Anodal transcranial direct current stimulation and intermittent theta-burst stimulation improve deglutition and swallowing reproducibility in elderly patients with dysphagia

Giuseppe Cosentino, Cristina Tassorelli, Paolo Prunetti, Giulia Bertino, Roberto De Icco, Massimiliano Todisco, Salvatore Di Marco, Filippo Brighina, Antonio Schindler, Mariangela Rondanelli, Mauro Fresia, Luca Mainardi, Domenico A. Restivo, Alberto Priori, Giorgio Sandrini, Enrico Alfonsi

Research output: Contribution to journalArticle

Abstract

Background: Dysphagia in the elderly, known as presbydysphagia, has become a relevant public health problem in several countries. Swallowing disorders may be a consequence of different neurological disorders (secondary presbydysphagia) or the expression of the aging process itself (primary presbydysphagia). We aimed to test the therapeutic potential of two different non-invasive brain stimulation (NIBS) techniques in subjects with primary or secondary presbydysphagia. Methods: A blinded randomized controlled trial with crossover design was carried out in 42 patients, randomly assigned to anodal transcranial direct current stimulation (tDCS) or intermittent theta-burst stimulation (TBS) group. Both tDCS and TBS were applied for 5 consecutive days over the right swallowing motor cortex. The swallowing function was assessed before and 1 and 3 months after the stimulation using the Dysphagia Outcome and Severity Scale (DOSS), scored based on clinical assessment and fiberoptic endoscopic evaluation of swallowing. An electrophysiological method was also applied to evaluate changes in the reproducibility of the swallowing behavior. Key Results: Both real tDCS and TBS had beneficial effects on the swallowing function in patients with primary and secondary presbydysphagia. Anodal tDCS resulted in an improvement of 0.5 points in DOSS at 1-month follow-up (P =.014), whereas intermittent TBS induced an increase of 0.7 and 0.6 points at 1- and 3-month follow-up evaluations, respectively (P =.0001 and P =.005, respectively). Reproducibility of both the oral and pharyngeal phases of swallowing significantly increased at 1-month follow-up. Conclusions and Inferences: Our results suggest that non-invasive cortical stimulation may be useful for dysphagia recovery in elderly patients.

Original languageEnglish
Article numbere13791
JournalNeurogastroenterology and Motility
DOIs
Publication statusAccepted/In press - Jan 1 2020

Fingerprint

Deglutition
Deglutition Disorders
Motor Cortex
Nervous System Diseases
Cross-Over Studies
Transcranial Direct Current Stimulation
Randomized Controlled Trials
Public Health
Brain

Keywords

  • brain stimulation
  • presbydysphagia
  • TBS
  • tDCS
  • TMS

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Anodal transcranial direct current stimulation and intermittent theta-burst stimulation improve deglutition and swallowing reproducibility in elderly patients with dysphagia. / Cosentino, Giuseppe; Tassorelli, Cristina; Prunetti, Paolo; Bertino, Giulia; De Icco, Roberto; Todisco, Massimiliano; Di Marco, Salvatore; Brighina, Filippo; Schindler, Antonio; Rondanelli, Mariangela; Fresia, Mauro; Mainardi, Luca; Restivo, Domenico A.; Priori, Alberto; Sandrini, Giorgio; Alfonsi, Enrico.

In: Neurogastroenterology and Motility, 01.01.2020.

Research output: Contribution to journalArticle

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AU - Cosentino, Giuseppe

AU - Tassorelli, Cristina

AU - Prunetti, Paolo

AU - Bertino, Giulia

AU - De Icco, Roberto

AU - Todisco, Massimiliano

AU - Di Marco, Salvatore

AU - Brighina, Filippo

AU - Schindler, Antonio

AU - Rondanelli, Mariangela

AU - Fresia, Mauro

AU - Mainardi, Luca

AU - Restivo, Domenico A.

AU - Priori, Alberto

AU - Sandrini, Giorgio

AU - Alfonsi, Enrico

PY - 2020/1/1

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