Abstract
Background. Poststroke dysphagia is associated with considerable morbidity and has high health care cost implications.
Objective.
To evaluate whether anodal transcranial direct current stimulation
(tDCS) over the lesioned hemisphere and cathodal tDCS to the
contralateral one during the early stage of rehabilitation can improve
poststroke dysphagia.
Methods. A total of 40 patients referred to
our neurorehabilitation department were randomized to receive anodal
tDCS over the damaged hemisphere plus cathodal stimulation over the
contralateral one versus sham stimulation during swallowing maneuvers
over the course of 10 sessions of treatment. Swallowing function was
evaluated before and after stimulation using the Dysphagia Outcome and
Severity Scale (DOSS).
Results. The percentage of patients who
reached various thresholds of improvement was higher in the tDCS group
than in the sham group, but the differences were not significant (eg,
DOSS score ≥ 20% increase from baseline: 55% in the tDCS group vs 40% in
the sham group; P = .53). Among all variables recorded at
baseline, only a subgroup of patients without nasogastric tube showed a
significantly higher improvement with tDCS treatment versus sham (DOSS
score ≥10% and ≥20% from baseline: 64.29% vs 0%, P = .01).
Conclusions.
In patients with poststroke dysphagia, treatment with dual tDCS in the
early phase of rehabilitation does not significantly increase the
probability of recovery compared with sham stimulation.
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