Application of non-invasive brain stimulation with the use of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in the treatment of dysphagia following an ischemic stroke – analysis of research reports

Karolina Sandecka, Zbigniew Śliwiński


Karolina Sandecka, Zbigniew Śliwiński – Application of non-invasive brain stimulation with the use of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in the treatment of dysphagia following an ischemic stroke – analysis of research reports. Fizjoterapia Polska 2022; 22(5); 108-114

DOI: https://doi.org/10.56984/8ZG20ANp0

Abstract

Stroke is one of the significant problems and causes of death, in particular in highly developed countries. It is also the most common cause of dysphagia.
This study is devoted to the analysis of publications from the last decade concerning research on the use of non-invasive brain stimulation (TMS, tDCS) in the treatment of dysphagia following an ischemic stroke. The following databases were searched for publications: PUBMED, Polish Scientific Journals Database, EBSCO, ScienceDirect. Out of 358 articles found, only two met all the inclusion conditions.
The studies discussed in this article included patients who had their first unilateral ischemic stroke, followed by dysphagia.
Findings from pilot studies on the effectiveness of the use of tDCS in the treatment of dysphagia following an ischemic stroke were analysed. Fourteen patients aged 50-92 were randomly assigned to two groups. The study group was treated with anodic stimulation, and the control group with sham brain stimulation. The results showed that patients in the study group obtained a statistically significant result, indicating an improvement in the swallowing function as measured by the Dysphagia Score and Severity Scale. The above data may indicate the effectiveness of the use of tDCS in the treatment of dysphagia.
Fifty patients were qualified for the research on the effectiveness of rTMS in the treatment of dysphagia. Three groups were created: the first group treated with high frequency rTMS, where patients received rTMS stimulation – 3Hz; the second group with low frequency rTMS – 1Hz; and the control group. The effectiveness of the therapy used was assessed on the fifth day and after 1, 2 and 3 months. After 5 days the groups where active rTMS stimulation was used showed greater improvement in the swallowing function compared to the sham stimulation group. Improved results in the Standardized Swallowing Assessment were also recorded after 3 months in the 1Hz and 3Hz groups, but this did not apply to the control group. In three groups, the results of the water swallow test and the degree of dysphagia improved after 3 months.
This analysis shows that non-invasive brain stimulation using tDCS and rTMS in the treatment of dysphagia is associated with improved swallowing function. However, the small number of studies conducted in this area does not allow for extrapolation of their results.

Keywords:
dysphagia, transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS)

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Neuromuscular electrical stimulation therapy on controlling dysphagia in spastic cerebral palsy: A randomized controlled clinical trial

Amira Farag El-Sheikh, Amira Mohamed El- Tohamy, Bosina Mohamed Abd El-Aziz, Manal Salah El-Din. Abd El-wahab

Amira Farag El-Sheikh, Amira Mohamed El- Tohamy, Bosina Mohamed Abd El-Aziz, Manal Salah El-Din. Abd El-wahab – Neuromuscular electrical stimulation therapy on controlling dysphagia in spastic cerebral palsy: A randomized controlled clinical trial. Fizjoterapia Polska 2020; 20(2); 194-198

Abstract
Purpose. The purpose of this study was to evaluate the effectiveness of neuromuscular electrical stimulation (NMES) on controlling dysphagia in children with spastic cerebral palsy. Methods. Forty children, with age ranging from 2 to 5 years with a diagnosis of spastic cerebral palsy, they had dysphagia with level four or more in functional oral intake scale. They were randomly assigned into two groups of equal number, the study group that was treated by NMES in addition to selected oromotor exercise home program, whereas the control group was treated by placebo effect of NMES and the same oromotor exercise home program. Feeding level progress was evaluated by functional oral intake scale, weight gain and height were measured pre and post 2 months of the treatment. Results. A statistically insignificant difference was recorded before treatment (P > 0.05) between the study and control group, while a significant difference was recorded in each group after treatment in all measured variables. Comparing between both groups regarding feeding level progress there was significant difference (P < 0.05), but no statistically significant difference between both groups regarding weight gain and height (P < 0.05). Conclusions. The results of this randomized controlled study showed that NMES has more effect on feeding level progress than oromotor exercise home programme but no effect on weight gain and height, so the study suggests that oromotor exercise home Programme with NMES is superior to oromotor exercise home Programme alone for treating dysphagia in children with spastic cp.

Key words:
dysphagia, neuromuscular electrical stimulation, spastic cerebral palsy

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Swallowing – an important aspect of a patient’s functioning in the process of rehabilitation and neuro-speech therapy

Karolina Sandecka, Zbigniew Śliwiński, Grzegorz Śliwiński

K. Sandecka, Z. Śliwiński, G. Śliwiński – Swallowing – an important aspect of a patient’s functioning in the process of rehabilitation and neuro-speech therapy. Fizjoterapia Polska 2020; 20(2); 186-193

Abstract
Swallowing is a complicated, multi-stage process, which consists of forms of volitional and automated activities of our body. Irregularities in its scope may have a neurological basis, not related to the morphology and function of the nervous system, or may be associated with the physiological aging process.
Dysphagia, presbyphagia and aphagia may have complications in the form of aspiration pneumonia, malnutrition, dehydration, and deterioration of the quality of life. Multidisciplinary treatment, therapeutic and rehabilitation treatment, as well as involvement of a patient’s family and caregivers in this process is extremely important for patients with dysphagia.

Key words:
swallowing, swallowing disorders, dysphagia, aphagia, presbyphagia, odynophagia

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