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
Background: The present study will be a longitudinal investigation of language abilities in individuals with mild cognitive impairment (MCI). The research question will include whether there will be an evidence for language impairment in individuals with MCI, and if so, what aspects of language will be the most affected and whether language abilities will be significantly changed over a 12-month period. Methods: We will diagnose 30 individuals with mild cognitive impairment (MCI), Alzheimer's disease (AD), and controlled participants using Montreal Cognitive Assessment-Basic (MoCA-B), as a cognitive test, and by asking expert opinions and conducting interviews. Participants will be selected from memory clinics and nursing homes in Tehran during 2018-2019. A comprehensive language test (Barnes Language Assessment (BLA)) will be performed to obtain baseline performance in the elderly. These tests will be repeated after 3, 6, and 12 months. Repeated measures analysis of variance (ANOVA) will be used to determine whether there will be a significant change in participants' language abilities over a 12-month period. In the case of deficient language performance, a discriminant function analysis will be used to identify the language task type that will be highly sensitive to change. Results and Conclusion: The present study will provide evidence for the nature of language change and will be done in a-year course on individuals with MCI and AD and on healthy elders. Also, in this study, the relative sensitivity of various language components to MCI will be determined, and the relationship between language performance and performance on (MoCA-B) neuropsychological test will be examined.
