Objective: we investigated the effect of anodal transcranial direct current stimulation (tDCS) applied over the pharyngeal motor area in dysphagia associated with multiple sclerosis (MS). Methods: Eighteen MS patients with dysphagia associated with brainstem involvement were randomized to receive either “real” or “sham” tDCS. Primary outcome: The Penetration/Aspiration Scale (PAS). Secondary outcomes: changes in electromyographic (EMG) parameters and pharyngeal cortical motor evoked potentials (MEPs). Patients were evaluated at baseline (T0), at the end of 5-session cycle of tDCS stimulations (T1), after two (T2), and four (T3) weeks. Results: the PAS values were significantly lower in the active group than in “sham” group at T1, and at T3. Over the post-stimulation periods, PAS significantly improved only in the “real” group. As regards the secondary outcomes, we observed a statistically significant difference between the 2 groups only in the MEPs amplitude at T1. The comparison between baseline and each of the post-stimulation times showed significant differences only of the “real” group across all the secondary parameters. Conclusions: Our findings support a beneficial effect of anodal tDCS applied to the pharyngeal motor cortex in MS-associated dysphagia. Significance: Considering its safety and efficacy, tDCS may represent an important resource in MS-associated dysphagia.

A pilot study on the efficacy of transcranial direct current stimulation applied to the pharyngeal motor cortex for dysphagia associated with brainstem involvement in multiple sclerosis

Casabona A.
Formal Analysis
;
2019-01-01

Abstract

Objective: we investigated the effect of anodal transcranial direct current stimulation (tDCS) applied over the pharyngeal motor area in dysphagia associated with multiple sclerosis (MS). Methods: Eighteen MS patients with dysphagia associated with brainstem involvement were randomized to receive either “real” or “sham” tDCS. Primary outcome: The Penetration/Aspiration Scale (PAS). Secondary outcomes: changes in electromyographic (EMG) parameters and pharyngeal cortical motor evoked potentials (MEPs). Patients were evaluated at baseline (T0), at the end of 5-session cycle of tDCS stimulations (T1), after two (T2), and four (T3) weeks. Results: the PAS values were significantly lower in the active group than in “sham” group at T1, and at T3. Over the post-stimulation periods, PAS significantly improved only in the “real” group. As regards the secondary outcomes, we observed a statistically significant difference between the 2 groups only in the MEPs amplitude at T1. The comparison between baseline and each of the post-stimulation times showed significant differences only of the “real” group across all the secondary parameters. Conclusions: Our findings support a beneficial effect of anodal tDCS applied to the pharyngeal motor cortex in MS-associated dysphagia. Significance: Considering its safety and efficacy, tDCS may represent an important resource in MS-associated dysphagia.
2019
Cortico-pharyngeal excitability
Cricopharyngeal muscle
Multiple sclerosis-associated dysphagia
Pharyngeal MEPs
Swallowing motor cortex
Transcranial direct current stimulation (tDCS)
Adult
Brain Stem
Deglutition Disorders
Electromyography
Female
Humans
Male
Motor Cortex
Multiple Sclerosis
Pharynx
Pilot Projects
Transcranial Direct Current Stimulation
Treatment Outcome
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/489988
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