Objective To compare the efficacy of different combinations of electromagnetic stimulation schemes in the treatment of pseudobulbar palsy,and provide reference for the optimization of treatment plans.Methods A total of 120 patients with pseudobulbar palsy after stroke were selected at Mianyang Central Hospital from January 2022 to March 2023.They were randomly divided into four groups:a control group,a group receiving transcranial direct current stimula-tion(tDCS)+neuromuscular electrical stimulation(NMES),a group receiving repetitive transcranial magnetic stimula-tion(rTMS)+NMES,and a group receiving tDCS+rTMS.Each group consisted of 30 cases.The control group received routine treatment,while the other three groups received different combinations of electromagnetic stimulation.The evalua-tion included the swallowing efficacy score of Ichiro Fujishima,the standardized swallowing assessment(SSA),the swal-lowing-quality of life(SWAL-QOL),PAS grading under fiberoptic endoscopic evaluation of swallowing(FEES),hyoid laryngeal complex motility,and average surface electromyography(AEMG).Results After treatment,the rTMS+NMES group exhibited significantly higher Ichiro Fujishima's swallowing efficacy scores(5.04±0.79)compared to the control group(3.51±0.64),tDCS+NMES group(4.19±0.79),and tDCS+rTMS group(3.96±0.73).The rTMS+NMES group also demonstrated a significantly lower SSA than the other three groups(P＜0.05).In terms of SWAL-QOL,the rTMS+NMES group only showed improvement compared to the control group,with no difference when compared to the other two groups.However,in PAS assessment,the rTMS+NMES group was superior to the other three groups(P＜0.05).Regarding mobility of the bone throat complex,the rTMS+NMES group displayed a greater distance of upward and forward movement of the hyoid bone compared to all other groups(P＜0.05).Additionally,rTMS+NMES group re-vealed higher sEMG than both control and tDCS+NMES groups(P＜0.05).Conclusion The combination of rTMS+NMES has the best overall effect in the treatment of pseudobulbar palsy.
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