Correspondence: Dr Pengfei Guo, BS, Department of Rehabilitation, Xuzhou Central Hospital, No.199 South Jiefang Road, Xuzhou, Jiangsu 221009, China. Email: [email protected]

Search for more papers by this author

Shan Yao,

Shan Yao

Department of Rehabilitation, Xuzhou Central Hospital, Xuzhou, China

Search for more papers by this author

Xuxia Wang,

Xuxia Wang

Department of Rehabilitation, Xuzhou Central Hospital, Xuzhou, China

Search for more papers by this author

Jie Sun,

Jie Sun

Department of Rehabilitation, Xuzhou Central Hospital, Xuzhou, China

Search for more papers by this author

Pengfei Guo,

Corresponding Author

Pengfei Guo

[email protected]

orcid.org/0000-0002-1992-5156

Department of Rehabilitation, Xuzhou Central Hospital, Xuzhou, China

Correspondence: Dr Pengfei Guo, BS, Department of Rehabilitation, Xuzhou Central Hospital, No.199 South Jiefang Road, Xuzhou, Jiangsu 221009, China. Email: [email protected]

Search for more papers by this author

First published: 09 February 2024

https://doi.org/10.1111/psyg.13090

Disclosure: No conflict of interests.

Share a link

Email
Wechat
Bluesky

Abstract

Background

Given the potential harms of dysphagia after stroke, we noticed the possibility of non-invasive brain stimulation treatments in the management process.

Methods

The meta-analysis search for articles published before May 2023 in databases. We used STATA 12.0 software to compute the standard mean difference (SMD) and 95% confidence intervals (CI).

Results

The study showed a greater improvement in swallowing function in post-stroke dysphagia given transcranial direct current stimulation (tDCS) immediately after treatment, compared to those given sham tDCS (SMD = 2.99, 95% CI = 1.86–4.11). The study showed a greater improvement in swallowing function in post-stroke dysphagia given tDCS some days after treatment, compared to those given sham tDCS (SMD = 2.01, 95% CI = 0.87–3.16). The study showed a greater improvement in swallowing function in post-stroke dysphagia given repetitive transcranial magnetic stimulation (rTMS) immediately after treatment, compared to those given sham rTMS (SMD = 4.17, 95% CI = 3.11–5.23). The study showed a greater improvement in swallowing function in post-stroke dysphagia given rTMS some days after treatment, compared to those given sham rTMS (SMD = 1.77, 95% CI = 0.94–2.60).

Conclusions

In conclusion, our study showed the beneficial effects of non-invasive brain stimulation on difficulty swallowing for stroke patients and speculated about the potential application of non-invasive brain stimulation on post-stroke dysphagia improvement.

Open Research

DATA AVAILABILITY STATEMENT

The data that supports the findings of this study are available in the supplementary material of this article.

Supporting Information

Filename	Description
psyg13090-sup-0001-Supplementary_Figure_1.docxWord 2007 document , 563.6 KB	Supplementary Figure S1. Subgroup analysis regarding an immediate effect of tDCS on post-stroke dysphagia in different ethnicities (a), when combined or not combined with CT (b), with different sites of stimulation (c). CI, confidence interval; CT, conventional therapy; SMD, standard mean difference; tDCS, transcranial direct current stimulation.
psyg13090-sup-0002-Supplementary_Figure_2.docxWord 2007 document , 560.6 KB	Supplementary Figure S2. Sensitivity analysis (a) and funnel plot (b) regarding an immediate effect of tDCS on post-stroke dysphagia. tDCS, transcranial direct current stimulation.
psyg13090-sup-0003-Supplementary_Figure_3.docxWord 2007 document , 244.7 KB	Supplementary Figure S3. Subgroup analysis regarding the long-term effect of tDCS on post-stroke dysphagia in different ethnicities. CI, confidence interval; SMD, standard mean difference; tDCS, transcranial direct current stimulation.
psyg13090-sup-0004-Supplementary_Figure_4.docxWord 2007 document , 342.4 KB	Supplementary Figure S4. Sensitivity analysis (a) and funnel plot (b) regarding the long-term effect of tDCS on post-stroke dysphagia. tDCS, transcranial direct current stimulation.
psyg13090-sup-0005-Supplementary_Figure_5.docxWord 2007 document , 724.2 KB	Supplementary Figure S5. Subgroup analysis regarding an immediate effect of rTMS on post-stroke dysphagia in different ethnicities (a), with different frequencies of rTMS (b), when combined or not combined with CT (c), with different sites of stimulation (d). CI, confidence interval; CT, conventional therapy; rTMS, repetitive transcranial magnetic stimulation; SMD, standard mean difference.
psyg13090-sup-0006-Supplementary_Figure_6.docxWord 2007 document , 570.2 KB	Supplementary Figure S6. Sensitivity analysis (a) and funnel plot (b) regarding an immediate effect of rTMS on post-stroke dysphagia. rTMS, repetitive transcranial magnetic stimulation.
psyg13090-sup-0007-Supplementary_Figure_7.docxWord 2007 document , 642.1 KB	Supplementary Figure S7. Subgroup analysis regarding the long-term effect of rTMS on post-stroke dysphagia in different ethnicities (a), with different frequencies of rTMS (b), when combined or not combined with CT (c), with different sites of stimulation (d). CI, confidence interval; CT, conventional therapy; rTMS, repetitive transcranial magnetic stimulation; SMD, standard mean difference.
psyg13090-sup-0008-Supplementary_Figure_8.docxWord 2007 document , 522 KB	Supplementary Figure S8. Sensitivity analysis (a) and funnel plot (b) regarding the long-term effect of rTMS on post-stroke dysphagia. rTMS, repetitive transcranial magnetic stimulation.
psyg13090-sup-0009-Supplementary_Figure_9.docxWord 2007 document , 303.4 KB	Supplementary Figure S9. Risk of bias graph for studies regarding the effect of tDCS (a) and rTMS (b) on post-stroke dysphagia. rTMS, repetitive transcranial magnetic stimulation; tDCS, transcranial direct current stimulation.
psyg13090-sup-0010-Supplementary_Figure_10.docxWord 2007 document , 896.9 KB	Supplementary Figure S10. Risk of bias summary for studies regarding the effect of tDCS (a) and rTMS (b) on post-stroke dysphagia. rTMS, repetitive transcranial magnetic stimulation; tDCS, transcranial direct current stimulation.
psyg13090-sup-0011-Supplementary_Table_1.docxWord 2007 document , 38.3 KB	Supplementary Table S1. Characteristics of included studies regarding efficacy of tDCS on post-stroke dysphagia. tDCS, transcranial direct current stimulation.
psyg13090-sup-0012-Supplementary_Table_2.docxWord 2007 document , 39.6 KB	Supplementary Table S2. Characteristics of included studies regarding efficacy of rTMS on post-stroke dysphagia. rTMS, repetitive transcranial magnetic stimulation.

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

REFERENCES

1Rommel N, Hamdy S. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol 2016; 13: 49–59.
10.1038/nrgastro.2015.199
PubMed Web of Science® Google Scholar
2Panebianco M, Marchese-Ragona R, Masiero S, Restivo DA. Dysphagia in neurological diseases: a literature review. Neurol Sci 2020; 41: 3067–3073.
10.1007/s10072-020-04495-2
CAS PubMed Web of Science® Google Scholar
3Shigematsu T, Fujishima I. Dysphagia and swallowing rehabilitation. Brain Nerve 2015; 67: 169–182.
PubMed Google Scholar
4Sura L, Madhavan A, Carnaby G, Crary MA. Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 2012; 7: 287–298.
PubMed Web of Science® Google Scholar
5Lu Y, Chen Y, Huang D, Li J. Efficacy of acupuncture for dysphagia after stroke: a systematic review and meta-analysis. Annof Palliat Med 2021; 10: 3410–3422.
10.21037/apm-21-499
PubMed Web of Science® Google Scholar
6Jones CA, Colletti CM, Ding MC. Post-stroke dysphagia: recent insights and unanswered questions. Curr Neurol Neurosci Rep 2020; 20: 61.
10.1007/s11910-020-01081-z
PubMed Web of Science® Google Scholar
7Arnold M, Liesirova K, Broeg-Morvay A et al. Dysphagia in acute stroke: incidence, burden and impact on clinical outcome. PloS One 2016; 11: e0148424.
10.1371/journal.pone.0148424
PubMed Web of Science® Google Scholar
8Suttrup I, Warnecke T. Dysphagia in Parkinson's disease. Dysphagia 2016; 31: 24–32.
10.1007/s00455-015-9671-9
PubMed Web of Science® Google Scholar
9Lloyd DM, Wittkopf PG, Arendsen LJ, Jones AKP. Is transcranial direct current stimulation (tDCS) effective for the treatment of pain in fibromyalgia? A systematic review and meta-analysis. J Pain 2020; 21: 1085–1100.
10.1016/j.jpain.2020.01.003
PubMed Web of Science® Google Scholar
10Pacheco-Barrios K, Cardenas-Rojas A, Thibaut A et al. Methods and strategies of tDCS for the treatment of pain: current status and future directions. Expert Rev Med Devices 2020; 17: 879–898.
10.1080/17434440.2020.1816168
CAS PubMed Web of Science® Google Scholar
11Dondé C, Amad A, Nieto I et al. Transcranial direct-current stimulation (tDCS) for bipolar depression: a systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78: 123–131.
10.1016/j.pnpbp.2017.05.021
PubMed Web of Science® Google Scholar
12Woodham R, Rimmer RM, Mutz J, Fu CHY. Is tDCS a potential first line treatment for major depression? Int Rev Psychiatry 2021; 33: 250–265.
10.1080/09540261.2021.1879030
PubMed Web of Science® Google Scholar
13Sudbrack-Oliveira P, Razza LB, Brunoni AR. Non-invasive cortical stimulation: transcranial direct current stimulation (tDCS). Int Rev Neurobiol 2021; 159: 1–22.
10.1016/bs.irn.2021.01.001
PubMed Web of Science® Google Scholar
14Burke MJ, Fried PJ, Pascual-Leone A. Transcranial magnetic stimulation: neurophysiological and clinical applications. Handb Clin Neurol 2019; 163: 73–92.
10.1016/B978-0-12-804281-6.00005-7
PubMed Google Scholar
15Chou YH, Ton That V, Sundman M. A systematic review and meta-analysis of rTMS effects on cognitive enhancement in mild cognitive impairment and Alzheimer's disease. Neurobiol Aging 2020; 86: 1–10.
10.1016/j.neurobiolaging.2019.08.020
PubMed Web of Science® Google Scholar
16Chen W, Meiya W. Influence of transcranial direct current stimulation on the recovery of swallowing function and cerebral blood flow in stroke patients with dysphagia. Clin Med Eng 2022; 29: 601–602.
CAS Google Scholar
17Jinxiu H, Jianhui Y, Sun Mingying O, Xiaofeng O. Clinical observation of transcranial direct current stimulation combined with swallowing rehabilitation training in the treatment of dysphagia in pharynx during convalescence of stroke. Modern Chin Doctor 2022; 60: 5.
Google Scholar
18Panmo D, Ruan Maya L, Bingyuan C, Jie J. Repeated transcranial magnetic stimulation in the treatment of swallowing dysfunction after stroke. Chin Med J (Engl) 2022; 57: 4.
Google Scholar
19Yingying Y, Ganghua G, Jun G, Zhe L, Yingzi L. Therapeutic effect of different frequency and high frequency repeated transcranial magnetic stimulation on dysphagia in patients with unilateral stroke. China Rehabil 2022; 37: 3.
Google Scholar
20Lim KB, Lee HJ, Yoo J, Kwon YG. Effect of low-frequency rTMS and NMES on subacute unilateral hemispheric stroke with dysphagia. Ann Rehabil Med 2014; 38: 592–602.
10.5535/arm.2014.38.5.592
PubMed Google Scholar
21Cheng IKY, Chan KMK, Wong CS et al. Neuronavigated high-frequency repetitive transcranial magnetic stimulation for chronic post-stroke dysphagia: a randomized controlled study. J Rehabil Med 2017; 49: 475–481.
10.2340/16501977-2235
PubMed Web of Science® Google Scholar
22Kumar S, Marchina S, Langmore S et al. Fostering eating after stroke (FEASt) trial for improving post-stroke dysphagia with non-invasive brain stimulation. Sci Rep 2022; 12: 9607.
10.1038/s41598-022-14390-9
CAS PubMed Web of Science® Google Scholar
23Yang SN, Pyun SB, Kim HJ, Ahn HS, Rhyu BJ. Effectiveness of non-invasive brain stimulation in dysphagia subsequent to stroke: a systemic review and meta-analysis. Dysphagia 2015; 30: 383–391.
10.1007/s00455-015-9619-0
PubMed Web of Science® Google Scholar
24Wang T, Dong L, Cong X et al. Comparative efficacy of non-invasive neurostimulation therapies for poststroke dysphagia: a systematic review and meta-analysis. Neurophysiol Clin 2021; 51: 493–506.
10.1016/j.neucli.2021.02.006
PubMed Web of Science® Google Scholar
25He K, Wu L, Huang Y et al. Efficacy and safety of transcranial direct current stimulation on post-stroke dysphagia: a systematic review and meta-analysis. J Clin Med 2022; 11: 2297.
10.3390/jcm11092297
Web of Science® Google Scholar
26Lo WL, Leu HB, Yang MC, Wang DH, Hsu ML. Dysphagia and risk of aspiration pneumonia: a nonrandomized, pair-matched cohort study. J Dent Sci 2019; 14: 241–247.
10.1016/j.jds.2019.01.005
PubMed Web of Science® Google Scholar
27Farpour S, Farpour H, Zakeri M. Oropharyngeal dysphagia in elderly people. J Rehabil Sci Res 2018; 5: 120–123.
Google Scholar
28Cabré M, Almirall J, Clave P. Aspiration pneumonia: management in Spain. Eur Geriatric Med 2011; 2: 180–183.
10.1016/j.eurger.2011.03.004
Web of Science® Google Scholar
29Farpour S, Farpour HR, Smithard D, Kardeh B, Ghazaei F, Zafarghasempour M. Dysphagia Management in Iran: knowledge, attitude and practice of healthcare providers. Dysphagia 2019; 34: 105–111.
10.1007/s00455-018-9919-2
PubMed Web of Science® Google Scholar

Volume24, Issue2

March 2024

Pages 433-442

Efficacy of non-invasive brain stimulation for post-stroke dysphagia: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Efficacy of non-invasive brain stimulation for post-stroke dysphagia: a meta-analysis

Abstract

Background

Methods

Results

Conclusions

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

References

Related

Information