Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review

Cenci, Giulia Isadora; Rocha, Rebeka Bustamante; Ferreira Bomtempo, Fernanda; Nager, Gabriela Borges; Silva, Guilherme Diogo; Figueiredo, Eberval Gadelha; Telles, João Paulo Mota

doi:10.1007/s10072-023-07216-7

Cited by 2 publications

References 36 publications

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Progress in dysphagia management in older patients

Lueg,

Pourhassan,

Wirth

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review The review summarizes current knowledge, recent findings and knowledge gaps about the pathophysiology and therapy of oropharyngeal dysphagia in older persons. Recent findings Oropharyngeal dysphagia is a major yet underrecognized health problem in older persons. Due to its high prevalence, its multifactorial etiology and multimodal treatment it has been classified as a geriatric syndrome. Although the knowledge of its pathophysiology and the effective diagnostic approach increased substantially during the last years, there is still minor evidence on how to effectively manage and treat dysphagia. However, treatment should be a multicomponent approach, combining swallowing training, nutritional therapy and oral hygiene. Emerging new fields are neurostimulation and chemical sensory stimulation which may be added in selected patients and indications. The individual components to be chosen should be based on the individual dysphagia pattern and severity as well as the capabilities of the patient. Frequently, the competing risks of inadequate nutrition and unsafe swallowing represent a challenge in determining the individual relevance of each component. Summary The understanding of the pathophysiology of oropharyngeal dysphagia increased substantially during recent years. However, due the multifaceted appearance of dysphagia, which requires an individualized treatment, the evidence for therapeutic approaches increases rather slowly.

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Progress in dysphagia management in older patients

Lueg,

Pourhassan,

Wirth

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Effect of transcranial direct current stimulation on swallowing improvement and cortical excitability in hemispheric stroke patients: a randomized, sham-controlled trial

Duan,

Yuan,

Hua

et al. 2024

Preprint

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Transcranial direct current stimulation (tDCS) has been extensively utilized in the treatment of post-stroke dysphagia; however, the effect of different tDCS protocols remains uncertain. This study aims to investigate the effect of tDCS on dysphagia after hemispheric stroke and compare the effect of tDCS among three protocols. A total of 90 hemispheric stroke patients were randomized into three groups: bilateral, contralesional, and ipsilesional tDCS. Each group received anodal tDCS over the orofacial sensorimotor cortex (S1M1) of the bilateral, contralesional, and ipsilesional hemispheres, respectively, administered for 20 sessions overall, combined with exercise-based swallowing therapy. After tDCS, both the dysphagia assessment scale and the swallow severity scale showed significant improvement in all three groups (all p <0.01). In the comparisons among the three groups, the bilateral tDCS demonstrated significantly greater improvement than both the contralesional and ipsilesional tDCS group, in terms of the dysphagia assessment scale (all p <0.001) and swallow severity scale (all p <0.05). The analysis of ApEn showed increased cortical excitability in both stimulated and non-stimulated areas of bilateral hemispheres after bilateral and unilateral tDCS. Moreover, larger cortical areas of bilateral hemispheres were activated after bilateral tDCS, compared to those after unilateral tDCS. Trial registration: ChiCTR-TRC-14004955(16/07/2014).

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Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review

Cited by 2 publications

References 36 publications

Progress in dysphagia management in older patients

Progress in dysphagia management in older patients

Effect of transcranial direct current stimulation on swallowing improvement and cortical excitability in hemispheric stroke patients: a randomized, sham-controlled trial

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