{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:59:04Z","timestamp":1775833144733,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) applied to the motor cortex representation of the mylohyoid muscle in treating post-stroke dysphagia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety-two patients with post-stroke dysphagia (July 2022\u2013May 2023) were randomized into three groups: rTMS (<jats:italic>n<\/jats:italic>\u202f=\u202f31), iTBS (<jats:italic>n<\/jats:italic>\u202f=\u202f30), and control (<jats:italic>n<\/jats:italic>\u202f=\u202f31). The rTMS and iTBS groups received respective stimulations plus routine rehabilitation; the control group received routine rehabilitation alone. Swallowing function was assessed pre- and post-intervention using the Penetration-Aspiration Scale (PAS) and Dysphagia Disability Index (DD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 2\u202fweeks, all groups showed significant swallowing improvement (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Both rTMS and iTBS groups demonstrated greater improvement in PAS and DD scores versus controls (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). No significant difference emerged between rTMS and iTBS efficacy (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>rTMS and iTBS equivalently improve post-stroke dysphagia. iTBS achieves comparable outcomes with shorter treatment duration, supporting its clinical adoption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>Identifier ChiCTR2200058246, <jats:uri>https:\/\/www.chictr.org.cn\/<\/jats:uri>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1650216","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:19:11Z","timestamp":1760069951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of repetitive transcranial magnetic stimulation and intermittent theta burst stimulation efficacy in treating post-stroke dysphagia: a prospective, single-blind, randomized controlled study"],"prefix":"10.3389","volume":"16","author":[{"given":"Fang","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinling","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanying","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zicai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1038\/s41467-023-36448-6","article-title":"Electroacupuncture improves swallowing function in a post-stroke dysphagia mouse model by activating the motor cortex inputs to the nucleus tractus solitarii through the parabrachial nuclei","volume":"14","author":"Yao","year":"2023","journal-title":"Nat Commun"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1161\/01.Str.30.4.744","article-title":"Swallowing function after stroke","volume":"30","author":"Mann","year":"1999","journal-title":"Stroke"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.1016\/s0140-6736(15)00126-9","article-title":"Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial","volume":"386","author":"Kalra","year":"2015","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1053\/j.gastro.2009.04.056","article-title":"Reversal of a virtual lesion in human pharyngeal motor cortex by high frequency contralesional brain stimulation","volume":"137","author":"Jefferson","year":"2009","journal-title":"Gastroenterology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s00455-024-10757-4","article-title":"Correction to: evidence for intermittent theta burst transcranial magnetic stimulation for dysphagia after stroke: a systematic review and Meta-analysis","volume":"40","author":"Han","year":"2025","journal-title":"Dysphagia"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1113\/jphysiol.2013.263475","article-title":"Transcranial direct current stimulation reverses neurophysiological and behavioural effects of focal inhibition of human pharyngeal motor cortex on swallowing","volume":"592","author":"Vasant","year":"2014","journal-title":"J Physiol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1177\/0300060518807340","article-title":"Repetitive transcranial magnetic stimulation in combination with neuromuscular electrical stimulation for treatment of post-stroke dysphagia","volume":"47","author":"Zhang","year":"2018","journal-title":"J Int Med Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e00613","DOI":"10.1016\/j.neurot.2025.e00613","article-title":"Treating postextubation dysphagia after stroke with pharyngeal electrical stimulation-insights from a randomized controlled pilot trial","volume":"22","author":"Suntrup-Krueger","year":"2025","journal-title":"Neurotherapeutics"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1007\/s00455-022-10512-7","article-title":"The effects of neuromuscular electrical stimulation on swallowing functions in post-stroke dysphagia: a randomized controlled trial","volume":"38","author":"Tarihci Cakmak","year":"2022","journal-title":"Dysphagia"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.brs.2016.08.005","article-title":"Effects of bilateral repetitive transcranial magnetic stimulation on post-stroke dysphagia","volume":"10","author":"Park","year":"2017","journal-title":"Brain Stimul"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1016\/j.brs.2023.05.023","article-title":"Effect of cerebellar transcranial magnetic stimulation with double-cone coil on dysphagia after subacute infratentorial stroke: a randomized, single-blinded, controlled trial","volume":"16","author":"Dai","year":"2023","journal-title":"Brain Stimul"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1197422","DOI":"10.3389\/fimmu.2023.1197422","article-title":"Repetitive transcranial magnetic stimulation for stroke rehabilitation: insights into the molecular and cellular mechanisms of neuroinflammation","volume":"14","author":"Sheng","year":"2023","journal-title":"Front Immunol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s00455-022-10483-9","article-title":"Effect of repetitive transcranial magnetic stimulation on post-stroke dysphagia: a meta-analysis of stimulation frequency, stimulation site, and timing of outcome measurement","volume":"38","author":"Hsiao","year":"2022","journal-title":"Dysphagia"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1177\/0269215516644771","article-title":"Repetitive transcranial magnetic stimulation as an alternative therapy for dysphagia after stroke: a systematic review and meta-analysis","volume":"31","author":"Liao","year":"2016","journal-title":"Clin Rehabil"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2493","DOI":"10.1111\/j.1460-9568.2012.08157.x","article-title":"Remote effects of intermittent theta burst stimulation of the human pharyngeal motor system","volume":"36","author":"Mistry","year":"2012","journal-title":"Eur J Neurosci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"543","DOI":"10.23736\/S1973-9087.23.08023-1","article-title":"Theta-burst transcranial magnetic stimulation for dysphagia patients during recovery stage of stroke: a randomized controlled trial","volume":"59","author":"Tai","year":"2023","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1177\/15459683221092995","article-title":"Bilateral cerebellar intermittent theta burst stimulation combined with swallowing speech therapy for dysphagia after stroke: a randomized, double-blind, sham-controlled, clinical trial","volume":"36","author":"Rao","year":"2022","journal-title":"Neurorehabil Neural Repair"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1097\/mrr.0000000000000621","article-title":"The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial","volume":"47","author":"Suh","year":"2024","journal-title":"Int J Rehabil Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1053\/j.gastro.2011.09.040","article-title":"Targeting unlesioned pharyngeal motor cortex improves swallowing in healthy individuals and after dysphagic stroke","volume":"142","author":"Michou","year":"2012","journal-title":"Gastroenterology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e28576","DOI":"10.1097\/MD.0000000000028576","article-title":"Theta burst stimulation versus high-frequency repetitive transcranial magnetic stimulation for poststroke dysphagia","volume":"101","author":"Yu-Lei","year":"2022","journal-title":"Medicine"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"8726","DOI":"10.1038\/s41598-021-87916-2","article-title":"Determining the optimal pulse number for theta burst induced change in cortical excitability","volume":"11","author":"McCalley","year":"2021","journal-title":"Sci Rep"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.1016\/j.brs.2023.11.011","article-title":"MNI2CPC: a probabilistic cortex-to-scalp mapping for non-invasive brain stimulation targeting","volume":"16","author":"Liu","year":"2023","journal-title":"Brain Stimul"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/j.brs.2022.06.001","article-title":"A scalp-measurement based parameter space: towards locating TMS coils in a clinically-friendly way","volume":"15","author":"Jiang","year":"2022","journal-title":"Brain Stimul"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2140","DOI":"10.1016\/j.clinph.2017.08.003","article-title":"The associative brain at work: evidence from paired associative stimulation studies in humans","volume":"128","author":"Suppa","year":"2017","journal-title":"Clin Neurophysiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/ana.10848","article-title":"Influence of interhemispheric interactions on motor function in chronic stroke","volume":"55","author":"Murase","year":"2004","journal-title":"Ann Neurol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.brs.2017.01.006","article-title":"Targeting interhemispheric inhibition with neuromodulation to enhance stroke rehabilitation","volume":"10","author":"Boddington","year":"2017","journal-title":"Brain Stimul"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1161\/strokeaha.110.592766","article-title":"Fugl-Meyer assessment of sensorimotor function after stroke: standardized training procedure for clinical practice and clinical trials","volume":"42","author":"Sullivan","year":"2011","journal-title":"Stroke"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/bf00417897","article-title":"A penetration-aspiration scale","volume":"11","author":"Rosenbek","year":"1996","journal-title":"Dysphagia"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1111\/j.1600-0404.2008.01093.x","article-title":"Treatment of post-stroke dysphagia with repetitive transcranial magnetic stimulation","volume":"119","author":"Khedr","year":"2009","journal-title":"Acta Neurol Scand"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1113\/JP285564","article-title":"The neurorehabilitation of post-stroke dysphagia: physiology and pathophysiology","volume":"603","author":"Sasegbon","year":"2024","journal-title":"J Physiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1113\/jphysiol.2007.144592","article-title":"Unilateral suppression of pharyngeal motor cortex to repetitive transcranial magnetic stimulation reveals functional asymmetry in the hemispheric projections to human swallowing","volume":"585","author":"Mistry","year":"2007","journal-title":"J Physiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"584727","DOI":"10.1155\/2012\/584727","article-title":"Noninvasive brain stimulation for motor recovery after stroke: mechanisms and future views","volume":"2012","author":"Takeuchi","year":"2012","journal-title":"Stroke Res Treat"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"451","DOI":"10.3390\/brainsci13030451","article-title":"Noninvasive brain stimulation for neurorehabilitation in post-stroke patients","volume":"13","author":"Li","year":"2023","journal-title":"Brain Sci"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s00455-024-10729-8","article-title":"Evidence for intermittent theta burst transcranial magnetic stimulation for dysphagia after stroke: a systematic review and meta-analysis","volume":"40","author":"Han","year":"2024","journal-title":"Dysphagia"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jneumeth.2014.06.010","article-title":"The effect of swallowing treatments on corticobulbar excitability: a review of transcranial magnetic stimulation induced motor evoked potentials","volume":"233","author":"Macrae","year":"2014","journal-title":"J Neurosci Methods"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1590\/s0004-2803.201800000-45","article-title":"Neural control of swallowing","volume":"55","author":"Costa","year":"2018","journal-title":"Arq Gastroenterol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/mrr.0000000000000336","article-title":"The effect of repetitive transcranial magnetic stimulation combined with traditional dysphagia therapy on poststroke dysphagia: a pilot double-blinded randomized-controlled trial","volume":"42","author":"Tarameshlu","year":"2019","journal-title":"Int J Rehabil Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1111\/nmo.12063","article-title":"The effect of 5\u202fHz high-frequency rTMS over contralesional pharyngeal motor cortex in post-stroke oropharyngeal dysphagia: a randomized controlled study","volume":"25","author":"Park","year":"2012","journal-title":"Neurogastroenterol Motil"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.brs.2016.08.011","article-title":"Effects of theta burst stimulation on suprahyoid motor cortex excitability in healthy subjects","volume":"10","author":"Lin","year":"2017","journal-title":"Brain Stimul"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1650216\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:19:11Z","timestamp":1760069951000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1650216\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":39,"alternative-id":["10.3389\/fneur.2025.1650216"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1650216","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]},"article-number":"1650216"}}