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Neurophysiological Adaptation and Neuromodulatory Treatment Approaches in Patients Suffering from Post-stroke Dysphagia

Published on Dec 1, 2018in Current Physical Medicine and Rehabilitation Reports
· DOI :10.1007/s40141-018-0201-1
Paul Muhle7
Estimated H-index: 7
,
Sonja Suntrup-Krueger7
Estimated H-index: 7
,
Rainer Dziewas34
Estimated H-index: 34
Abstract
Purpose of Review This review gives an outline of the current state of knowledge on swallowing-related neurophysiology, neuroplasticity mechanisms following dysphagic stroke and neuromodulatory treatment approaches to enhance recovery processes for faster and better rehabilitation of post-stroke dysphagia.
  • References (114)
  • Citations (0)
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References114
Newest
#1Rainer DziewasH-Index: 34
#2Rebecca StellatoH-Index: 1
Last. Bettina PfauslerH-Index: 1
view all 25 authors...
Summary Background Dysphagia after stroke is common, especially in severely affected patients who have had a tracheotomy. In a pilot trial, pharyngeal electrical stimulation (PES) improved swallowing function in this group of patients. We aimed to replicate and extend this single-centre experience. Methods We did a prospective, single-blind, randomised controlled trial across nine sites (seven acute care hospitals, two rehabilitation facilities) in Germany, Austria, and Italy. Patients with rece...
13 CitationsSource
#1Jacqueline A. Palmer (Emory University)H-Index: 7
#2Steven L. Wolf (Emory University)H-Index: 69
Last. Michael R. Borich (Emory University)H-Index: 20
view all 3 authors...
7 CitationsSource
#2Corinna RingmaierH-Index: 1
Last. Rainer DziewasH-Index: 34
view all 11 authors...
10 CitationsSource
#1Paul MuhleH-Index: 7
#2Inga ClausH-Index: 3
Last. Sonja Suntrup-KruegerH-Index: 7
view all 9 authors...
Background/Aims: Performing neurophysiological and functional imaging studies in severely affected patients to investigate novel neurostimulation techniques for the treatment of neurogenic dysphagia is difficult. Therefore, basic research needs to be conducted in healthy subjects. Swallowing is a motor function highly dependent on sensory afferent input. Here we propose a virtual peripheral sensory lesion model to mimic pharyngeal sensory impairment, which is known as a major contributor to dysp...
3 CitationsSource
#1Wang-Sheng Lin (Taipei Veterans General Hospital)H-Index: 1
#2Chen-Liang Chou (NYMU: National Yang-Ming University)H-Index: 1
Last. Po-Yi Tsai (NYMU: National Yang-Ming University)H-Index: 1
view all 6 authors...
Abstract Background & aims Stroke involving the brainstem (SBS) causes severe oropharyngeal dysphagia (OD). Research on the therapeutic efficacy of vagus nerve modulation (VNM) by using repetitive transcranial magnetic stimulation (rTMS) in SBS patients with OD has been limited thus far. We aimed to assess the effect of VNM by using rTMS in improving swallowing function after SBS. Method We conducted a sham-controlled, double-blinded, parallel pilot study in 28 SBS patients with OD randomly allo...
5 CitationsSource
#1Christoph Zrenner (University of Tübingen)H-Index: 9
#2D. Desideri (University of Tübingen)H-Index: 4
Last. Ulf Ziemann (University of Tübingen)H-Index: 83
view all 4 authors...
Abstract Background Rapidly changing excitability states in an oscillating neuronal network can explain response variability to external stimulation, but if repetitive stimulation of always the same high- or low-excitability state results in long-term plasticity of opposite direction has never been explored in vivo . Objective/hypothesis Different phases of the endogenous sensorimotor μ-rhythm represent different states of corticospinal excitability, and repetitive transcranial magnetic stimulat...
50 CitationsSource
#1Thomas MarianH-Index: 4
Last. Rainer DziewasH-Index: 34
view all 8 authors...
Background: Dysphagia is a frequent and dangerous complication of acute stroke. Apart from a well-timed oropharyngeal muscular contraction pattern, sensory feedback is of utmost importance for safe and efficient swallowing. In the present study, we therefore analyzed the relation between pharyngolaryngeal sensory deficits and post-stroke dysphagia (PSD) severity in a cohort of acute stroke patients with middle cerebral artery (MCA) infarction. Methods: Eighty-four first-ever MCA stroke patients ...
8 CitationsSource
#1H. Essa (University of Manchester)H-Index: 1
#2Dipesh H. Vasant (University of Manchester)H-Index: 5
Last. Shaheen Hamdy (University of Manchester)H-Index: 42
view all 6 authors...
Background The aim of this study was to explore the effect of brain-derived neurotrophic factor (BDNF) polymorphism rs6265 (Val66Met) in both “natural” and treatment induced recovery of swallowing after dysphagic stroke. Methods Sixteen dysphagic stroke patients that completed a single-blind randomized sham controlled trial of pharyngeal electrical stimulation (PES) within 6 weeks of their stroke (N=38), were genotyped for the BDNF SNP Val66Met (rs6265) from saliva samples. These patients receiv...
3 CitationsSource
#1Rainer DziewasH-Index: 34
#2Satish MistryH-Index: 15
Last. Philip M.W. Bath (University of Nottingham)H-Index: 67
view all 7 authors...
RationaleOngoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) of tracheotomized dysphagic stroke patients regained sufficient control of airway management allowing tracheotomy tube removal (decannulation) 24–72 h after pharyngeal electrical stimulation (PES) compared to controls who received standard therapy over ...
6 CitationsSource
#1Sonja Suntrup-Krueger (WWU: University of Münster)H-Index: 7
#2André KemmlingH-Index: 21
Last. Rainer Dziewas (WWU: University of Münster)H-Index: 34
view all 9 authors...
Background and purpose Dysphagia is a well-known complication of acute stroke. Given the complexity of cerebral swallowing control it is still difficult to predict which patients are likely to develop swallowing dysfunction based on their neuroimaging. In Part 2 of a comprehensive voxel-based imaging study, whether the location of a stroke lesion can be correlated with further dysfunctional swallowing patterns, pulmonary protective reflexes and pneumonia was evaluated. Methods In all, 200 acute ...
12 CitationsSource
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