Oral pharyngeal dysphagia (OD) has been reported in 20% to 81% of patients after stroke. As transcranial direct current stimulation (tDCS) has been found to enhance brain plasticity, this study examined the effects of this intervention on patients with OD after stroke.

Subjects were patients hospitalized for acute ischemic stroke who demonstrated dysphagia at admission screening. Of those screened for participation, 60 were identified and randomized to receive either 20 minutes of active tDCS or a sham tDCS over the center of the motor cortical swallowing network onfour consecutive days. The subjects were evaluated before and after this intervention with the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and by clinical assessment.

Scores on the FEDSS significantly improved from baseline to postintervention in both groups. More patients in the active group improved by one or more points on the FEDSS than in the sham group (83.3% vs 36.7%; P<0.0005). In addition, the active treatment group showed greater improvement in all secondary swallow outcomes, including the Dysphagia Severity Rating Scale (P＝0.001) and the FEDSS (P＝0.04). Pneumonia was identified in 53.3% of the sham group and 37.9% of the active treatment group, although this difference failed to reach statistical significance.

This study of patients with stroke related dysphagia found that transcranial direct current stimulation can accelerate the recovery of swallowing.