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Transcranial direct current stimulation improves the swallowing function in patients with cricopharyngeal muscle dysfunction following a brainstem stroke

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Abstract

Objective

This study investigated the effects of transcranial direct current stimulation (tDCS) combined with conventional swallowing training on the swallowing function in brainstem stroke patients with cricopharyngeal muscle dysfunction (CPD).

Methods

Twenty-eight brainstem stroke patients with CPD were assigned randomly to an anodal tDCS group or a sham tDCS group. The patients received anodal tDCS or sham tDCS over the bilateral oesophageal cortical area combined with simultaneous catheter balloon dilatation and conventional swallowing therapy for 20 days. Swallowing function was assessed using the functional oral intake scale (FOIS) and the functional dysphagia scale (FDS) and by measuring the pharyngoesophageal Segment Opening (PESO) before and immediately after the intervention.

Results

Both groups showed a significant improvement in the FDS, FOIS and PESO scores immediately after the intervention (all p < .005). However, compared with the sham stimulation group, the anodal tDCS group showed greater improvements in the FDS, FOIS and PESO scores immediately after the intervention (all p < .005).

Conclusion

The bihemispheric anodal tDCS combined with simultaneous catheter balloon dilatation and conventional swallowing therapy effectively improves the swallowing function in patients with CPD caused by a brainstem stroke. tDCS may be an effective adjuvant therapy in CPD rehabilitation.

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Abbreviations

tDCS:

transcranial direct current stimulation

CPD:

cricopharyngeal muscle dysfunction

FOIS:

functional oral intake scale

FDS:

functional dysphagia scale

PESO:

pharyngoesophageal Segment Opening

rTMS:

repetitive transcranial magnetic stimulation

VFSS:

videofluoroscopic swallowing study

DOSS:

Dysphagia Outcome and Severity Scale

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Acknowledgements

The authors would like to thank all the coworkers for their tireless assistance in this project. The authors also thank the individuals who participated in this study.

Funding

The study was supported by Startup Fund for scientific research, Fujian Medical University (Grant number, 2016QH071), and National Natural Science Foundation of China (81572219).

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China

    Zhi-Yong Wang, Jian-Min Chen & Guo-Xin Ni

  2. Department of Rehabilitation Medicine, The 909th Hospital, 269 Zhanghua Middle Road, Zhangzhou, 363000, China

    Zheng-kun Lin

  3. School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China

    Guo-Xin Ni

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  1. Zhi-Yong Wang
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  2. Jian-Min Chen
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Correspondence to Guo-Xin Ni.

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The authors declare that they have no conflict of interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the First Affiliated Hospital, Fujian Medical University (reference number, [2016]152) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained prior to participation.

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Wang, ZY., Chen, JM., Lin, Zk. et al. Transcranial direct current stimulation improves the swallowing function in patients with cricopharyngeal muscle dysfunction following a brainstem stroke. Neurol Sci 41, 569–574 (2020). https://doi.org/10.1007/s10072-019-04120-x

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  • DOI: https://doi.org/10.1007/s10072-019-04120-x

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