Transcranial Direct Current Stimulation for Post-stroke Dysphagia: A Meta-Analysis

Journal of Neuroengineering and Rehabilitation

Gómez-García, N., Álvarez-Barrio, L., et al. (2023).

Journal of Neuroengineering and Rehabilitation, 20(1), 165.

This meta-analysis investigates the effects of transcranial direct current stimulation (tDCS) in patients with post-stroke dysphagia.

No funding received

Not specified

Randomized controlled trials

11 (9 included in the meta-analysis)

Combined treatments of tDCS and conventional dysphagia therapy improved Penetration-Aspiration Scale scores (g = 0.70) and swallowing function (g = 0.55) in adults with post-stroke dysphagia (<strong>Moderate Certainty of Evidence</strong>). Specific findings included:<br /> <ul> <li><span style="color: #333333;">Treatment effects were maintained at one month (2 studies) and three months (2 studies). </span></li> <li><span style="color: #333333;">While sham treatments also improved swallowing function, true tDCS generally resulted in superior outcomes (9 of 11 studies).</span></li> <li><span style="color: #333333;">Combined treatments reduced oral transit time (2 studies) and reduced risk of aspiration and penetration (3 studies).&nbsp;</span></li> <li><span style="color: #333333;">Additional improvements were seen in hyoid movement (1 study), cricopharyngeal functioning (2 studies), brain activation (1 study), cerebral metabolism (1 study), and lab values (1 study).</span></li> <li><span style="color: #333333;">In one study, combined treatments reduced the need for nasogastric (NG) tube feeding in 100% of participants, while no participants in the control group (i.e., those receiving sham tDCS and conventional dysphagia therapy) discontinued the use of NG tubes.&nbsp;</span></li> <li><span style="color: #333333;">Individuals with less severe and more recent strokes demonstrated greater swallowing improvements (3 studies).&nbsp;</span></li> </ul> <span style="color: #333333;">Limitations to this review include a small number of studies included in the meta-analysis, heterogeneity regarding outcome measures, and differences between studies regarding tDCS protocols.</span>