Adjunctive transcranial direct current stimulation to improve swallowing functions in Parkinson's disease

Authors

  • Ali Akbar Dashtelei Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-1656-5140
  • Michael A. Nitsche Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, IfADo, Dortmund, Germany; German Centre for Mental Health (DZPG), Bochum/Marburg, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Bielefeld, Germany https://orcid.org/0000-0002-2207-5965
  • Mohammad Ali Salehinejad Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, IfADo, Dortmund, Germany https://orcid.org/0000-0003-1913-4677
  • Amir Hassan Habibi Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Bielefeld, Germany https://orcid.org/0000-0001-6896-4779
  • Jalal Bakhtyiari Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-8789-5737
  • Ahmad Reza Khatoonabadi Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran, P.O. Box 11489-65141. E-mail: khatoonabadi@tums.ac.ir https://orcid.org/0000-0003-1984-5911

DOI:

https://doi.org/10.17179/excli2023-6496

Keywords:

Parkinson's disease, dysphagia, transcranial Direct Current Stimulation, conventional dysphagia treatment, combination therapy

Abstract

Swallowing problems are frequent in Parkinson's disease (PD). The aim of this study was to determine the effectiveness of combined transcranial Direct Current Stimulation (tDCS) and Conventional Dysphagia Therapy (CDT) on dysphagia in PD patients. Twenty PD patients with dysphagia were randomized into two groups: combination therapy (anodal tDCS plus CDT) and sham tDCS combined with CDT. Anodal or sham tDCS, bilaterally over the pharyngeal motor cortex, was applied with one mA during the first 20 min (real) or 30 s (sham) of CDT, which was delivered for 30 min. Both groups received twice-daily treatment sessions within two weeks. Swallowing functions were evaluated before, immediately, and one month after the intervention via the Penetration-Aspiration Scale (PAS), and the Swallowing Disorder Questionnaire (SDQ) as the primary outcome measures, and the Dysphagia Handicap Index (DHI) as the secondary outcome measure. The results showed a significant improvement of PAS scores from baseline to post-intervention and baseline to follow-up in both groups without significant differences between groups (t=0.03, p=0.973, and t=1.27, p=0.22 for post-intervention and follow-up time points, respectively). The results showed a significant reduction of SDQ and DHI scores in both groups after the intervention, but the magnitude of the change was significantly larger in the anodal tDCS group at the post-intervention (ta=2.58, pa=0.019 and tb=2.96, pb=0.008) and follow-up (ta=2.65, pa=0.016 and tb=2.97, pb=0.008) time points. This study provides preliminary evidence that bi-hemispheric anodal tDCS combined with CDT enhances swallowing functions in patients with Parkinson's disease more than CDT alone.

Published

2024-01-18

How to Cite

Dashtelei, A. A., Nitsche, M. A., Salehinejad, M. A., Habibi, A. H., Bakhtyiari, J., & Khatoonabadi, A. R. (2024). Adjunctive transcranial direct current stimulation to improve swallowing functions in Parkinson’s disease. EXCLI Journal, 23, 95–107. https://doi.org/10.17179/excli2023-6496

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