Objective: We evaluated whether transcranial direct current stimulation (tDCS) is able to enhance dysphagia rehabilitation following stroke. Besides relating clinical effects with neuroplastic changes in cortical swallowing processing, we aimed to identify factors influencing treatment success.
Methods: In this double-blind, randomized study, 60 acute dysphagic stroke patients received contralesional anodal (1mA, 20 minutes) or sham tDCS on 4 consecutive days. Swallowing function was thoroughly assessed before and after the intervention using the validated Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and clinical assessment. In 10 patients, swallowing-related brain activation was recorded applying magnetoencephalography before and after the intervention. Voxel-based statistical lesion pattern analysis was also performed.
Results: Study groups did not differ according to demographic data, stroke characteristics, or baseline dysphagia severity. Patients treated with tDCS showed greater improvement in FEDSS than the sham group (1.3 vs 0.4 points, mean difference = 0.9, 95% confidence interval [CI] = 0.4-1.4, p < 0.0005). Functional recovery was accompanied by a significant increase of activation (p < 0.05) in the contralesional swallowing network after real but not sham tDCS. Regarding predictors of treatment success, for every hour earlier that treatment was initiated, there was greater improvement on the FEDSS (adjusted odds ratio = 0.99, 95% CI = 0.98-1.00, p < 0.05) in multivariate analysis. Stroke location in the right insula and operculum was indicative of worse response to tDCS (p < 0.05).
Interpretation: Application of tDCS over the contralesional swallowing motor cortex supports swallowing network reorganization, thereby leading to faster rehabilitation of acute poststroke dysphagia. Early treatment initiation seems beneficial. tDCS may be less effective in right-hemispheric insulo-opercular stroke. Ann Neurol 2018;83:328-340.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ana.25151 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multi-target combination treatment with rTMS and tDCS for Tourette syndrome: a case report.
Front Hum Neurosci
January 2025
The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China.
Tourette syndrome (TS) is a neuropsychiatric disorder characterized by chronic motor and phonic tics, with a higher prevalence among boys. This condition can significantly impact patients' learning and daily life. Due to the limited efficacy and potential side effects of pharmacological treatments for TS, there is a critical need to develop novel, tailored therapeutic strategies.
View Article and Find Full Text PDFFatigue relief in multiple sclerosis by personalized neuromodulation: A multicenter pilot study [FaremusGE].
Mult Scler Relat Disord
January 2025
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.
Background: A recent application of the GRADE guidelines indicated Faremus, a 5-day neuromodulation for 15 min per day via transcranial direct current stimulation (tDCS), as medium to highly recommendable for alleviating fatigue in multiple sclerosis (MS).
Methods: With this pilot study we aimed to evaluate the feasibility, acceptance, safety, and effectiveness of the Faremus treatment carried out in a multicenter context. The Rome unit prepared the intervention, supplied the personalized electrodes to the San Martino Hospital in Genova, where the neurological team enrolled the population of fatigued people with multiple sclerosis (PwMS) and carried out the treatment.
A novel pulse-current waveform circuit for low-energy consumption and low-noise transcranial magnetic stimulation.
Front Neurosci
January 2025
School of Electronic Information and Communications, Huazhong University of Science and Technology, Wuhan City, China.
Introduction: Transcranial magnetic stimulation (TMS) is widely used for the noninvasive activation of neurons in the human brain. It utilizes a pulsed magnetic field to induce electric pulses that act on the central nervous system, altering the membrane potential of nerve cells in the cerebral cortex to treat certain mental diseases. However, the effectiveness of TMS can be compromised by significant heat generation and the clicking noise produced by the pulse in the TMS coil.
View Article and Find Full Text PDFPreoperative mapping techniques for brain tumor surgery: a systematic review.
Front Oncol
January 2025
Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Accurate preoperative mapping is crucial for maximizing tumor removal while minimizing damage to critical brain functions during brain tumor surgery. Navigated transcranial magnetic stimulation (nTMS), magnetoencephalography (MEG), and functional magnetic resonance imaging (fMRI) are established methods for assessing motor and language function. Following PRISMA guidelines, this systematic review analyzes the reliability, clinical utility, and accessibility of these techniques.
View Article and Find Full Text PDFClinical application of 3D slicer reconstruction and 3D printing localization combined with neuroendoscopy technology in VPS surgery.
Sci Rep
January 2025
Department of Neurosurgery, Renmin Hospital of Wuhan University, No. 238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
To explore techniques, advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization technology combined with transcranial neuroendoscopy in ventriculoperitoneal shunt surgery. Retrospective analysis of clinical data of patients with hydrocephalus treated by ventriculoperitoneal shunt surgery using 3D Slicer reconstruction and 3D printing positioning technology combined with transcranial neuroendoscopy in our hospital from October 2021 to March 2023. A total of 33 patients with complete data were collected, including 19 males and 14 females, aged 10-81 years.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!