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评估经颅电刺激对脑卒中后吞咽障碍的影响:系统评价和荟萃分析。

Evaluating the impact of transcranial electrical stimulation on post-stroke dysphagia: a systematic review and meta-analysis.

机构信息

Rehabilitation Department of Encephalopathy Centre, the Third Clinical Hospital Affiliated to Changchun University of Traditional Chinese Medicine, Changchun, Jilin Province, China.

Endoscopic Centre, the Third Clinical Hospital Affiliated to Changchun University of Traditional Chinese Medicine, Changchun, Jilin Province, China.

出版信息

J Int Med Res. 2024 Oct;52(10):3000605241288843. doi: 10.1177/03000605241288843.

DOI:10.1177/03000605241288843
PMID:39474766
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11529671/
Abstract

OBJECTIVE

To conduct a systematic review and meta-analysis to assess the impact of transcranial electrical stimulation (TES), proposed as a potential therapy for post-stroke dysphagia, on swallowing function in stroke survivors.

METHODS

The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for relevant studies on TES for post-stroke dysphagia. Search results were reviewed following PRISMA guidelines, and the following data were extracted from included studies: study characteristics, demographics, and outcomes. Bias was assessed using the Cochrane tool. Heterogeneity and effect sizes were analysed using I statistics and appropriate effects models. The study protocol was registered with PROSPERO (registration No. CRD42024578243).

RESULTS

Six randomized controlled trials met the inclusion criteria (I = 0.0%). The meta-analysis indicated a significant improvement in dysphagia with TES (standardized mean difference [SMD] 0.43, 95% confidence interval [CI] 0.13, 0.73). Subgroup analysis suggested that low-intensity TES was effective (SMD 0.46, 95% CI 0.09, 0.82), whereas high-intensity TES showed no significant improvement (SMD 0.37, 95% CI -0.17, 0.91). No publication bias was detected.

CONCLUSION

TES may improve swallowing in stroke patients, with potential benefits from low-intensity protocols.

摘要

目的

系统评价和荟萃分析评估经颅电刺激(TES)对脑卒中后吞咽障碍患者吞咽功能的影响,TES 被提议作为一种潜在的治疗方法。

方法

检索 PubMed、Embase、Web of Science 和 Cochrane Library 数据库中关于 TES 治疗脑卒中后吞咽障碍的相关研究。按照 PRISMA 指南对检索结果进行评价,并从纳入研究中提取以下数据:研究特征、人口统计学和结局。使用 Cochrane 工具评估偏倚。使用 I ²统计量和适当的效应模型分析异质性和效应大小。该研究方案在 PROSPERO(注册号:CRD42024578243)中进行了注册。

结果

纳入的 6 项随机对照试验符合纳入标准(I=0.0%)。荟萃分析表明 TES 可显著改善吞咽障碍(标准化均数差[SMD]0.43,95%置信区间[CI]0.13,0.73)。亚组分析表明,低强度 TES 有效(SMD 0.46,95% CI 0.09,0.82),而高强度 TES 无明显改善(SMD 0.37,95% CI-0.17,0.91)。未发现发表偏倚。

结论

TES 可能改善脑卒中患者的吞咽功能,低强度方案可能具有潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/6c3ff6e390df/10.1177_03000605241288843-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/383af0082e94/10.1177_03000605241288843-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/b1dd3dbd7e69/10.1177_03000605241288843-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/23543a0d31b6/10.1177_03000605241288843-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/6aa63945478b/10.1177_03000605241288843-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/6c3ff6e390df/10.1177_03000605241288843-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/383af0082e94/10.1177_03000605241288843-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/b1dd3dbd7e69/10.1177_03000605241288843-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/23543a0d31b6/10.1177_03000605241288843-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/6aa63945478b/10.1177_03000605241288843-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb50/11529671/6c3ff6e390df/10.1177_03000605241288843-fig5.jpg

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本文引用的文献

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Front Hum Neurosci. 2024 Jun 6;18:1404398. doi: 10.3389/fnhum.2024.1404398. eCollection 2024.
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The effectiveness of transcranial magnetic stimulation for dysphagia in stroke patients: an umbrella review of systematic reviews and meta-analyses.经颅磁刺激对脑卒中患者吞咽困难的有效性:系统评价和荟萃分析的综合评价
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非侵入性脑刺激治疗脑卒中后吞咽障碍的疗效:一项荟萃分析。
Psychogeriatrics. 2024 Mar;24(2):433-442. doi: 10.1111/psyg.13090. Epub 2024 Feb 9.
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Transcranial direct current stimulation for post-stroke dysphagia: a meta-analysis.经颅直流电刺激治疗脑卒中后吞咽障碍的Meta 分析。
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Dysphagia following cerebellar stroke: analyzing the contribution of the cerebellum to swallowing function.小脑卒中后的吞咽困难:分析小脑对吞咽功能的作用
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