Xie Jianwei, Zhou Chiteng, Ngaruwenayo Gilbert, Wu Minghui, Jiang Xiaoyu, Li Xiaohan
School of Nursing, China Medical University, Shenyang, China.
The First Clinical College, China Medical University, Shenyang, China.
Front Neurol. 2023 Jan 24;14:1098831. doi: 10.3389/fneur.2023.1098831. eCollection 2023.
This systematic review and network meta-analysis sought to determine the efficacy of different intensities of transcranial direct current stimulation (tDCS) in patients with dysphagia after stroke to improve swallowing function.
Randomized-controlled trials (RCTs) of tDCS in post-stroke dysphagia were searched from Pubmed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), Wanfang database, and Chinese Scientific Journals Database (VIP) from databases' inception to June 22, 2022. Article screening, data extraction, and article quality evaluation were completed by 2 independent researchers. Network meta-analysis was performed using Stata.
A final total of 20 studies involving 838 stroke patients were included. The included control interventions were sham tDCS and conventional therapy (CT). Network meta-analysis showed that 20 min of 1.2, 1.4, 1.5, 1.6, and 2 mA anodal tDCS and 30 min of 2 mA anodal tDCS significantly improved post-stroke dysphagia compared with CT (all P < 0.05). In addition, 20 min of 1, 1.4, 1.6, and 2 mA anodal tDCS also significantly improved post-stroke dysphagia compared with sham tDCS (all < 0.05). Our results demonstrated that 20 min of stimulation at 1.4 mA was the optimal parameters for anodal tDCS and exhibited superior efficacy to CT [SMD = 1.08, 95% CI (0.46, 1.69)] and sham tDCS [SMD = 1.45, 95% CI (0.54, 2.36)].
Different durations and intensities of anodal tDCS are effective in improving post-stroke dysphagia. However, 20 min of tDCS at 1.4 mA may be the optimal regimen.
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42022342506.
本系统评价和网状Meta分析旨在确定不同强度的经颅直流电刺激（tDCS）对脑卒中后吞咽困难患者吞咽功能改善的疗效。
从PubMed、EMBASE、Cochrane图书馆、科学网、中国知网（CNKI）、中国生物医学文献服务系统（SinoMed）、万方数据库和维普中文科技期刊数据库中检索自建库至2022年6月22日关于tDCS治疗脑卒中后吞咽困难的随机对照试验（RCT）。由2名独立研究人员完成文献筛选、数据提取及文献质量评价。采用Stata进行网状Meta分析。
最终纳入20项研究，共838例脑卒中患者。纳入的对照干预措施为假tDCS和传统治疗（CT）。网状Meta分析显示，与CT相比，1.2、1.4、1.5、1.6和2 mA阳极tDCS刺激20分钟以及2 mA阳极tDCS刺激30分钟均能显著改善脑卒中后吞咽困难（均P<0.05）。此外，与假tDCS相比，1、1.4、1.6和2 mA阳极tDCS刺激20分钟也能显著改善脑卒中后吞咽困难（均P<0.05）。我们的结果表明，1.4 mA刺激20分钟是阳极tDCS的最佳参数，其疗效优于CT[标准化均数差（SMD）=1.08，95%可信区间（CI）（0.46，1.69）]和假tDCS[SMD=1.45，95%CI（0.54，2.36）]。
不同时长和强度的阳极tDCS对改善脑卒中后吞咽困难均有效。然而，1.4 mA的tDCS刺激20分钟可能是最佳方案。
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符CRD42022342506。
