + active-rPMS group showing the most pronounced therapeutic gains. Concurrently, this group displayed significant improvements of laryngeal vestibular closure duration (LCD, MD = -3.598, 95% CI -4.177 to -3.019, adjusted p < 0.001) and superior hyoid excursion (SHE, MD = -3.708, 95% CI -4.213 to -3.18, adjusted p < 0.001). Neurophysiologically, increased functional connectivity (FC) within the ipsilesional prefrontal-sensorimotor network was observed and the changes of FC in ipsilesional M1 and S1 is significantly correlated with the change magnitude of LCD (rs = 0.78, p = 0.004) and SHE (rs = 0.67, P = 0.023).
CONCLUSIONS: The combined central-peripheral magnetic stimulation robustly improved swallowing function, temporal and kinematic sequence of swallowing, and sensori-motor connectivity in PSD patients, representing a promising neuromodulatory therapy for PSD.
PMID:42496873 | DOI:10.1007/s12975-026-01482-1