Pharyngeal electrical stimulation in amyotrophic lateral sclerosis: a pilot study

Area of Science:

• Neurology
• Gastroenterology
• Rehabilitation

Background:

• Amyotrophic lateral sclerosis (ALS) frequently causes dysphagia, increasing risks of aspiration, pneumonia, and weight loss.
• Pharyngeal electrical stimulation (PES) is a technique aimed at improving swallowing by leveraging cortical plasticity.
• Prior research indicates PES benefits patients with various neurological conditions.

Purpose of the Study:

• To evaluate the efficacy of PES in enhancing swallowing function among ALS patients with severe dysphagia.
• To compare the effects of PES combined with Standard Logopaedic Therapy (SLT) versus SLT alone.

Main Methods:

• Twenty ALS patients with severe dysphagia (Penetration Aspiration Scale [PAS] ≥ 4) were randomized into two groups: PES + SLT or SLT alone.
• Swallowing function was assessed using Fiberoptic Endoscopic Evaluation of Swallowing (FEES) at multiple time points.
• Primary endpoint was PAS score; secondary endpoints included quality of life, dysphagia severity, and functional status.

Main Results:

• A significant short-term improvement in median Total-PAS was observed across both groups combined post-treatment.
• No significant difference in swallowing function was found between the PES and control groups one day after intervention.
• While PAS scores increased after the initial improvement, they remained below baseline levels throughout the study.

Conclusions:

• PES does not appear to offer additional benefits for swallowing function in ALS patients beyond standard therapy.
• Standard Logopaedic Therapy (SLT) alone demonstrates potential for short-term improvements in swallowing function and quality of life for ALS patients.
• Further research may be needed to explore optimal therapeutic strategies for dysphagia in ALS.