Document Type : Original Article


1 Department of Speech and Language Pathology, School of Rehabilitation ‎Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Cellular and Molecular Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Department of Physiotherapy, School of Rehabilitation, Tehran University of ‎Medical Sciences, Tehran, Iran

4 ‎Department of Physical Medicine and Rehabilitation, School of Medicine, Iran ‎University of Medical Sciences, Tehran, Iran

5 ‎Department of Neurology, Firouzgar Hospital, Iran University of Medical ‎Sciences, Tehran, Iran


Background: Post-stroke dysphagia is common and is associated with the development of pneumonia. To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with traditional dysphagia therapy (TDT) on swallowing function in patients with post-stroke dysphagia.Methods: In this single-subject study, four patients with dysphagia post-stroke included. The patients received the rTMS applied to the intact cerebral hemisphere at 1 Hz with train of 1200 for 5 consecutive days combined with TDT 3 days per week for 6 weeks. The main outcome measure was the Mann Assessment of Swallowing Ability (MASA). Measurements were taken before, after the end of 5th, 10th, 15th treatment sessions, and after the end of the treatment (18th session).Results: The MASA scores improved in all patients following treatment. The maximum and minimum change in level between the baseline phase and treatment phase was +84 and +36. The greatest percentage improvement was observed after 5th treatment sessions ranging between 11 and 35%. The treatment trend was upward shown by the directions of the slopes indicated by positive values (+9.1-+20.7). The dysphagia was resolved after 10th treatment session in all participants. The aspiration resolved in two participants after the 5th treatment session and resolved in another 2 participants after the 10th treatment session.Conclusion: The combination therapy of rTMS plus TDT improved swallowing function in patients with post-stroke dysphagia. Further research with a larger sample size is recommended.