Valeria Pingue1, Alberto Priori2, Alberto Malovini1, Caterina Pistarini3. 1. 1 IRCCS ICS Maugeri, Pavia, Italy. 2. 2 "Aldo Ravelli" Center for Neurotechnology & Experimental Brain Therapeutics, University of Milan, Department of Health Sciences, ASST Santi Paolo e Carlo, Milan, Italy. 3. 3 IRCCS ICS Maugeri, Genova Nervi, Italy.
Abstract
BACKGROUND:Poststroke dysphagia is associated with considerable morbidity and has high health care cost implications. OBJECTIVE: To evaluate whether anodal transcranial direct current stimulation (tDCS) over the lesioned hemisphere and cathodal tDCS to the contralateral one during the early stage of rehabilitation can improve poststroke dysphagia. METHODS: A total of 40 patients referred to our neurorehabilitation department were randomized to receive anodal tDCS over the damaged hemisphere plus cathodal stimulation over the contralateral one versus sham stimulation during swallowing maneuvers over the course of 10 sessions of treatment. Swallowing function was evaluated before and after stimulation using the Dysphagia Outcome and Severity Scale (DOSS). RESULTS: The percentage of patients who reached various thresholds of improvement was higher in the tDCS group than in the sham group, but the differences were not significant (eg, DOSS score ≥ 20% increase from baseline: 55% in the tDCS group vs 40% in the sham group; P = .53). Among all variables recorded at baseline, only a subgroup of patients without nasogastric tube showed a significantly higher improvement with tDCS treatment versus sham (DOSS score ≥10% and ≥20% from baseline: 64.29% vs 0%, P = .01). CONCLUSIONS: In patients with poststroke dysphagia, treatment withdual tDCS in the early phase of rehabilitation does not significantly increase the probability of recovery compared with sham stimulation.
RCT Entities:
BACKGROUND:Poststroke dysphagia is associated with considerable morbidity and has high health care cost implications. OBJECTIVE: To evaluate whether anodal transcranial direct current stimulation (tDCS) over the lesioned hemisphere and cathodal tDCS to the contralateral one during the early stage of rehabilitation can improve poststroke dysphagia. METHODS: A total of 40 patients referred to our neurorehabilitation department were randomized to receive anodal tDCS over the damaged hemisphere plus cathodal stimulation over the contralateral one versus sham stimulation during swallowing maneuvers over the course of 10 sessions of treatment. Swallowing function was evaluated before and after stimulation using the Dysphagia Outcome and Severity Scale (DOSS). RESULTS: The percentage of patients who reached various thresholds of improvement was higher in the tDCS group than in the sham group, but the differences were not significant (eg, DOSS score ≥ 20% increase from baseline: 55% in the tDCS group vs 40% in the sham group; P = .53). Among all variables recorded at baseline, only a subgroup of patients without nasogastric tube showed a significantly higher improvement with tDCS treatment versus sham (DOSS score ≥10% and ≥20% from baseline: 64.29% vs 0%, P = .01). CONCLUSIONS: 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.
Entities:
Keywords:
dual stimulation; noninvasive brain stimulation; poststroke dysphagia; poststroke recovery; swallowing rehabilitation; transcranial direct current stimulation
Authors: Marom Bikson; Zeinab Esmaeilpour; Devin Adair; Greg Kronberg; William J Tyler; Andrea Antal; Abhishek Datta; Bernhard A Sabel; Michael A Nitsche; Colleen Loo; Dylan Edwards; Hamed Ekhtiari; Helena Knotkova; Adam J Woods; Benjamin M Hampstead; Bashar W Badran; Angel V Peterchev Journal: Brain Stimul Date: 2019-07-17 Impact factor: 8.955
Authors: Sarah Marchina; Jessica M Pisegna; Joseph M Massaro; Susan E Langmore; Courtney McVey; Jeffrey Wang; Sandeep Kumar Journal: J Neurol Date: 2020-08-14 Impact factor: 4.849