Abstract
ObjectiveTo investigate the effect of transcranial direct current stimulation (tDCS) combined with conventional comprehensive rehabilitation on dysphagia after brainstem stroke.Materials and methodsForty brainstem stroke patients were randomly divided into tDCS group and conventional comprehensive treatment group, including 20 patients in each group. Both groups were given routine swallowing function training, and tDCS group added transcranial direct current stimulation (tDCS). The Dysphagia Outcome and Severity Scale (DOSS) and Functional Dysphagia Scale (FDS) were evaluated respectively before and after 8 weeks of continuous treatment with VFSS. The white blood cell (WBC), c-reactive protein, prealbumin (PAB), albumin (Alb), and hemoglobin (Hb) were also compared between the two groups before and after 8 weeks of continuous treatment.ResultsAfter 8 consecutive weeks of treatment, the score of DOSS scale and FDS scale in both groups was improved (P < 0.05), WBC and CRP were decreased (P < 0.05), and Alb and Hb were improved (P < 0.05), and PAB had no differences (P=0.474). The tDCS group was superior to conventional comprehensive group in improving the swallowing function and nutritional indexes (P < 0.05).ConclusionstDCS therapy combined with routine training can improve the swallowing function and nutritional status of patients, and reduce infection.
Highlights
Brainstem stroke accounts for about 9 to 21.9% of stroke [1]
It takes long time to recover and brings heavy economic burden to the family and the whole society [4, 5]. Several interventions such as cricopharyngeal muscle myotomy, injection of botulinum toxin A, catheter balloon dilatation, and conventional dysphagia treatments have been recommended for brainstem stroke patients with dysphagia
(d) Balloon dilatation [10]: using No 12 catheter inserted through the mouth slowly into the esophagus, inject 2–8 mL cold saline slowly into the balloon until the patients feel stuck, instruct the patient to swallow while gently pulling catheter outward, once feeling the resistance of balloon has passed the cricopharyngeus muscle, quickly draw out the saline in the balloon catheter
Summary
There is a control center of swallowing in the brainstem, such as ambiguous nucleus, solitary tract nucleus, and surrounding reticular structure. The characteristics of main performance for Huiwen Mao and Yi Lyu contributed to this work. Several interventions such as cricopharyngeal muscle myotomy, injection of botulinum toxin A, catheter balloon dilatation, and conventional dysphagia treatments have been recommended for brainstem stroke patients with dysphagia. While these methods target the peripheral nervous system. There have been a few studies show that stimulation over the cortical swallowing center can improve swallowing
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