Improving Swallowing Function and Ability in Post Stroke Dysphagia: A Randomized Clinical Trial.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Medical Technology

Background:

• Post-stroke dysphagia is a common and serious complication.
• Behavioral therapies are standard, but novel technologies like transcranial direct current stimulation (TDCS) show potential.
• The supramarginal gyrus (SMG) plays a crucial role in swallowing control.

Purpose of the Study:

• To evaluate the efficacy of anodal TDCS applied to the supramarginal gyrus (SMG) for improving post-stroke dysphagia.
• To compare the effects of real TDCS versus sham stimulation when combined with behavioral therapy.

Main Methods:

• A randomized, double-blind study involving 44 patients with post-stroke dysphagia.
• All participants received standardized behavioral therapy.
• The experimental group received anodal TDCS (2 mA, 20 min) on the intact SMG, while the control group received sham stimulation (30 s) over 5 sessions.
• Swallowing ability was assessed using the Mann Assessment of Swallowing Ability (MASA) and Functional Oral Intake Scale (FOIS).

Main Results:

• Both real and sham TDCS groups showed significant improvement in MASA scores over time (p < 0.001).
• The real TDCS group demonstrated significantly greater MASA improvement compared to the sham group post-treatment (p = 0.002) and at one-month follow-up (p < 0.001).
• Following one month, 72.7% of patients in the real TDCS group achieved high FOIS levels (6 or 7), significantly more than the sham group (31.8%, p = 0.007).

Conclusions:

• TDCS applied over the SMG, in conjunction with behavioral therapy, effectively enhances swallowing function in stroke patients with dysphagia.
• This non-invasive neuromodulation technique represents a valuable addition to dysphagia rehabilitation strategies.
• Further research into optimal TDCS parameters and montages for dysphagia is warranted.