Neurostimulation could improve ability to swallow in patients affected by conditions such as stroke, according to a new UK study.
Previous work indicated that dysphagia was caused only by problems in the brain stem, but more recent work suggests the cerebral cortex is also involved, researchers say.
A team led by Dr Ivy Cheng at the University of Manchester, UK, carried out a review of current knowledge on the cerebral control of swallowing.
They examined 174 animal and human studies and found that swallowing is mediated by “multiple distinct cortical and subcortical regions, and that lesions to these regions can result in dysphagia”.
In *Journal of the neurological sciences* recently, they write: “Cortical and subcortical regions that mediate swallowing are functionally connected.”
This led to an analysis of 30 trials of neurostimulation treatments for dysphagia after brain injury. Three of these treatments may be beneficial, they report, via "promoting the reorganisation of the swallowing neural network".
These treatments are pharyngeal electrical stimulation, in which electrodes are inserted to deliver a constant low current to the pharynx, Repetitive Transcranial Magnetic Stimulation (rTMS) in which pulsing magnetic fields are created via a coil placed on the scalp, and Transcranial Direct Current Stimulation (tDCS) in which a direct electric current stimulates the brain via pads on the scalp.
Dr Cheng said: "This review shows neurostimulation has a great deal of potential, but we need long term studies to assess the best protocols for using neurostimulation in treating dysphagia."
Cheng, I. et al. Cerebral control of swallowing: An update on neurobehavioral evidence. *Journal of the neurological sciences* 22 September 2022
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