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Swallowing disorders are common after a stroke but effective treatments are currently lacking. Hemispheric strokes, which denote strokes that are confined to the cerebral hemispheres occur frequently in general population and often produce swallowing impairments. In this pilot study, the investigators plan to investigate the efficacy of a novel cortical stimulation technique, tDCS for improving swallowing impairments in patients who develop swallowing impairments after an acute hemispheric (Stroke that involves the cerebral hemispheres of the brain) ischemic stroke. All patients will be randomized to receive anodal tDCS versus sham.
We will enroll acute ischemic stroke patients from our inpatient stroke service with dysphagia between 24-168 hours after stroke. Patients with moderate to severe dysphagia will be enrolled using validated swallowing assessment by a speech and swallow pathologist. The swallowing assessments will be recorded by a speech and language pathologist blinded to the stimulation allocation. The subjects will be randomized to receive anodal tDCS versus sham stimulation over the swallowing cortex in conjunction with standardized swallowing maneuvers. Sham stimulation is subjectively indistinguishable from tDCS. A final swallowing assessment will be made after the final session of tDCS/sham. The relative differences in swallowing improvements between the 2 groups will be computed.
Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center
Published on BioPortfolio: 2014-08-27T03:13:22-0400
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Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.
A hypermotility disorder of the ESOPHAGUS that is characterized by spastic non-peristaltic responses to SWALLOWING; CHEST PAIN; and DYSPHAGIA.
Acute types of coxsackievirus infections or ECHOVIRUS INFECTIONS that usually affect children during the summer and are characterized by vesiculoulcerative lesions on the MUCOUS MEMBRANES of the THROAT; DYSPHAGIA; VOMITING, and FEVER.
A syndrome of DYSPHAGIA with IRON-DEFICIENCY ANEMIA that is due to congenital anomalies in the ESOPHAGUS (such as cervical esophageal webs). It is known as Patterson-Kelly syndrome in the United Kingdom.
Pathological enlargement of the LINGUAL THYROID, ectopic thyroid tissue at the base of the TONGUE. It may cause upper AIRWAY OBSTRUCTION; DYSPHAGIA; or HYPOTHYROIDISM symptoms.
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