Effect of transcranial direct current stimulation on dysphagia in patients with post thermal inhalation injury: A randomized controlled trial

Abstract

Background: The most dangerous complications of post-thermal inhalation injury dysphagia are aspiration risks and the inability to efficiently manage solid food textures, which almost persist for weeks and even for months. Objectives: To investigate the effect of transcranial direct current stimulation (tDCS) to conventional therapy for treating post thermal inhalation injury dysphagia. Participants and Methodology: Sixty patients aged from 13 to 35, suffering from post-thermal inhalation injury dysphagia were randomly allocated into two equal groups. The experimental group(A) received 2-mA tDCS through 2 surface electrodes, three times/week for 3 weeks plus conventional physical therapy. While the control group (B) received sham tDCS as a placebo plus the same conventional physical therapy. The Mann Assessment of Swallowing Ability (MASA) as well as Video fluoroscopy Swallow Study (VFSS) were used to assess the swallowing ability in both groups before and after 3 weeks of intervention. Outcome measures included oral transportation time, hyoid elevation, laryngeal elevation, the oesophageal sphincter opens, and aspiration measured by VFSS as well as swallowing ability measured by the MASA. Results: Post-treatment results showed a significant decrease in the oral transportation time, hyoid elevation, laryngeal elevation, the oesophageal sphincter opens, and aspiration, as well as outcomes of the MASA in both groups in favour of the tDCS group(p < .05). Conclusion: Application of tDCS has a significant effect as an adjuvant strategy during swallowing training in patients with post thermal inhalation injury dysphagia.