Transcranial direct current stimulation improves the swallowing function in patients with cricopharyngeal muscle dysfunction following a brainstem stroke

Neurol Sci. 2020 Mar;41(3):569-574. doi: 10.1007/s10072-019-04120-x. Epub 2019 Nov 12.

Abstract

Objective: This study investigated the effects of transcranial direct current stimulation (tDCS) combined with conventional swallowing training on the swallowing function in brainstem stroke patients with cricopharyngeal muscle dysfunction (CPD).

Methods: Twenty-eight brainstem stroke patients with CPD were assigned randomly to an anodal tDCS group or a sham tDCS group. The patients received anodal tDCS or sham tDCS over the bilateral oesophageal cortical area combined with simultaneous catheter balloon dilatation and conventional swallowing therapy for 20 days. Swallowing function was assessed using the functional oral intake scale (FOIS) and the functional dysphagia scale (FDS) and by measuring the pharyngoesophageal Segment Opening (PESO) before and immediately after the intervention.

Results: Both groups showed a significant improvement in the FDS, FOIS and PESO scores immediately after the intervention (all p < .005). However, compared with the sham stimulation group, the anodal tDCS group showed greater improvements in the FDS, FOIS and PESO scores immediately after the intervention (all p < .005).

Conclusion: The bihemispheric anodal tDCS combined with simultaneous catheter balloon dilatation and conventional swallowing therapy effectively improves the swallowing function in patients with CPD caused by a brainstem stroke. tDCS may be an effective adjuvant therapy in CPD rehabilitation.

Keywords: Brainstem stroke; Cricopharyngeal muscle dysfunction; Dysphagia; Transcranial direct current stimulation.

Publication types

  • Clinical Study

MeSH terms

  • Aged
  • Brain Stem Infarctions / complications*
  • Combined Modality Therapy
  • Deglutition Disorders / etiology
  • Deglutition Disorders / therapy*
  • Dilatation
  • Esophageal Diseases / etiology
  • Esophageal Diseases / therapy*
  • Esophageal Sphincter, Upper / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Cortex*
  • Muscular Diseases / etiology
  • Muscular Diseases / therapy*
  • Outcome Assessment, Health Care*
  • Random Allocation
  • Transcranial Direct Current Stimulation*