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.
ABSTRACT
Parkinson's disease (PD) is a neurodegenerative disease of the central nervous system that is characterized by a set of motor and non-motor symptoms. Impaired swallowing or dysphagia is one relatively common motor symptom in patients with PD. We investigated whether neuroplasticity induction by spaced transcranial Direct Current Stimulation (tDCS) combined with conventional swallowing therapy leads to long-lasting effects on swallowing ability in patients with PD. We present a case of a 61-year-old male PD patient with dysphagia. Conventional Swallowing Therapy (CDT) combined with tDCS (bilateral anodal, 1 mA, 20 min, 10 online sessions, twice daily with a 20 min interval in between for five days over two weeks) was applied over the pharyngeal motor cortex. Our findings suggest that anodal tDCS combined with CDT is feasible, safe, and well-tolerated, and leads to a clinically relevant improvement of swallowing functions.
