Sensory transcutaneous electrical stimulation improves post-stroke dysphagic patients.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Oropharyngeal dysphagia is a common and serious complication in stroke survivors, leading to increased mortality primarily due to pulmonary issues.
• Impaired swallowing function post-stroke significantly impacts quality of life and necessitates effective rehabilitation strategies.

Purpose of the Study:

• To investigate the efficacy of sensitive transcutaneous electrical stimulation applied submentally during swallowing for rehabilitating post-stroke oropharyngeal dysphagia.
• To assess the impact of this stimulation on cortical sensory-motor circuits involved in swallowing.

Main Methods:

• Eleven patients with recent post-stroke oropharyngeal dysphagia underwent daily 1-hour submental electrical stimulation for 5 days.
• Stimulation parameters included 80 Hz trains for 5 seconds every minute, below motor threshold.
• Swallowing function was evaluated using the Dysphagia Handicap Index, videofluoroscopy, and cortical mapping before and after the intervention.

Main Results:

• Significant improvements were observed in oropharyngeal dysphagia symptoms as reported by the questionnaire (p < 0.05).
• Videofluoroscopy revealed a decrease in laryngeal aspiration (p < 0.05) and pharyngeal residue (p < 0.05).
• Swallowing reaction time improved significantly (p < 0.05), while transit times and laryngeal closure duration remained unchanged.

Conclusions:

• Sensitive submental electrical stimulation during swallowing tasks is effective in rehabilitating post-stroke oropharyngeal dysphagia.
• The treatment appears to improve swallowing coordination, potentially through enhanced plasticity of the sensory swallowing cortex.
• This method offers a promising, non-invasive approach to managing dysphagia in stroke survivors.