İnme Geçiren Bireylerde Transkraniyal Doğru Akım Uyarımının (Tdcs) Disfaji Üzerine Etkilerinin İncelenmesi

Abstract

For many years, swallowing rehabilitation after stroke has focused on traditional swallowing therapy. One of the relatively newer applications to improve dysphagia after stroke is Transcranial Direct Current Stimulation (tDCS), a neuromodulation method. A total of 12 participants who still had dysphagia at least 3 months after stroke were randomly divided into two groups: stimulation (n=8) and sham (n=4). The stimulation group received 1.5 milliampere anodal tDCS to the pharyngeal motor cortex in the unaffected hemisphere and conventional swallowing therapy for 10 consecutive sessions. Under the same conditions, the sham group received ipsilesional sham stimulation and conventional swallowing therapy. Before, immediately after and 3 months after stimulation, participants' swallowing was scored with Dysphagia Outcome and Severity Scale (DOSS), Functional Oral Intake Scale (FOIS), Modified Barium Swallowing Impairment Profile (MBSImP) and Penetration Aspiration Scale (PAS) and their quality of life was assessed with Turkish Swallowing Related Quality of Life Scale (T-SWAL-QOL) and Turkish Eating Assessment Tool (T-EAT-10). We found a statistically significant improvement in the anodal tDCS group between the initial DOSS scores and the DOSS scores after 3 months (p = 0.026), and a similar improvement between the initial FOIS scores and the FOIS scores after 3 months (p = 0.003). When swallowing-related quality of life was compared, a significant improvement was found between the initial EAT-10 scores of participants in the anodal tDCS group and their EAT-10 scores 3 months later (p=0.001). This study suggests that noninvasive brain stimulation accompanied by conventional swallowing therapy may help reduce dysphagia severity, improve oral intake status and the quality of life of patients with chronic dysphagia after stroke.