Abstract：
BACKGROUND: Dysphagia has been recognized by the World Health Organization as a medical disability. Improving mylohyoid muscle function plays an important role in pharyngeal dysphagia. The aim of this study was to evaluate the treatment of transcranial magnetic stimulation (TMS), peripheral magnetic stimulation (PMS), and electrical stimulation (ES) for dysphagia.
METHODS: Forty healthy subjects were randomly divided into four groups: TMS+PMS, TMS, PMS, and ES. TMS stimulated the cortical representative area of the mylohyoid muscle and the PMS was directly stimulating the mylohyoid muscle, both of them at a frequency of 10 Hz for a total of 1,800 pulses. The intensity of ES was based on the subject\'s tolerance level, usually 2-5 mA. Functional near infrared spectroscopy (fNIRS) and motor evoked potential (MEP) of the mylohyoid muscle were used to evaluate the immediate effects of stimulation on swallowing cortex excitability of healthy subjects before and after intervention.
RESULTS: The fNIRS results revealed notable activation across multiple channels in the four groups of healthy subjects both pre- and post- the intervention. Among these channels, the activation levels were most pronounced in the TMS+PMS group, followed by the TMS, PMS, and ES groups, respectively. Regarding the MEP results, post-intervention observations indicated a reduction in bilateral latency and an increase in bilateral amplitude in the TMS+PMS group. Additionally, the left amplitude exhibited an increase in the TMS group.
CONCLUSIONS: In fNIRS, all four stimulation methods significantly activated the swallowing cortex of healthy subjects, and the activation of TMS+PMS was the most obvious, followed by TMS, PMS, and ES.
METHODS: Forty healthy subjects were randomly divided into four groups: TMS+PMS, TMS, PMS, and ES. TMS stimulated the cortical representative area of the mylohyoid muscle and the PMS was directly stimulating the mylohyoid muscle, both of them at a frequency of 10 Hz for a total of 1,800 pulses. The intensity of ES was based on the subject\'s tolerance level, usually 2-5 mA. Functional near infrared spectroscopy (fNIRS) and motor evoked potential (MEP) of the mylohyoid muscle were used to evaluate the immediate effects of stimulation on swallowing cortex excitability of healthy subjects before and after intervention.
RESULTS: The fNIRS results revealed notable activation across multiple channels in the four groups of healthy subjects both pre- and post- the intervention. Among these channels, the activation levels were most pronounced in the TMS+PMS group, followed by the TMS, PMS, and ES groups, respectively. Regarding the MEP results, post-intervention observations indicated a reduction in bilateral latency and an increase in bilateral amplitude in the TMS+PMS group. Additionally, the left amplitude exhibited an increase in the TMS group.
CONCLUSIONS: In fNIRS, all four stimulation methods significantly activated the swallowing cortex of healthy subjects, and the activation of TMS+PMS was the most obvious, followed by TMS, PMS, and ES.
摘要：
背景：吞咽困难已被世界卫生组织确认为医学残疾。改善舌骨肌功能在咽部吞咽困难中起重要作用。这项研究的目的是评估经颅磁刺激（TMS）的治疗，外周磁刺激(PMS),和电刺激（ES）用于吞咽困难。
方法：将40名健康受试者随机分为四组：TMS+PMS,TMS,PMS,和ES。TMS刺激舌骨肌的皮质代表区，PMS直接刺激舌骨肌，它们都在10Hz的频率下，总共有1800个脉冲。ES的强度基于受试者的耐受水平，通常2-5mA。应用功能性近红外光谱（fNIRS）和舌骨肌的运动诱发电位（MEP）评估刺激对健康受试者干预前后吞咽皮质兴奋性的直接影响。
结果：fNIRS结果显示，四组健康受试者在干预前和干预后的多个通道均有明显的激活。在这些频道中，激活水平在TMS+PMS组中最明显，其次是TMS，PMS,和ES组，分别。关于MEP结果，干预后观察表明,TMS+PMS组的双侧潜伏期减少,双侧波幅增加.此外,TMS组左侧波幅增加。
结论：在fNIRS中，所有四种刺激方法都显著激活了健康受试者的吞咽皮层，TMS+PMS的激活最为明显,其次是TMS，PMS,和ES。
方法：将40名健康受试者随机分为四组：TMS+PMS,TMS,PMS,和ES。TMS刺激舌骨肌的皮质代表区，PMS直接刺激舌骨肌，它们都在10Hz的频率下，总共有1800个脉冲。ES的强度基于受试者的耐受水平，通常2-5mA。应用功能性近红外光谱（fNIRS）和舌骨肌的运动诱发电位（MEP）评估刺激对健康受试者干预前后吞咽皮质兴奋性的直接影响。
结果：fNIRS结果显示，四组健康受试者在干预前和干预后的多个通道均有明显的激活。在这些频道中，激活水平在TMS+PMS组中最明显，其次是TMS，PMS,和ES组，分别。关于MEP结果，干预后观察表明,TMS+PMS组的双侧潜伏期减少,双侧波幅增加.此外,TMS组左侧波幅增加。
结论：在fNIRS中，所有四种刺激方法都显著激活了健康受试者的吞咽皮层，TMS+PMS的激活最为明显,其次是TMS，PMS,和ES。
