The Use of Brain Stimulation in Dysphagia Management

AbstractDysphagia is common sequela of brain injury with as many as 50% of patients suffering from dysphagia following stroke. Currently, the majority of guidelines for clinical practice in the management of dysphagia focus on the prevention of complications while any natural recovery takes place. Recently, however, non-invasive brain stimulation (NIBS) techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have started to attract attention and are applied to investigate both the physiology of swallowing and influences on dysphagia. TMS allows for painless stimulation of the brain through an intact skull —an effect which would normally be impossible with electrical currents due to the high resistance of the skull. By comparison, tDCS involves passing a small electric current (usually under 2 mA) produced by a current generator over the scalp and cranium external to the brain. Initial studies used these techniques to better understand the physiological mechanisms of swallowing in healthy subjects. More recently, a number of studies have investigated the efficacy of these techniques in the management of neurogenic dysphagia with mixed results. Controversy still exists as to which site, streng th and duration of stimulation yields the greatest improvement in dysphagia. And while multiple studies have suggested promising effects of NIBS, more randomised control trials with larger sample sizes are needed to investigate...
Source: Dysphagia - Category: Speech Therapy Source Type: research

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Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Brener SJ, Alapati V, Chan D, Da-Wariboko A, Kaid Y, Latyshev Y, Moussa A, Narayanan CA, O'Laughlin JP, Raizada A, Verma G, Sacchi TJ Abstract BACKGROUND: Short-term outcome after percutaneous coronary intervention (PCI) has improved dramatically, but the association between clinical or angiographic characteristics and long-term outcome remains less well described. The SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) II score has been designed to overcome the limitations of the purely angiographic SYNTAX I score by including clinical parameters and comorbidities. It has not been tested extensive...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
HIGH blood pressure can increase your risk of early death from conditions such as stroke and heart disease. It can be raised by several substances in your diet, such as caffeine. Here ’s how to tell if this has had an effect.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Answers on: Comments on "Adapted physical activity and stroke: a systematic review". J Sports Med Phys Fitness. 2018 Jun 14;: Authors: Belfiore P, Miele A, Liguori G PMID: 29905423 [PubMed - as supplied by publisher]
Source: Journal of Sports Medicine and Physical Fitness - Category: Sports Medicine Tags: J Sports Med Phys Fitness Source Type: research
Abstract A 40-year-old woman presented to our stroke center for a left middle cerebral artery embolic occlusion. This was successfully treated with mechanical thrombectomy using a stent retriever and balloon guide catheter aspiration. The patient was discharged home in good condition on clopidogrel but returned 2 months later with a contralateral right middle cerebral artery embolic occlusion. This was also successfully treated, this time with a stent retriever and local aspiration (Sol-Arc technique). She was once again discharged in good condition but with warfarin and an implanted loop recorder. This case ...
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research
We report a case of a man who resumed dabigatran after 6 weeks of prior therapy and began experiencing hematuria with worsening kidney function. Renal biopsy with immunofluorescence and electron microscopy showed mesangial deposits consistent with immunoglobulin A nephropathy. With discontinuation of dabigatran and addition of methylprednisolone, the gross hematuria cleared and urine output improved. PMID: 29904298 [PubMed]
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research
Conclusion: The critical event benchmarks proposed in this study by logistic regression closely correlate with the critical event benchmarks described in the AHA/ASA acute stroke guidelines. PMID: 29904443 [PubMed]
Source: Clin Med Res - Category: Research Authors: Tags: J Clin Med Res Source Type: research
Conclusions: Mortality in critically ill stroke patients is high and occurs most often shortly after the event. Less than one in three surviving patients is able to function independently after 1 year. This study has identified several clinical variables that predict long-term all-cause mortality and functional outcome among critically ill stroke patients and found that mainly acute physiologic disturbance and absolute values of neurologic clinical assessment are predictive.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research
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Source: Critical Care Medicine - Category: Emergency Medicine Tags: Editorials Source Type: research
This study evaluated the efficacies of conventional treatment with or without intravascular temperature management for severe heat stroke. Design: Prospective multicenter study. Setting: Critical care and emergency medical centers at 10 tertiary hospitals. Patients: Patients with severe heat stroke hospitalized during two summers. Interventions: Conventional cooling with or without intravascular temperature management. Measurements and Main Results: Cooling efficacy, Sequential Organ Failure Assessment score, occurrence rate of serious adverse events, and prognosis based on the modified Rankin Scale and Cere...
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
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