Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial

Abstract Transcranial direct current stimulation (tDCS) has been extensively utilized in the treatment of post-stroke dysphagia; however, the effect of different tDCS protocols remains uncertain. This study aims to investigate the effect of tDCS on dysphagia after hemispheric stroke and compare the...

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Main Authors: Guoping Duan, Ying Yuan, Heliu Hua, Xu Zhang, Baohu Liu, Yuanyuan Li, Jiayi Zhao, Qiuyue Wang, Jie Wang, Dongyu Wu
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-04939-9
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author Guoping Duan
Ying Yuan
Heliu Hua
Xu Zhang
Baohu Liu
Yuanyuan Li
Jiayi Zhao
Qiuyue Wang
Jie Wang
Dongyu Wu
author_facet Guoping Duan
Ying Yuan
Heliu Hua
Xu Zhang
Baohu Liu
Yuanyuan Li
Jiayi Zhao
Qiuyue Wang
Jie Wang
Dongyu Wu
author_sort Guoping Duan
collection DOAJ
description Abstract Transcranial direct current stimulation (tDCS) has been extensively utilized in the treatment of post-stroke dysphagia; however, the effect of different tDCS protocols remains uncertain. This study aims to investigate the effect of tDCS on dysphagia after hemispheric stroke and compare the effect of tDCS among three protocols. A total of 90 hemispheric stroke patients were randomized into three groups: bilateral, contralesional, and ipsilesional tDCS. Each group received anodal tDCS over the orofacial sensorimotor cortex (S1M1) of the bilateral, contralesional, and ipsilesional hemispheres, respectively, administered for 20 sessions overall, combined with exercise-based swallowing therapy. After tDCS, both the dysphagia assessment scale and the swallow severity scale showed significant improvement in all three groups (all p < 0.01). In the comparisons among the three groups, the bilateral tDCS demonstrated significantly greater improvement than the contralesional and ipsilesional tDCS group in terms of the dysphagia assessment scale (all p < 0.001), and superior to contralesional tDCS group in terms of the swallow severity scale (p = 0.019). The analysis of ApEn showed increased cortical activity in both stimulated and non-stimulated areas of bilateral hemispheres after bilateral and unilateral tDCS. Moreover, larger cortical areas of bilateral hemispheres were activated after bilateral tDCS, compared to those after unilateral tDCS. Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR-TRC-14004955, 16/07/2014.
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spelling doaj-art-d596aab26c534988b93e49618bbc8d1c2025-08-20T03:25:18ZengNature PortfolioScientific Reports2045-23222025-06-0115111310.1038/s41598-025-04939-9Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trialGuoping Duan0Ying Yuan1Heliu Hua2Xu Zhang3Baohu Liu4Yuanyuan Li5Jiayi Zhao6Qiuyue Wang7Jie Wang8Dongyu Wu9Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Xuanwu Hospital Capital Medical UniversityDepartment of Rehabilitation, Longyan First Affiliated Hospital of Fujian Medical UniversityDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceDepartment of Rehabilitation, Xuanwu Hospital Capital Medical UniversityDepartment of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical ScienceAbstract Transcranial direct current stimulation (tDCS) has been extensively utilized in the treatment of post-stroke dysphagia; however, the effect of different tDCS protocols remains uncertain. This study aims to investigate the effect of tDCS on dysphagia after hemispheric stroke and compare the effect of tDCS among three protocols. A total of 90 hemispheric stroke patients were randomized into three groups: bilateral, contralesional, and ipsilesional tDCS. Each group received anodal tDCS over the orofacial sensorimotor cortex (S1M1) of the bilateral, contralesional, and ipsilesional hemispheres, respectively, administered for 20 sessions overall, combined with exercise-based swallowing therapy. After tDCS, both the dysphagia assessment scale and the swallow severity scale showed significant improvement in all three groups (all p < 0.01). In the comparisons among the three groups, the bilateral tDCS demonstrated significantly greater improvement than the contralesional and ipsilesional tDCS group in terms of the dysphagia assessment scale (all p < 0.001), and superior to contralesional tDCS group in terms of the swallow severity scale (p = 0.019). The analysis of ApEn showed increased cortical activity in both stimulated and non-stimulated areas of bilateral hemispheres after bilateral and unilateral tDCS. Moreover, larger cortical areas of bilateral hemispheres were activated after bilateral tDCS, compared to those after unilateral tDCS. Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR-TRC-14004955, 16/07/2014.https://doi.org/10.1038/s41598-025-04939-9DysphagiaStrokeTranscranial direct current stimulationElectroencephalogramCortical activity
spellingShingle Guoping Duan
Ying Yuan
Heliu Hua
Xu Zhang
Baohu Liu
Yuanyuan Li
Jiayi Zhao
Qiuyue Wang
Jie Wang
Dongyu Wu
Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
Scientific Reports
Dysphagia
Stroke
Transcranial direct current stimulation
Electroencephalogram
Cortical activity
title Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
title_full Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
title_fullStr Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
title_full_unstemmed Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
title_short Effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients: a randomized, controlled trial
title_sort effect of transcranial direct current stimulation on swallowing improvement and cortical activity in hemispheric stroke patients a randomized controlled trial
topic Dysphagia
Stroke
Transcranial direct current stimulation
Electroencephalogram
Cortical activity
url https://doi.org/10.1038/s41598-025-04939-9
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