增强吞咽启动的指南：来自健康受试者和吞咽困难患者研究结果的见解
Guide to Enhancing Swallowing Initiation: Insights from Findings in Healthy Subjects and Dysphagic Patients.
作者信息
Yamamura Kensuke, Kurose Masayuki, Okamoto Keiichiro
机构信息
Division of Oral Physiology, Department of Oral Biological Sciences, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514 Japan.
出版信息
Curr Phys Med Rehabil Rep. 2018;6(3):178-185. doi: 10.1007/s40141-018-0192-y. Epub 2018 May 23.
PURPOSE OF REVIEW
Difficulty in initiating swallowing is one of the main symptoms of oropharyngeal dysphagia. Therefore, enhancing swallowing initiation is an important approach for the treatment of oropharyngeal dysphagia. This review aims to introduce recent approaches to enhancing swallowing and to discuss their therapeutic potential.
RECENT FINDINGS
Both central interventions such as non-invasive brain stimulation and peripheral interventions such as electrical stimulation to peripheral tissues are conducted to enhance swallowing. Recent studies have paid more attention to generating neuroplasticity to produce long-lasting facilitative effect on swallowing.
SUMMARY
Transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), pharyngeal electrical stimulation (PES), transcutaneous electrical stimulation, and somatic and chemical stimulation were introduced. Considerable evidence supports the therapeutic potential of TMS and PES. Other approaches need further studies to verify their efficacy (e.g., duration of the effect and a limit of effectiveness) and/or possible risk of adverse effects.
综述目的
吞咽启动困难是口咽性吞咽困难的主要症状之一。因此，增强吞咽启动是治疗口咽性吞咽困难的重要方法。本综述旨在介绍近期增强吞咽的方法并探讨其治疗潜力。
最新发现
为增强吞咽，既进行了诸如无创脑刺激等中枢干预措施，也开展了如对周围组织进行电刺激等外周干预措施。近期研究更加关注产生神经可塑性以对吞咽产生持久的促进作用。
总结
介绍了经颅磁刺激（TMS）、经颅直流电刺激（tDCS）、咽部电刺激（PES）、经皮电刺激以及躯体和化学刺激。大量证据支持TMS和PES的治疗潜力。其他方法需要进一步研究以验证其疗效（如效果持续时间和有效性限度）和/或可能的不良反应风险。
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