Article

Poststroke dysphagia is associated with considerable morbidity and
has high health care cost implications. OBJECTIVE: To evaluate whether anodal
transcranial direct current stimulation (tDCS) over the lesioned hemisphere and
cathodal tDCS to the contralateral one during the early stage of rehabilitation
can improve poststroke dysphagia. METHODS: A total of 40 patients referred to our
neurorehabilitation department were randomized to receive anodal tDCS over the
damaged hemisphere plus cathodal stimulation over the contralateral one versus
sham stimulation during swallowing maneuvers over the course of 10 sessions of
treatment. Swallowing function was evaluated before and after stimulation using
the Dysphagia Outcome and Severity Scale (DOSS). RESULTS: The percentage of
patients who reached various thresholds of improvement was higher in the tDCS
group than in the sham group, but the differences were not significant (eg, DOSS
score >/= 20% increase from baseline: 55% in the tDCS group vs 40% in the sham
group; P = .53). Among all variables recorded at baseline, only a subgroup of
patients without nasogastric tube showed a significantly higher improvement with
tDCS treatment versus sham (DOSS score >/=10% and >/=20% from baseline: 64.29% vs
0%, P = .01). CONCLUSIONS: In patients with poststroke dysphagia, treatment with
dual tDCS in the early phase of rehabilitation does not significantly increase
the probability of recovery compared with sham stimulation.

Langue : ANGLAIS