Comparison of repetitive transcranial magnetic stimulation and intermittent theta burst stimulation efficacy in treating post-stroke dysphagia: a prospective, single-blind, randomized controlled study.

Objective: 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. Methods: Ninety-two patients with post-stroke dysphagia (July 2022-May 2023) were randomized into three groups: rTMS (n = 31), iTBS (n = 30), and control (n = 31). 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). Results: After 2 weeks, all groups showed significant swallowing improvement (p < 0.001). Both rTMS and iTBS groups demonstrated greater improvement in PAS and DD scores versus controls (p < 0.001). No significant difference emerged between rTMS and iTBS efficacy (p > 0.05). Conclusion: rTMS and iTBS equivalently improve post-stroke dysphagia. iTBS achieves comparable outcomes with shorter treatment duration, supporting its clinical adoption. Clinical trial registration: Identifier ChiCTR2200058246, https://www.chictr.org.cn/.