Supplementary Material for: Noninvasive Brain Stimulation for Poststroke Dysphagia: A Meta-Analysis for Randomized Controlled Trials

<b><i>Background:</i></b> Past research has indicated that repetitive transcranial magnetic stimulation (rTMS) on the pharyngeal motor cortex may be beneficial to poststroke dysphagic patients. In addition, some studies have supported that transcranial direct current stimulation (tDCS) over the pharyngeal motor cortex can improve swallowing function in poststroke dysphagia. However, some studies showed that rTMS and tDCS show no effect on poststroke dysphagia. This study aims to make a meta-analysis to investigate the therapy effect of rTMS and tDCS on poststroke dysphagia in randomized controlled trials (RCTs). <b><i>Methods:</i></b> We searched for studies published before March 2021 in databases (PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar). Meta-analysis was made to compute the results of included studies using STATA 12.0 software. <b><i>Results:</i></b> The present study shows a significant increase in the swallowing function in poststroke dysphagia given rTMS compared to those given sham rTMS (standardized mean difference [SMD] = 1.08, 95% confidence interval [CI] = 0.37–1.80, <i>I</i>² = 81.2%, <i>p</i> &lt; 0.001). In addition, the study shows a significant increase in the swallowing function in poststroke dysphagia given tDCS (combined or not combined with conventional swallowing therapy), compared to those given sham tDCS (combined or not combined with conventional swallowing therapy) (SMD = 1.43, 95% CI = 0.73–2.13, <i>I</i>² = 77.6%, <i>p</i> &lt; 0.001). <b><i>Conclusions:</i></b> The study demonstrates that rTMS and tDCS over the pharyngeal motor cortex show therapy effects on poststroke dysphagia. Many more large-scale, blinded RCTs are essential to investigate the effect of rTMS and tDCS on poststroke dysphagia.

**研究背景：** 既往研究表明，针对咽运动皮层的重复经颅磁刺激（repetitive transcranial magnetic stimulation, rTMS）或许对脑卒中后吞咽障碍患者具有治疗益处。此外，多项研究证实，对咽运动皮层施以经颅直流电刺激（transcranial direct current stimulation, tDCS）可改善脑卒中后吞咽障碍患者的吞咽功能。但也有部分研究显示，rTMS与tDCS对脑卒中后吞咽障碍并无改善效果。本研究旨在通过荟萃分析，探究随机对照试验（randomized controlled trials, RCTs）中rTMS与tDCS对脑卒中后吞咽障碍的治疗效果。**研究方法：** 我们检索了2021年3月之前发表于PubMed、Web of Science、MEDLINE、EMBASE及Google Scholar等数据库的相关研究。本研究采用STATA 12.0软件对纳入研究的结果进行荟萃分析计算。**研究结果：** 本研究结果显示，与假rTMS治疗组相比，接受rTMS治疗的脑卒中后吞咽障碍患者的吞咽功能得到显著改善（标准化均数差[standardized mean difference, SMD]=1.08，95%置信区间[confidence interval, CI]=0.37~1.80，I²=81.2%，p<0.001）。此外，相较于接受假tDCS治疗（联合或不联合常规吞咽治疗）的患者，接受tDCS治疗（联合或不联合常规吞咽治疗）的脑卒中后吞咽障碍患者的吞咽功能同样得到显著改善（SMD=1.43，95%CI=0.73~2.13，I²=77.6%，p<0.001）。**研究结论：** 本研究证实，针对咽运动皮层施以rTMS与tDCS对脑卒中后吞咽障碍具有治疗效果。未来仍需开展更多大规模、盲法随机对照试验，以进一步探究rTMS与tDCS对脑卒中后吞咽障碍的治疗效果。