Related Experiment Video
Updated: Jul 2, 2026
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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
Intensive Rehabilitation With Adjunctive Bilateral Anodal tDCS in Post-Stroke Dysphagia: A Multicenter Randomized
Giuseppe Cosentino1,2, Tommaso Bocci3,4, Francesca Cecchi5,6
1Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
European Journal of Neurology
|July 1, 2026
Summary
Intensive speech-language therapy significantly improved swallowing in stroke patients. Bilateral transcranial direct current stimulation (tDCS) showed potential benefits for specific subgroups, warranting further investigation.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Medical Devices
Background:
- Oropharyngeal dysphagia is a common and disabling condition following stroke.
- Transcranial direct current stimulation (tDCS) is being explored for its potential to enhance swallowing recovery.
- Existing evidence on tDCS for post-stroke dysphagia remains limited.
Purpose of the Study:
- To evaluate the efficacy of bilateral anodal tDCS combined with intensive speech-language therapy (SLT) in improving swallowing outcomes in post-stroke dysphagia patients.
- To compare the effects of active tDCS versus sham stimulation on swallowing function.
- To conduct exploratory analyses on factors influencing treatment response, including treatment phase, sex, lesion site, and baseline severity.
Main Methods:
- A multicenter, randomized, double-blind, sham-controlled trial was conducted.
- Participants with post-stroke oropharyngeal dysphagia received either bilateral anodal tDCS or sham stimulation for 2 weeks, alongside intensive SLT over 6 weeks.
- Swallowing function was assessed using the Dysphagia Outcome and Severity Scale (DOSS), Penetration-Aspiration Scale (PAS), Mann Assessment of Swallowing Ability (MASA), and Swallowing Quality of Life questionnaire (SWAL-QoL).
Main Results:
- A total of 46 patients completed the study (24 active tDCS, 22 sham).
- Both groups demonstrated significant improvements in all swallowing outcomes (p < 0.001), with no statistically significant difference between active and sham tDCS.
- The DOSS proved to be the most sensitive outcome measure, showing sustained improvement. Exploratory analyses suggested potential benefits of active tDCS in patients with infratentorial strokes (p=0.04) and indicated that greater baseline dysphagia severity correlated with larger functional gains.
Conclusions:
- Intensive SLT alone led to meaningful recovery in swallowing function for patients with post-stroke dysphagia, irrespective of the stimulation condition.
- Exploratory findings suggest that bilateral tDCS may offer additional advantages in specific patient subgroups, particularly those with infratentorial lesions.