Transcranial direct current stimulation improves post-stroke dysphagia: Study

China: The height and considerable positive impact of transcranial direct current stimulation (tDCS) on improving post-stroke dysphagia were recently established by a new study published in Archives of Physical Medicine and Rehabilitation.

Dysphagia is a frequent side effect of stroke, which can cause people to cough when drinking water and raise the risk of aspiration pneumonia, which can cause malnutrition and asphyxia-related mortality. Because it is noninvasive, safe, and portable, transcranial direct current stimulation, a brain stimulation device, is utilized as a nondrug intervention treatment for several neurologic or psychiatric illnesses. According to studies, targeted deep brain stimulation (tDCS) can alter the motor function and psychophysiological processes. In order to assess the clinical effects of tDCS on post-stroke dysphagia using a meta-analysis, Na Zhao and colleagues conducted this review.

Up to June 2021, databases from PubMed, Cochrane Library (CENTRAL), Web of Science, VIP, CNKI, and Wanfang were carefully searched for this study. For evaluation, randomized controlled trials (RCTs) on the effects of tDCS on post-stroke dysphagia were considered. Author, location of publication, date of publication, sample size, demographic data (such as age, stage of disease, and location of stroke), key elements of bias risk assessment (such as RCTs and blind methods), interventional measures, tDCS treatment methods (stimulation location, intensity, duration), pertinent outcome indicators, and pertinent data were all extracted (SDs). The Physiotherapy Evidence Database Scale and the Cochrane Risk of Bias Assessment Tool were used to evaluate the risk of bias.

The key findings of this study were as follows:

1. This meta-analysis comprised sixteen RCTs. Overall, the findings showed that the pooled impact size was substantial and statistically significant.

2. For the chronic phase group, the subgroup that examined the course of the illness had a substantial and significant effect size. 1 mA and 1.6 mA of the stimulation intensity displayed moderate and substantial effect sizes.

3. The afflicted hemisphere exhibited a significant outcome in the subgroup analyses when compared to the unaffected hemisphere, and stimulation of the affected hemisphere had a more pronounced impact.

4. tDCS was beneficial for dysphagia following unilateral hemisphere stroke, bulbar paralysis, and brainstem stroke but not for dysphagia following ataxic and basal ganglia stroke.

5. However, the stroke location subgroup analysis produced a significant finding.

In conclusion, the Authors found that anode tDCS had a better impact on post-stroke dysphagia. Although these techniques have recently been studied with various patient demographics, bigger multicenter RCTs with clinically significant outcomes are required for a thorough evaluation of the efficacy of each technique.

Reference:

Zhao, N., Sun, W., Xiao, Z., Fan, C., Zeng, B., Xu, K., Liao, M., & Lu, W. (2022). Effects of Transcranial Direct Current Stimulation on Poststroke Dysphagia: A Systematic Review and Meta-analysis of Randomized Controlled Trials. In Archives of Physical Medicine and Rehabilitation (Vol. 103, Issue 7, pp. 1436–1447). Elsevier BV. https://doi.org/10.1016/j.apmr.2022.03.004