Table 1_Comparative efficacy of different interventions for post-stroke cricopharyngeal achalasia: a systematic review and network meta-analysis.docx

ObjectiveThis study aims to employ network meta-analysis to systematically compare and evaluate the efficacy of various interventions for post-stroke cricopharyngeal achalasia.
MethodsWe searched 10 databases and trial registries from inception to December 3, 2025, to identify randomized controlled trials (RCTs) on cricopharyngeal achalasia after stroke. Two investigators independently screened studies, extracted data, and assessed risk of bias. The outcome indicators included effective rate, videofluoroscopic swallowing study (VFSS) score, Functional Oral Intake Scale (FOIS) score, and Standardized Swallowing Assessment (SSA) score.
ResultsA total of 36 articles covering 13 interventions were included. Network meta-analysis revealed: ① Regarding the evaluation of effective rate, the top three interventions based on SUCRA values were: balloon dilation combined with repetitive transcranial magnetic stimulation (rTMS) (91.8%) > balloon dilation combined with electromyographic biofeedback (EMGBF) (82.8%) > balloon dilation combined with acupuncture (79.4%); ② For the VFSS assessment, the highest SUCRA rankings were: balloon dilation combined with acupuncture (92.0%) > balloon dilation combined with tongue pressure resistance feedback (TPRF) (79.6%) > balloon dilation combined with botulinum toxin type A (BTX-A) (78.4%); ③ Concerning the FOIS evaluation, the top three SUCRA values were: balloon dilation combined with BTX-A (87.4%) > balloon dilation combined with transcranial direct current stimulation (tDCS) (83.0%) > balloon dilation combined with acupuncture (76.8%); ④ In the SSA evaluation, the leading interventions by SUCRA were: balloon dilation combined with acupuncture (80.0%) > balloon dilation combined with BTX-A (69.5%) > balloon dilation combined with rTMS (68.5%).
ConclusionIntervention efficacy varied across outcome measures. Balloon dilation combined with acupuncture may be the optimal intervention for improving VFSS scores and reducing SSA scores. Balloon dilation combined with BTX-A may be optimal for improving FOIS scores, and balloon dilation combined with rTMS may be optimal for increasing the effective rate. However, given the small sample sizes of included studies, inadequate allocation concealment and blinding, and potential publication bias for some outcomes, the present findings should be interpreted with caution. Further high-quality studies are warranted to validate these results.
Systematic review registrationThis systematic review has been prospectively registered in PROSPERO. Identifier CRD420251186725.