Effect of transcranial direct current stimulation combined with respiratory training on dysphagia in post-stroke patients

Abstract

BACKGROUND: Transcranial direct current stimulation (tDCS) has a considerable advantage in the rehabilitation treatment of dysphagia. OBJECTIVE: The purpose of this study was to explore the effect of tDCS combined with respiratory training on dysphagia in post-stroke patients. METHODS: From December 2017 to January 2019, 64 post-stroke patients who were hospitalized in the Department of Neurology of the Second Hospital of Hebei Medical University were enrolled in this study. They were randomly divided into control and treatment groups (n= 32). Patients in the two groups received routine swallowing rehabilitation training and respiratory training. On this basis, the patients in the treatment group received tDCS. The anode was placed in the movement area of the pharyngeal cortex on the unaffected side of the patients’ bodies, and the cathode was placed in the upper orbital orbit on the opposite side. The current intensity was 1.5 mA, 20 min/time, 1 time/d, and 6 d/w. Before and after the treatment, the water swallow text, functional oral intake scale (FOIS), forced vital capacity (FVC) and peak expiratory flow (PEF) were assessed, and the correlation among them was evaluated. RESULTS: There were no differences in all indexes before and after treatment. After treatment, water swallow text, FOIS, FVC and PEF were all better than before treatment, and the clinical efficacy in the treatment group was significantly better than that in the control group. FVC and PEF were positively correlated with water swallow text and FOIS. CONCLUSION: tDCS combined with respiratory training may have a significant therapeutic effect on dysphagia in post-stroke patients.

Transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis

“…The included studies 18–61 involved 1555 patients (experimental group: 820, control group: 715) and were published between 2010 and 2024 in 20 countries. The top three countries based on the number of research studies were Italy ( n = 10), China ( n = 9), and the United States ( n = 5).…”

Efficacy of Transcranial Direct Current Stimulation Combined with Conventional Swallowing Rehabilitation Training on Post-stroke Dysphagia

“…The stimulation with a short duration is effective, possibly because tDCS alters the plasticity of neurons in the swallowing motor cortex, which is related to the long-term potentiation (LTP) effect of tDCS in the postsynaptic membrane [ 28 ], and this alteration is immediate and stable. The efficacy of tDCS for post-stroke dysphagia could be improved when stimulation intensity was 1–2 mA [ 29 ]. Jefferson [ 30 ] believed that higher intensity (1.5 mA) or longer duration (20 min) could contribute to stronger stimulation to the pharyngeal cortex.…”

Research Hotspots and Frontiers of Transcranial Direct Current Stimulation in Stroke: A Bibliometric Analysis

“…For motor dysfunction after stroke, studies have shown that tDCS combined with physiotherapy, mirror therapy, modified constraint-induced movement therapy, and virtual reality can accelerate the recovery of motor function in patients with stroke [50][51][52][53]. For dysphagia after stroke, studies indicated that tDCS combined with traditional Chinese medicine, dysphagia therapy, and respiratory training could improve dysphagia [54][55][56]. For shoulder pain in stroke, one study indicated that tDCS was not a useful combination strategy when physical therapy had a large effect by itself [42].…”