Transcranial direct current stimulation for post-stroke dysphagia: a meta-analysis
Nerea Gómez-García,1 Lorena Álvarez-Barrio,1 Raquel Leirós-Rodríguez,2 Anxela Soto-Rodríguez,3 Elena Andrade-Gómez,4 and Pablo Hernández-Lucas
2023
Results
Of the 9 investigations analyzed, all applied transcranial direct current stimulation in combination with conventional dysphagia therapy to the experimental group. All the studies analyzed identified improvements in swallowing function and meta-analysis confirmed their strong effect on reducing the risk of penetration and aspiration (Hedges’s g = 0.55). The results showed that participants who received transcranial direct current stimulation significantly improved swallowing function.
Conclusions
Transcranial direct current stimulation has positive effects in the treatment of poststroke dysphagia by improving swallowing function, oral and pharyngeal phase times and the risk of penetration and aspiration. Furthermore, its combination with conventional dysphagia therapy, balloon dilatation with catheter or training of the swallowing muscles ensures improvement of swallowing function.
Optimization of electrical stimulation for the treatment of lower limb dysfunction after stroke: A systematic review and Bayesian network meta-analysis of randomized controlled trials
Yu Fang et al
2023
Results
A total of 33 trials with a final total of 2246 subjects were included in the analysis. By combining the comprehensive Rehabilitation Treatment (RT), the treatment effects of using five electrical stimulation methods were surperior to those of using RT only. In the meantime, RT+transcranial Direct Current Stimulation(tDCS) and RT+Functional Electrical Stimulation(FES) could be the optimal electric stimulation schemes for restoring lower limb motor function(SMD 8.35, 95%CI [3.05, 13.34]/ SMD 5.64, 95%CI [3.68, 7.56]), improving balance (SMD 9.80, 95%CI [0.67, 20.93]/ SMD 6.54, 95%CI [3.85, 10.95]) and activities of daily living(SMD 18.95, 95%CI [0.401, 36.9]/ SMD 15.47, 95%CI [7.89, 22.75]), and the treatment effects would be even better using RT+FES+tDCS combination.
Conclusion
tDCS and FES superior to other electrical stimulation methods based on RT in the treatment of lower limb dysfunction after stroke.
Non-invasive brain stimulation for improving gait, balance, and lower limbs motor function in stroke
2022
Results
Overall, 25 appropriate studies (including 657 stroke subjects) were found. The data indicates that non-invasive brain stimulation/spinal cord stimulation is effective in supporting recovery. However, the effects are inhomogeneous across studies: (1) transcranial/trans-spinal direct current/alternating current stimulation induce greater effects than repetitive transcranial magnetic stimulation, and (2) bilateral application of non-invasive brain stimulation is superior to unilateral stimulation.
Conclusions
The current evidence encourages further research and suggests that more individualized approaches are necessary for increasing effect sizes in stroke patients.
Self-administered transcranial direct current stimulation for pain in older adults with knee osteoarthritis: A randomized controlled study
Geraldine Martorella a, Kenneth Mathis b, Hongyu Miao a, Duo Wang c, Lindsey Park a, Hyochol Ahn
2022
Methods: One hundred twenty participants aged 50e85 years with knee OA pain were randomly assigned to receive fifteen daily sessions of 2 mA tDCS for 20 min (n . 60) or sham tDCS (60) over 3 weeks with remote supervision via telehealth. Clinical pain intensity was measured by the Numeric Rating Scale andWestern Ontario and McMaster Universities Osteoarthritis Index. Also, we collected data on the tDCS experience via a questionnaire.
Results: Participants (68% female) had a mean age of 66 years. Active tDCS significantly reduced pain intensity compared to sham tDCS after completion of the fifteen daily sessions (Cohen's d . 1.20; p-value< 0.0001). Participants showed high levels of satisfaction with their tDCS experience, and there havebeen no adverse events.
Conclusion: We demonstrated that home-based self-administered tDCS was feasible and reduced clinical pain intensity in older adults with knee OA, which can increase its accessibility. Future studies with multi-site randomized controlled trials are needed to validate our findings.
Treating fibromyalgia with electrical neuromodulation: A systematic review and meta-analysis
Ying Chin Cheng et al
2023
Results:
Twenty-five studies and 1061 fibromyalgia patients were included in the quantitative analysis. Active electrical neuromodulation and active tDCS both showed significant effects on subjective pain, depression, and functioning. For different anode tDCS electrode positions, only F3-F4 revealed a significant effect on depression. Meta-regression tDCS effects on depression were significantly associated with age.
Conclusions:
Electrical neuromodulation is significantly effective in treating pain, depression, and functioning in patients with fibromyalgia.
Significance:
The results may help clinicians to arrange effective treatment plans for patients with fibromyalgia, especially in those patients who reveal limited response to pharmacotherapy and psychotherapy.
Large Treatment Effect With Extended Home-Based Transcranial Direct Current Stimulation Over Dorsolateral Prefrontal Cortex in Fibromyalgia: A Proof of Concept Sham-Randomized Clinical Study
Aline P. Brietzke,*,y Maxciel Zortea,*,y Fabiana Carvalho,*,y Paulo R.S. Sanches,z Danton P. Jr. Silva,z Iraci Lucena da Silva Torres,*,y,z,x,{,k Felipe Fregni,x and Wolnei Caumo*,y,x,{
Journal of Pain 2020
Zaključci:
produljeno razdoblje liječenje (60 sesija, do danas najveći broj testiranih tDCS sesija) za fibromialgiju izaziva veliko smanjenje boli (velika veličina učinka od 1,59)
podupire izvedivost kućne terapije tDCS kao metoda intervencije
pruža dodatne podatke o DLPFC kao ciljanom području neuromodulacije za liječenje fibromijalgije.