Short‐term neurophysiological effects of sensory pathway neurorehabilitation strategies on chronic poststroke oropharyngeal dysphagia
| Autor: | Ernest Palomeras, Emilia Michou, Weslania Viviane Nascimento, Omar Ortega, Noemí Tomsen, Christopher Cabib, Pere Clavé, Laia Rofes, Viridiana Arreola, Lluís Mundet |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Physiology medicine.medical_treatment Stimulation Sensory system 03 medical and health sciences 0302 clinical medicine Humans Medicine Neurostimulation Neurorehabilitation Aged Aged 80 and over Cross-Over Studies Endocrine and Autonomic Systems business.industry Stroke Rehabilitation Gastroenterology Recovery of Function Somatosensory Cortex Middle Aged Transcranial Magnetic Stimulation Deglutition Stroke Transcranial magnetic stimulation Treatment Outcome medicine.anatomical_structure Anesthesia Brain stimulation Pharynx Female 030211 gastroenterology & hepatology medicine.symptom Deglutition Disorders business 030217 neurology & neurosurgery Oropharyngeal dysphagia Motor cortex |
| Zdroj: | Neurogastroenterology & Motility. 32 |
| ISSN: | 1365-2982 1350-1925 |
| DOI: | 10.1111/nmo.13887 |
| Popis: | BACKGROUND Neurorehabilitation strategies for chronic poststroke (PS) oropharyngeal dysphagia (OD) have been mainly focused on the neurostimulation of the pharyngeal motor cortex with only marginal effects. In contrast, treatments targeting the PS oropharyngeal sensory pathway dysfunction offer very promising results, but there is little knowledge on the underlying mechanisms. We aimed to explore the neurophysiological mechanisms behind the effect of three sensory neurostimulation strategies. METHODS We carried out a randomized two-blinded parallel group's crossover sham-controlled clinical trial in 36 patients with unilateral stroke and chronic unsafe swallow to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) of the primary sensory cortex (A), oral capsaicin (B) and intra-pharyngeal electrical stimulation (IPES; C). The effect was evaluated immediately after the interventions with videofluoroscopy (VFS) and motor/sensory evoked potentials (MEP/SEP). KEY RESULTS Interventions induced no changes in the biomechanics of the swallow response during VFS. However, an enhancement of motor cortex excitability (latency shortening and increased size of thenar MEP) was found with active interventions (A + B + C, and B/C alone; P |
| Databáze: | OpenAIRE |
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