Change in Excitability of Cortical Projection After Modified Catheter Balloon Dilatation Therapy in Brainstem Stroke Patients with Dysphagia: A Prospective Controlled Study.
Xiaomei Wei, Fan Yu, Meng Dai and 4 others
PMID 28550485WHAT IT FOUND
Balloon dilatation added to conventional swallowing exercises and budesonide inhalation increased affected-side muscle responses after brain stimulation and improved tube feeding and hyoid movement more than conventional exercises alone in 30 brainstem stroke patients.
Key findings
01After treatment, affected submental muscle responses evoked by ipsilateral cortical stimulation were larger in the dilatation group than in the control group.
02After treatment, two dilatation patients and nine control patients remained tube-fed.
03Hyoid displacement and maximal UES opening diameter improved more in the dilatation group than in the control group after treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 30 patients were analysed, so the results are imprecise and may not generalise to less selected patients. Patients and therapists were not blinded, and there was no sham balloon control, so expectation effects and co-interventions could influence the outcomes. The dilatation group received balloon dilatation, conventional swallowing therapy, and budesonide inhalation, so the contribution of any single component cannot be separated. The stated primary outcome was a brain-stimulation muscle response measure, and follow-up ended at up to 3 weeks, so longer-term swallowing safety and function were not assessed. Unaffected submental MEP amplitudes were lower than previously reported normal values, which may affect interpretation of excitability changes.
Declared interests
The supplied article text does not include a conflicts-of-interest declaration. Publication metadata lists research support from non-U.S. government sources.
The easy way to misread this
Do not conclude that balloon dilatation alone caused the improvements. The dilatation group also received conventional swallowing exercises and budesonide inhalation, while the control group received conventional exercises twice daily, and patients and therapists were not blinded.