Transcranial direct current stimulation for post-stroke dysphagia: a meta-analysis.
Nerea Gómez-García, Lorena Álvarez-Barrio, Raquel Leirós-Rodríguez and 3 others
PMID 38082316WHAT IT FOUND
Adding tDCS to conventional swallowing therapy improved swallowing and reduced aspiration/penetration in randomized trials.
The trials tested tDCS plus therapy, not tDCS alone.
Key findings
01In the included trials, tDCS was given together with conventional dysphagia therapy, while controls received sham tDCS with the same therapy or therapy alone.
02Swallowing improved more with tDCS plus therapy than with control treatment in nine studies, and improvement was similar in two studies.
03The meta-analysis of swallowing function pooled 8 trials with 273 participants and reported a Hedges g of 0.7 with a 95% CI of 0.46 to 0.94 and p<0.001.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The meta-analysis included only 8 trials and 273 participants. The tDCS technique was not protocolized, and electrode placement, hemisphere choice, intensity and duration varied between studies. Some trials had critical risk of bias, and many did not report missing data. The included trials tested tDCS added to conventional dysphagia therapy, so the effect of tDCS alone was not tested. Several studies did not describe the conventional therapy methods used. Only a limited range of outcomes could be pooled because assessment methods and missing data varied.
The easy way to misread this
Do not conclude that tDCS alone improves swallowing after stroke. The trials applied tDCS together with conventional dysphagia therapy, and the contribution of any single component cannot be separated.