Improving Swallowing Function and Ability in Post Stroke Dysphagia: A Randomized Clinical Trial.
Sima Farpour, Majid Asadi-Shekaari, Afshin Borhani Haghighi and 1 others
PMID 35715574WHAT IT FOUND
Adding anodal transcranial direct current stimulation over the supramarginal gyrus to standard behavioral therapy significantly improved swallowing function and ability in post-stroke dysphagia compared to sham stimulation.
The real group showed greater gains in functional oral intake and swallowing ability scores at one-month follow-up.
Key findings
01The real TDCS group showed significantly higher improvement in the primary outcome (Functional Oral Intake Scale) and secondary outcome (Mann Assessment of Swallowing Ability) compared to the sham group at post-treatment and one-month follow-up.
02At one-month follow-up, 72.70% of the sham group and 90.90% of the real group achieved two or more levels of improvement on the Functional Oral Intake Scale, a difference that was not statistically significant.
03Significantly more patients in the real group reached Functional Oral Intake Scale levels 6 or 7 (no need for special food preparation) compared to the sham group at both post-treatment and one-month follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size (44 patients) was small, preventing subgroup analyses based on stroke severity or dysphagia severity. Only two patients had brainstem strokes, limiting conclusions for that specific population. The supramarginal gyrus was localized using the 10-10 EEG system, which is less accurate than MRI or TMS-guided localization, though more feasible clinically. The study did not measure quality of life or mental health outcomes, which are important considerations for dysphagia management.
Declared interests
The study was supported by non-U.S. government funding. The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the non-significant difference in 'two or more FOIS level improvement' at one-month follow-up as evidence that the TDCS effect disappears. The real group still showed significantly higher mean FOIS scores and a significantly higher proportion of patients reaching independent oral intake (levels 6 or 7) at follow-up compared to the sham group.