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Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review

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Abstract

Background

Swallowing is a complex function that can be disrupted after stroke. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation therapy that recently has been tested to treat stroke-related dysphagia.

Methods

The authors performed a search in the literature to review the described evidence of the use of tDCS in dysphagia after stroke. Three electronic databases were searched. The risk of bias evaluation was carried out through the RoB-2 tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was also implemented.

Results

Of 265 articles, only nine studies were included in this review. The most common location of the tDCS stimulation was the unaffected hemisphere (44%). Regarding the outcome measure, the Dysphagia Outcome and Severity Scale (DOSS) was the most commonly used (55%). However, due to the high heterogeneity of the protocols, and considering the differences between the types of stroke, the authors opted not to perform a metanalysis. Instead, a systematic review with a thorough analysis of each individual study and the impact of the differences to the outcomes was preferred.

Conclusions

The final considerations are that even though the majority of studies described benefits from tDCS in post-stroke dysphagia, as they present too many methodological differences, it is not possible to compare them. In addition, many articles included patients with less than 6 months after stroke, which is an important bias as the swallowing function can be recovered spontaneously within this period, turning the certainty of the evidence really low.

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Authors and Affiliations

  1. School of Medicine, Meridional Faculty, Passo Fundo, Brazil

    Giulia Isadora Cenci

  2. School of Medicine, Federal University of Amazonas, Manaus, Brazil

    Rebeka Bustamante Rocha

  3. School of Medicine, Medical Sciences Faculty of Minas Gerais, Belo Horizonte, Brazil

    Fernanda Ferreira Bomtempo

  4. School of Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil

    Gabriela Borges Nager

  5. Department of Neurology, University of São Paulo, São Paulo, Brazil

    Guilherme Diogo Silva & João Paulo Mota Telles

  6. Division of Neurosurgery, University of São Paulo, São Paulo, Brazil

    Eberval Gadelha Figueiredo

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  1. Giulia Isadora Cenci
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Correspondence to Giulia Isadora Cenci.

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As a systematic review article, all the data utilized was collected from previous clinical trials. Therefore, the author’s declare that this article fits the definition of studies that are exempt from ethics approval.

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Cenci, .I., Rocha, R.B., Ferreira Bomtempo, F. et al. Efficacy of transcranial direct current stimulation in patients with dysphagia after stroke: a systematic review. Neurol Sci 45, 2119–2125 (2024). https://doi.org/10.1007/s10072-023-07216-7

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  • DOI: https://doi.org/10.1007/s10072-023-07216-7

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