Effect Of Bilateral Anode Transcranial Direct Current Stimulation On Dysphagia After Ischemic Stroke

ObjectThis study aims to investigate the clinical efficacy of bilateral cerebral hemisphere anode transcranial current stimulation(tDCS)in patients with ischemic stroke swallowing disorder,and the effect on the Root mean square(RMS)and swallowing time of submental muscle groups detected by Surface electromyography(sEMG).MethodsIn this study,patients with dysphagia after ischemic stroke hospitalized in Subei People’s Hospital from October 2021 to December 2022 were selected,and according to the inclusion and exclusion criteria,a total of 45 eligible patients were finally included,divided into 3 groups according to the random number table method:the affected side group,the healthy side group and the bilateral group,with 15 cases in each group.The three groups of patients received oral drugs such as antiplatelet aggregation,lipid regulation and stabilizing plaques,nourishing cranial nerves,controlling blood pressure,regulating blood sugar,improving cerebral circulation,and conventional swallowing rehabilitation training,including indirect training and direct training.Anode tDCS is given at the same time as conventional swallowing therapy.Affected side group:true tDCS on the injured side and pseudo tDCS on the uninjured hemisphere;The healthy side group:pseudo tDCS on the injured side and true tDCS on the uninjured hemisphere;Bilateral group:true tDCS on the injured side and true tDCS on the uninjured side.1 time per day,20 min each time,intensity 1.4mA,5 days a week,for 3 weeks.The functional oral intake scale(FOIS),the standardized swallowing assessment(SSA),and sEMG were used to detect the RMS of the submental muscles and the duration of swallowing after treatment,respectively,1 day before treatment and 3 weeks after treatment.Results(1)A total of 45 patients were included in the initial study,and all patients successfully completed the study.There were no significant differences in the general data of gender,age,location,and course of disease among the three groups(P>0.05).(2)Comparison of SSA scores between the three groups before and after treatment:Before treatment,the SSA scores of the three groups were compared with no significant difference(P>0.05).After treatment,the SSA scores of the three groups were significantly lower than those before treatment(P<0.05).Compared with the affected group,the SSA scores of the healthy side group and the bilateral group were improved after treatment,and the difference was statistically significant(P<0.05).Compared with the healthy side group,the SSA score of the bilateral group was significantly improved,and the difference was statistically significant(P<0.05).(3)Comparison of FOIS scores before and after treatment among the three groups:Before treatment,the FOIS scores of the three groups were compared with no significant difference(P>0.05).After treatment,the FOIS scores of the three groups increased compared with those before treatment,and the difference was statistically significant(P<0.05).Compared with the affected group,the FOIS score of the bilateral group improved significantly after treatment(P<0.05).(4)Comparison of sEMG before and after treatment in the three groups:Before treatment,the difference in the RMS of the submental muscles of the three groups was not statistically significant(P>0.05).After treatment,the RMS of the submental muscles of the three groups was higher than that before treatment,and the difference was statistically significant(P<0.05).Before treatment,the swallowing time of the submental muscles of the three groups was not statistically significant(P>0.05).After treatment,the swallowing time of submental muscle groups in the three groups was significantly lower than that before treatment(P<0.05).Compared with the affected group,the swallowing time of the submental muscle group was improved in the healthy side group and the bilateral group after treatment,and the difference was statistically significant(P<0.05).Compared with the unaffected group,the swallowing time of the submental muscles in the bilateral group was significantly improved,and the difference was statistically significant(P<0.05).Conclusion(1)Conventional rehabilitation combined with anode tDCS on the sensorimotor cortex of the affected side,the unaffected side and the bilateral hemisphere pharyngeal can improve the swallowing function of patients with unilateral hemisphere ischemic stroke dysphagia,and sEMG shows that the swallowing time of the submental muscle group is improved.(2)Conventional rehabilitation combined with anode tDCS had the best effect on bilateral anode tDCS treatment,and sEMG showed that the submental muscle group swallowing time was the most obvious,followed by the effect of healthy anode tDCS.