Transcranial Magnetic Stimulation as an Intervention Tool to Recover from Language, Swallowing and Attentional Deficits after Stroke: A Systematic Review

Abstract

Background: Following a stroke event, patients often are severely affected by disabilities that hinder their quality-of-life. There are currently several rehabilitative options and strategies, and it is crucial to find the most effective interventions. The applicability of transcranial magnetic stimulation (TMS) to the recovery of nonmotor functions such as communication skills, swallowing ability and spatial attention after stroke remains important clinical questions.

Summary: We searched PubMed and ISI Web of Science for articles that used repetitive TMS protocols to rehabilitate post-stroke deficits. We analysed qualitatively 38 articles that met the eligibility criteria; of these, 21 dealt with aphasia, 8 with dysphagia, 8 with neglect and 1 with visual extinction. The efficacy of TMS as an intervention for post-stroke rehabilitation of these nonmotor deficits was studied as well as the current limitations were assessed. Key Messages: Most part of the included studies reported statistically significant functional improvements, supporting the use of TMS for the rehabilitation of aphasia, dysphagia and neglect. Future research, with larger sample sizes, is mandatory to confirm its efficacy, determine the optimal stimulation parameters and investigate inter-subject variability.

Keywords: Aphasia; Dysphagia; Neglect; Stroke rehabilitation; Transcranial magnetic stimulation.