Dual Transcranial Direct Current Stimulation for Poststroke Dysphagia: A Randomized Controlled Trial

Pingue, Valeria; Priori, Alberto; Malovini, Alberto; Pistarini, Caterina

doi:10.1177/1545968318782743

Cited by 32 publications

(56 citation statements)

References 36 publications

(57 reference statements)

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“…The quality evaluation results of the PEDro scores are shown in Table 2 . Among these, there were 12 high-quality studies [ 17 – 20 , 24 – 28 , 30 , 31 , 34 ] and 6 medium-quality studies [ 21 – 23 , 29 , 32 , 33 ] with an average score of 7.22. These 18 studies [ 17 – 34 ] mentioned random grouping, but 5 studies [ 18 , 25 , 27 , 31 , 34 ] did not mention specific random methods.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies [ 24 , 34 ] have hidden the allocation schemes, while other studies have not described it. Nine studies [ 17 – 20 , 24 , 26 , 28 , 30 , 31 ] blinded researchers or patients, and 11 studies [ 17 – 20 , 24 – 28 , 30 , 34 ] blinded measurement results. The data contained in the studies is complete, and there was no selective report or other bias.…”

Section: Resultsmentioning

confidence: 99%

“…Eight RCTs [ 20 , 24 , 25 , 27 , 29 , 30 , 33 , 34 ] reported PAS scores, which were from 148 patients in the experimental group and 149 in the control group ( Figure 5 ). Subgroup analysis showed that PAS scores in the rTMS group were lower than those in the control group (SMD = −0.90, 95% CI -1.43 to -0.37, P < 0.05).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 405 studies were retrieved from the database; 248 studies were obtained after eliminating duplication with EndNote X9. After layer-by-layer screening, 18 studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] were finally included, with a total of 738 patients, 368 patients in the experimental group…”

Section: Study Selectionmentioning

confidence: 99%

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Systematic Review and Network Meta-Analysis of Noninvasive Brain Stimulation on Dysphagia after Stroke

Huang

Jia

et al. 2021

Neural Plasticity

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Background. Dysphagia is a common sequelae after stroke. Noninvasive brain stimulation (NIBS) is a tool that has been used in the rehabilitation process to modify cortical excitability and improve dysphagia. Objective. To systematically evaluate the effect of NIBS on dysphagia after stroke and compare the effects of two different NIBS. Methods. Randomized controlled trials about the effect of NIBS on dysphagia after stroke were retrieved from databases of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM, from inception to June 2021. The quality of the trials was assessed, and the data were extracted according to the Cochrane Handbook for Systematic Reviews of Interventions. A statistical analysis was carried out using RevMan 5.3 and ADDIS 1.16.8. The effect size was evaluated by using the standardized mean difference (SMD) and a 95% confidence interval (CI). Results. Ultimately, 18 studies involving 738 patients were included. Meta-analysis showed that NIBS could improve the dysphagia outcome and severity scale (DOSS) score (standard mean difference SMD = 1.44 , 95% CI 0.80 to 2.08, P < 0.05 ) and the water swallow test score ( SMD = 6.23 , 95% CI 5.44 to 7.03, P < 0.05 ). NIBS could reduce the standardized swallowing assessment (SSA) score ( SMD = − 1.04 , 95% CI -1.50 to -0.58, P < 0.05 ), the penetration-aspiration scale (PAS) score ( SMD = − 0.85 , 95% CI -1.33 to -0.36, P < 0.05 ), and the functional dysphagia scale score ( SMD = − 1.05 , 95% CI -1.48 to -0.62, P < 0.05 ). Network meta-analysis showed that the best probabilistic ranking of the effects of two different NIBS on the DOSS score is rTMS P = 0.52 > tDCS P = 0.48 , the best probabilistic ranking of the SSA score is rTMS P = 0.72 > tDCS P = 0.28 , and the best probabilistic ranking of the PAS score is rTMS P = 0.68 > tDCS P = 0.32 . Conclusion. Existing evidence showed that NIBS could improve swallowing dysfunction and reduce the occurrence of aspiration after stroke, and that rTMS is better than tDCS. Limited by the number of included studies, more large-sample, multicenter, double-blind, high-quality clinical randomized controlled trials are still needed in the future to further confirm the results of this research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

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Systematic Review and Network Meta-Analysis of Noninvasive Brain Stimulation on Dysphagia after Stroke

Huang

Jia

et al. 2021

Neural Plasticity

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“…Unilateral anodal tDCS involves placing the anode over the affected pharyngeal motor cortex and the cathode over the contralateral supraorbital region, whereas bilateral tDCS places an anode over the pharyngeal motor cortex of both hemispheres and a cathode over each corresponding contralesional supraorbital region [ 79 ]. Dual stimulation utilizes both anodal and cathodal tDCS, implementing anodal tDCS over the damaged hemisphere and cathodal tDCS over the contralesional one [ 80 ].…”

Section: How Can We Improve Treatment Of Post-stroke Dysphagia?mentioning

confidence: 99%

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

Jones¹,

Colletti

Ding

2020

Curr Neurol Neurosci Rep

102

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Purpose of Review We explored themes in recent post-stroke dysphagia literature, focusing on the following questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia? Recent Findings There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Summary Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.

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Oropharyngeal Dysphagia

Siwiec¹,

Babaei²

2019

Evaluation and Management of Dysphagia

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Dual Transcranial Direct Current Stimulation for Poststroke Dysphagia: A Randomized Controlled Trial

Abstract: In patients with poststroke dysphagia, treatment with dual tDCS in the early phase of rehabilitation does not significantly increase the probability of recovery compared with sham stimulation.

Cited by 32 publications

References 36 publications

Systematic Review and Network Meta-Analysis of Noninvasive Brain Stimulation on Dysphagia after Stroke

Systematic Review and Network Meta-Analysis of Noninvasive Brain Stimulation on Dysphagia after Stroke

Post-stroke Dysphagia: Recent Insights and Unanswered Questions

Oropharyngeal Dysphagia

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