Aiqun Shi

Post-stroke dysphagia (PSD) has a series of complications that are associated with poor recovery and even mortality. Uncovering abnormal neural activities during swallowing bears critical implications for optimising treatment strategies for PSD patients. The current study was designed to identify the abnormal neural representations of swallowing in PSD. PSD individuals, stroke individuals without dysphagia, and healthy controls underwent a swallowing task while ongoing EEG was recorded. Compared to healthy controls, PSD patients demonstrated predominant gamma-band hypoactivity and hypoconnectivity during swallowing. We also identified an excessive gamma-band hyperconnectivity that was related to more severe dysphagia, possibly reflect inefficient neural effort or muscle recruitment during swallowing. As a secondary outcome, PSD patients demonstrated lower theta-band connectivity compared to those without dysphagia. These novel findings may help inform future research on potential neuromodulation approaches for PSD. However, this is considered as a pilot study, and these findings should be explained in the context of a small sample size.

To observe the clinical effects of transcranial direct current stimulation (tDCS) combined with conventional swallowing rehabilitation training on post-stroke dysphagia and explore its long-term efficacy. A total of 40 patients with dysphagia after the first stroke were randomly divided into a treatment group (n = 20) and a conventional group (n = 20). The treatment group received tDCS combined with conventional swallowing rehabilitation training, while the conventional group only received conventional swallowing rehabilitation training. The Standardized Swallowing Assessment (SSA) Scale and the Penetration-Aspiration Scale (PAS) were used to assess dysphagia before and after treatment, at the end of 10 treatments, and at the 3-month follow-up. The changes in infection indicators [the white blood cell (WBC), C-reactive protein (CRP) and procalcitonin (PCT)], the oxygenation indicator [arterial partial pressure of oxygen (PaO₂)] and nutrition-related indicators [hemoglobin (Hb) and serum prealbumin (PAB)] were compared before and after treatment. The SSA and PAS scores were lower in both groups after treatment than before treatment, and the difference was statistically significant (P < 0.01). The SSA and PAS scores of the treatment group were lower than those of the conventional group before and after treatment and during follow-up, and the difference was statistically significant (P < 0.05, P < 0.01). A within-group comparison showed that WBC, CRP and PCT after treatment were lower than those before treatment, and the difference was statistically significant (P < 0.05). The PaO₂, Hb and serum PAB were higher after treatment than before treatment, with a statistically significant difference (P < 0.05). The WBC, CRP and PCT of the tDCS group were lower than those of the conventional group, and PaO₂, Hb and serum PAB were higher in the treatment group than in the conventional group, with a statistically significant difference (P < 0.01). The tDCS combined with conventional swallowing rehabilitation training can improve dysphagia with a better effect than conventional swallowing rehabilitation training and has a certain long-term efficacy. In addition, tDCS combined with conventional swallowing rehabilitation training can improve nutrition and oxygenation and reduce infection levels.