Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2019
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.
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Restivo Domenico A, Alfonsi Enrico, Casabona Antonino, Hamdy Shaheen, Tassorelli Cristina, Panebianco Mariangela, Marchese-Ragona Rosario, Quartarone Angelo, Centonze Diego, Pavone Antonino, Stampanoni Bassi Mario
Аннотация
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.
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.