Effectiveness of Non-invasive Brain Stimulation in Dysphagia Subsequent to Stroke: A Systemic Review and Meta-analysis

Seung Nam Yang, Sung Bom Pyun, Hyun Jung Kim, Hyeong Sik Ahn, Byung Joo Rhyu

Research output: Contribution to journalReview article

23 Citations (Scopus)

Abstract

The objective of this study is to assess the efficacy and safety of non-invasive brain stimulation (NIBS) in patients with dysphagia subsequent to stroke. A systematic search of the literature published by Medline (January 1, 1976 through June 21, 2013), EMBASE (January 1, 1985 through June 21, 2013), and the Cochrane Library (January 1, 1987 through June 21, 2013) was conducted for all relevant articles related to NIBS, dysphagia, and cerebrovascular disorders (CVD). Two reviewers (S.N.Y and S.B.P) independently evaluated the eligibility of retrieved data according to the selection criteria and assessed methodological quality of the studies using the ‘assessing risk of bias’ table recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.0.2). Six randomized controlled trials (59 intervention groups and 55 placebo groups) were identified as addressing the use of NIBS for dysphagia after CVD and were included in the meta-analysis. The function scale score improvement of dysphagia in patients treated with NIBS was statistically significant compared with that of patients who underwent sham stimulation (standardized mean difference = 1.08, 95 % confidence intervals = 0.29–1.88, p = 0.008; I2 = 72 %). A subgroup analysis based on the type of intervention (three repetitive transcranial magnetic stimulation (rTMS) studies and three transcranial direct current stimulation (tDCS) studies) revealed a statistically significant beneficial effect of NIBS compared with sham stimulation in the rTMS group, but not in the tDCS group. When the results were examined based on intervention site (ipsilesional vs. contralesional site stimulation), no statistically significant difference was noted between two groups. No complications of NIBS were reported in this analysis.

Original languageEnglish
Pages (from-to)383-391
Number of pages9
JournalDysphagia
Volume30
Issue number4
DOIs
Publication statusPublished - 2015 Aug 26

Fingerprint

Deglutition Disorders
Meta-Analysis
Stroke
Brain
Cerebrovascular Disorders
Transcranial Magnetic Stimulation
Patient Selection
Libraries
Randomized Controlled Trials
Placebos
Confidence Intervals
Safety

Keywords

  • Cerebrovascular disorders
  • Deglutition disorders
  • Meta-analysis
  • Transcranial direct current stimulation
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Gastroenterology
  • Speech and Hearing

Cite this

Effectiveness of Non-invasive Brain Stimulation in Dysphagia Subsequent to Stroke : A Systemic Review and Meta-analysis. / Yang, Seung Nam; Pyun, Sung Bom; Kim, Hyun Jung; Ahn, Hyeong Sik; Rhyu, Byung Joo.

In: Dysphagia, Vol. 30, No. 4, 26.08.2015, p. 383-391.

Research output: Contribution to journalReview article

@article{f84d3bacd67440b7812ad7ab1139965a,
title = "Effectiveness of Non-invasive Brain Stimulation in Dysphagia Subsequent to Stroke: A Systemic Review and Meta-analysis",
abstract = "The objective of this study is to assess the efficacy and safety of non-invasive brain stimulation (NIBS) in patients with dysphagia subsequent to stroke. A systematic search of the literature published by Medline (January 1, 1976 through June 21, 2013), EMBASE (January 1, 1985 through June 21, 2013), and the Cochrane Library (January 1, 1987 through June 21, 2013) was conducted for all relevant articles related to NIBS, dysphagia, and cerebrovascular disorders (CVD). Two reviewers (S.N.Y and S.B.P) independently evaluated the eligibility of retrieved data according to the selection criteria and assessed methodological quality of the studies using the ‘assessing risk of bias’ table recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.0.2). Six randomized controlled trials (59 intervention groups and 55 placebo groups) were identified as addressing the use of NIBS for dysphagia after CVD and were included in the meta-analysis. The function scale score improvement of dysphagia in patients treated with NIBS was statistically significant compared with that of patients who underwent sham stimulation (standardized mean difference = 1.08, 95 {\%} confidence intervals = 0.29–1.88, p = 0.008; I2 = 72 {\%}). A subgroup analysis based on the type of intervention (three repetitive transcranial magnetic stimulation (rTMS) studies and three transcranial direct current stimulation (tDCS) studies) revealed a statistically significant beneficial effect of NIBS compared with sham stimulation in the rTMS group, but not in the tDCS group. When the results were examined based on intervention site (ipsilesional vs. contralesional site stimulation), no statistically significant difference was noted between two groups. No complications of NIBS were reported in this analysis.",
keywords = "Cerebrovascular disorders, Deglutition disorders, Meta-analysis, Transcranial direct current stimulation, Transcranial magnetic stimulation",
author = "Yang, {Seung Nam} and Pyun, {Sung Bom} and Kim, {Hyun Jung} and Ahn, {Hyeong Sik} and Rhyu, {Byung Joo}",
year = "2015",
month = "8",
day = "26",
doi = "10.1007/s00455-015-9619-0",
language = "English",
volume = "30",
pages = "383--391",
journal = "Dysphagia",
issn = "0179-051X",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Effectiveness of Non-invasive Brain Stimulation in Dysphagia Subsequent to Stroke

T2 - A Systemic Review and Meta-analysis

AU - Yang, Seung Nam

AU - Pyun, Sung Bom

AU - Kim, Hyun Jung

AU - Ahn, Hyeong Sik

AU - Rhyu, Byung Joo

PY - 2015/8/26

Y1 - 2015/8/26

N2 - The objective of this study is to assess the efficacy and safety of non-invasive brain stimulation (NIBS) in patients with dysphagia subsequent to stroke. A systematic search of the literature published by Medline (January 1, 1976 through June 21, 2013), EMBASE (January 1, 1985 through June 21, 2013), and the Cochrane Library (January 1, 1987 through June 21, 2013) was conducted for all relevant articles related to NIBS, dysphagia, and cerebrovascular disorders (CVD). Two reviewers (S.N.Y and S.B.P) independently evaluated the eligibility of retrieved data according to the selection criteria and assessed methodological quality of the studies using the ‘assessing risk of bias’ table recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.0.2). Six randomized controlled trials (59 intervention groups and 55 placebo groups) were identified as addressing the use of NIBS for dysphagia after CVD and were included in the meta-analysis. The function scale score improvement of dysphagia in patients treated with NIBS was statistically significant compared with that of patients who underwent sham stimulation (standardized mean difference = 1.08, 95 % confidence intervals = 0.29–1.88, p = 0.008; I2 = 72 %). A subgroup analysis based on the type of intervention (three repetitive transcranial magnetic stimulation (rTMS) studies and three transcranial direct current stimulation (tDCS) studies) revealed a statistically significant beneficial effect of NIBS compared with sham stimulation in the rTMS group, but not in the tDCS group. When the results were examined based on intervention site (ipsilesional vs. contralesional site stimulation), no statistically significant difference was noted between two groups. No complications of NIBS were reported in this analysis.

AB - The objective of this study is to assess the efficacy and safety of non-invasive brain stimulation (NIBS) in patients with dysphagia subsequent to stroke. A systematic search of the literature published by Medline (January 1, 1976 through June 21, 2013), EMBASE (January 1, 1985 through June 21, 2013), and the Cochrane Library (January 1, 1987 through June 21, 2013) was conducted for all relevant articles related to NIBS, dysphagia, and cerebrovascular disorders (CVD). Two reviewers (S.N.Y and S.B.P) independently evaluated the eligibility of retrieved data according to the selection criteria and assessed methodological quality of the studies using the ‘assessing risk of bias’ table recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.0.2). Six randomized controlled trials (59 intervention groups and 55 placebo groups) were identified as addressing the use of NIBS for dysphagia after CVD and were included in the meta-analysis. The function scale score improvement of dysphagia in patients treated with NIBS was statistically significant compared with that of patients who underwent sham stimulation (standardized mean difference = 1.08, 95 % confidence intervals = 0.29–1.88, p = 0.008; I2 = 72 %). A subgroup analysis based on the type of intervention (three repetitive transcranial magnetic stimulation (rTMS) studies and three transcranial direct current stimulation (tDCS) studies) revealed a statistically significant beneficial effect of NIBS compared with sham stimulation in the rTMS group, but not in the tDCS group. When the results were examined based on intervention site (ipsilesional vs. contralesional site stimulation), no statistically significant difference was noted between two groups. No complications of NIBS were reported in this analysis.

KW - Cerebrovascular disorders

KW - Deglutition disorders

KW - Meta-analysis

KW - Transcranial direct current stimulation

KW - Transcranial magnetic stimulation

UR - http://www.scopus.com/inward/record.url?scp=84937974105&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937974105&partnerID=8YFLogxK

U2 - 10.1007/s00455-015-9619-0

DO - 10.1007/s00455-015-9619-0

M3 - Review article

C2 - 25917018

AN - SCOPUS:84937974105

VL - 30

SP - 383

EP - 391

JO - Dysphagia

JF - Dysphagia

SN - 0179-051X

IS - 4

ER -