Recent years, there have been a few studies show that stimulation over the cortical swallowing center can improve swallowing function, while these strokes occurs in the cortex. Transcranial direct current stimulation (tDCS), as a non-invasive brain stimulation (NIBS) technique, has shown increasing evidence remodeling the brain network to improve the motor, cognitive, and speech functions. While these methods target the peripheral nervous system. Several interventions such as cricopharyngeal muscle myotomy, injection of botulinum toxin A, catheter balloon dilatation, and conventional dysphagia treatments have been recommended for brainstem stroke patients with dysphagia. It takes long time to recover and brings heavy economic burden to the family and the whole society. Dysphagia will increase the incidence of complications such as dehydration, aspiration, pneumonia, and malnutrition, which not only affects the quality of life of patients but also increases the mortality and prolongs the duration of rehabilitation and hospitalization. The characteristics of main performance for pharyngeal swallowing disorder such as prolonged food passage in pharyngeal period, food residues in epiglottis and piriform fossa, abnormal upper laryngeal lift, and delayed ring pharyngeal muscle. Therefore, stroke in the medulla oblongata is called true bulbar paralysis, whose incidence is as high as 51 to 100%.

There is a control center of swallowing in the brainstem, such as ambiguous nucleus, solitary tract nucleus, and surrounding reticular structure. TDCS therapy combined with routine training can improve the swallowing function and nutritional status of patients, and reduce infection.īrainstem stroke accounts for about 9 to 21.9% of stroke. The tDCS group was superior to conventional comprehensive group in improving the swallowing function and nutritional indexes ( P < 0.05). ResultsĪfter 8 consecutive weeks of treatment, the score of DOSS scale and FDS scale in both groups was improved ( P < 0.05), WBC and CRP were decreased ( P < 0.05), and Alb and Hb were improved ( P < 0.05), and PAB had no differences ( P=0.474). The white blood cell (WBC), c-reactive protein, prealbumin (PAB), albumin (Alb), and hemoglobin (Hb) were also compared between the two groups before and after 8 weeks of continuous treatment. The Dysphagia Outcome and Severity Scale (DOSS) and Functional Dysphagia Scale (FDS) were evaluated respectively before and after 8 weeks of continuous treatment with VFSS. Both groups were given routine swallowing function training, and tDCS group added transcranial direct current stimulation (tDCS). Materials and methodsįorty brainstem stroke patients were randomly divided into tDCS group and conventional comprehensive treatment group, including 20 patients in each group. To investigate the effect of transcranial direct current stimulation (tDCS) combined with conventional comprehensive rehabilitation on dysphagia after brainstem stroke.

Brain stem stroke recovery