TY - JOUR
T1 - Effects of non-invasive brain stimulation on post-stroke dysphagia
T2 - A systematic review and meta-analysis of randomized controlled trials
AU - Pisegna, Jessica M.
AU - Kaneoka, Asako
AU - Pearson, William G.
AU - Kumar, Sandeep
AU - Langmore, Susan E.
N1 - Funding Information:
All authors, except for the second author, receive partial salary funding by the fourth author’s NIH grant, NIDCD 1R01DC012584-01A1. Research reported in this publication/presentation was supported by the National Institute On Deafness And Other Communication Disorders of the National Institutes of Health under Award Number R01DC012584. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of interest: The authors declare no conflict of interest.
Publisher Copyright:
© 2015 International Federation of Clinical Neurophysiology.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objective: The primary aim of this review is to evaluate the effects of non-invasive brain stimulation on post-stroke dysphagia. Methods: Thirteen databases were systematically searched through July 2014. Studies had to meet pre-specified inclusion and exclusion criteria. Each study's methodological quality was examined. Effect sizes were calculated from extracted data and combined for an overall summary statistic. Results: Eight randomized controlled trials were included. These trials revealed a significant, moderate pooled effect size (0.55; 95% CI = 0.17, 0.93; p = 0.004). Studies stimulating the affected hemisphere had a combined effect size of 0.46 (95% CI = -0.18, 1.11; p = 0.16); studies stimulating the unaffected hemisphere had a combined effect size of 0.65 (95% CI = 0.14, 1.16; p = 0.01). At long-term follow up, three studies demonstrated a large but non-significant pooled effect size (0.81, p = 0.11). Conclusions: This review found evidence for the efficacy of non-invasive brain stimulation on post-stroke dysphagia. A significant effect size resulted when stimulating the unaffected rather than the affected hemisphere. This finding is in agreement with previous studies implicating the plasticity of cortical neurons in the unaffected hemisphere. Significance: Non-invasive brain stimulation appears to assist cortical reorganization in post-stroke dysphagia but emerging factors highlight the need for more data.
AB - Objective: The primary aim of this review is to evaluate the effects of non-invasive brain stimulation on post-stroke dysphagia. Methods: Thirteen databases were systematically searched through July 2014. Studies had to meet pre-specified inclusion and exclusion criteria. Each study's methodological quality was examined. Effect sizes were calculated from extracted data and combined for an overall summary statistic. Results: Eight randomized controlled trials were included. These trials revealed a significant, moderate pooled effect size (0.55; 95% CI = 0.17, 0.93; p = 0.004). Studies stimulating the affected hemisphere had a combined effect size of 0.46 (95% CI = -0.18, 1.11; p = 0.16); studies stimulating the unaffected hemisphere had a combined effect size of 0.65 (95% CI = 0.14, 1.16; p = 0.01). At long-term follow up, three studies demonstrated a large but non-significant pooled effect size (0.81, p = 0.11). Conclusions: This review found evidence for the efficacy of non-invasive brain stimulation on post-stroke dysphagia. A significant effect size resulted when stimulating the unaffected rather than the affected hemisphere. This finding is in agreement with previous studies implicating the plasticity of cortical neurons in the unaffected hemisphere. Significance: Non-invasive brain stimulation appears to assist cortical reorganization in post-stroke dysphagia but emerging factors highlight the need for more data.
KW - Dysphagia
KW - Non-invasive brain stimulation
KW - Post-stroke population
KW - Transcranial direct current stimulation (tDCS)
KW - Transcranial magnetic stimulation (TMS)
KW - Unilateral lesion
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U2 - 10.1016/j.clinph.2015.04.069
DO - 10.1016/j.clinph.2015.04.069
M3 - Article
C2 - 26070517
AN - SCOPUS:84930599637
SN - 1388-2457
VL - 127
SP - 956
EP - 968
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 1
ER -