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Noninvasive Brain Stimulation for Poststroke Dysphagia: A Meta-Analysis for Randomized Controlled Trials
1Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Research Institution of Neuropsychiatry, Southeast University, Nanjing, China.
European Neurology
|October 27, 2021
Summary
Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) applied to the pharyngeal motor cortex significantly improve swallowing function in patients with post-stroke dysphagia. Further large-scale trials are needed to confirm these findings.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Medical Engineering
Background:
- Post-stroke dysphagia affects a significant number of patients, impacting their quality of life.
- Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive neuromodulation techniques explored for treating post-stroke dysphagia.
- Previous research on the efficacy of rTMS and tDCS for post-stroke dysphagia has yielded mixed results.
Purpose of the Study:
- To conduct a meta-analysis of randomized controlled trials (RCTs) evaluating the therapeutic effects of rTMS and tDCS on post-stroke dysphagia.
- To synthesize existing evidence on the efficacy of these neuromodulation techniques in improving swallowing function after stroke.
Main Methods:
- A systematic literature search was performed across major databases (PubMed, Web of Science, MEDLINE, EMBASE, Google Scholar) for studies published before March 2021.
- Meta-analysis was conducted using STATA 12.0 software to compute pooled results from included RCTs.
- Studies involving rTMS and tDCS targeting the pharyngeal motor cortex for post-stroke dysphagia were included.
Main Results:
- The meta-analysis revealed a significant improvement in swallowing function for patients receiving rTMS compared to sham rTMS (SMD = 1.08, 95% CI = 0.37-1.80).
- Significant improvements in swallowing function were also observed in patients receiving tDCS (alone or with conventional therapy) compared to sham tDCS (SMD = 1.43, 95% CI = 0.73-2.13).
- Both rTMS and tDCS demonstrated statistically significant positive effects on swallowing function in post-stroke dysphagia.
Conclusions:
- The findings indicate that both rTMS and tDCS applied over the pharyngeal motor cortex are effective therapies for post-stroke dysphagia.
- Larger-scale, blinded RCTs are necessary to further validate and refine the application of rTMS and tDCS in managing post-stroke dysphagia.
Keywords:
Meta-analysisPoststroke dysphagiaRepetitive transcranial magnetic stimulationTranscranial direct current stimulation
