Efficacy and Mechanisms of Combined Central-Peripheral Magnetic Stimulation on Prefrontal-Sensorimotor Cortex Connectivity in Post-Stroke Dysphagia after Supratentorial Stroke: A Randomized, Single-Blind, Parallel-Controlled Trial.

Authors

Zirui Luo, Zhiying Zhu, Yujue Wang, Na Su, Yajing Xue, Wanqi Zhang, Wei Liao, Yaoyao You, Lin Ling, Mei Li, Junjie Liang, Zulin Dou, Haian Mao, Nenggui Xu

Published in

Translational stroke research. Volume 17. Issue 4. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

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.
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).
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 (r_s = 0.78, p = 0.004) and SHE (r_s = 0.67, P = 0.023).
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
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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