Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran.
Faculty of Medicine, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Khalili Street, Shiraz, Iran.
Dysphagia. 2023 Feb;38(1):330-339. doi: 10.1007/s00455-022-10470-0. Epub 2022 Jun 17.
Post-stroke dysphagia is a prevalent, life threatening condition. Scientists recommended implementing behavioral therapies with new technologies such as transcranial direct current of stimulation (TDCS). Studies showed promising TDCS effects, and scientists suggested the investigation of the effectiveness of different montages. Supramarginal gyrus (SMG) is important in swallowing function. Our study aimed to investigate the effectiveness of stimulating SMG in improving post-stroke dysphagia. Forty-four patients finished the study (a randomized, double-blind one). All of them received behavioral therapy. The real group received anodal (2 mA, 20 min) stimulation on the intact SMG, and the sham group received the same for 30 s (5 sessions). Patients were assessed with Functional Oral Intake Scale (FOIS) and Mann Assessment of Swallowing Ability (MASA) after treatment and at one-month follow-up. The results showed that the difference between groups at baseline was not significant. According to MASA both groups improved significantly during the time (p-value < 0.001). The improvement in the real group was significantly higher than in the sham group after treatment (p-value = 0.002) and after one-month follow-up (p-value < 0.001). According to FOIS, most of the patients in the real group (72.70%) reached level 6 or 7 after one-month follow-up which was significantly higher than the sham group (31.80%, p-value = 0.007). In conclusion, TDCS applied to the scalp's surface associated with SMG localization may improve swallowing function in the stroke patients with dysphagia.
脑卒中后吞咽困难是一种普遍存在的、危及生命的疾病。科学家建议将行为疗法与经颅直流电刺激(tDCS)等新技术结合使用。研究表明 tDCS 具有有前景的效果,科学家建议研究不同刺激模式的有效性。缘上回(SMG)在吞咽功能中起着重要作用。我们的研究旨在探讨刺激 SMG 改善脑卒中后吞咽困难的效果。44 名患者完成了这项研究(一项随机、双盲研究)。他们都接受了行为疗法。真刺激组在完整的 SMG 上接受了 2mA(20 分钟)的阳极刺激,假刺激组接受了同样时长(30 秒)的假刺激(共 5 次)。治疗后和一个月随访时,患者使用功能性口腔摄入量表(FOIS)和吞咽能力评估量表(MASA)进行评估。结果显示,两组在基线时的差异不显著。根据 MASA,两组在治疗期间均显著改善(p 值<0.001)。治疗后,真刺激组的改善明显高于假刺激组(p 值=0.002),一个月随访时也明显高于假刺激组(p 值<0.001)。根据 FOIS,真刺激组的大多数患者(72.70%)在一个月随访时达到了 6 或 7 级,明显高于假刺激组(31.80%,p 值=0.007)。综上所述,头皮表面联合 SMG 定位应用 tDCS 可能改善吞咽困难的脑卒中患者的吞咽功能。