Dysphagia: New Research and Online Resources Tiny electric shocks to the throat may help those recovering from stroke to overcome swallowing difficulties, a small study suggests. The study, conducted by researchers at the University of Manchester and reported online in Gastroenterology, examined whether stimulating nerves in the throat with small electrical jolts can jump-start areas ... Research in Brief
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Research in Brief  |   May 01, 2010
Dysphagia: New Research and Online Resources
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Swallowing, Dysphagia & Feeding Disorders / Telepractice & Computer-Based Approaches / Research in Brief
Research in Brief   |   May 01, 2010
Dysphagia: New Research and Online Resources
The ASHA Leader, May 2010, Vol. 15, 18-19. doi:10.1044/leader.RIB.15062010.18
The ASHA Leader, May 2010, Vol. 15, 18-19. doi:10.1044/leader.RIB.15062010.18
Stroke-Induced Dysphagia
Tiny electric shocks to the throat may help those recovering from stroke to overcome swallowing difficulties, a small study suggests. The study, conducted by researchers at the University of Manchester and reported online in Gastroenterology, examined whether stimulating nerves in the throat with small electrical jolts can jump-start areas of the brain damaged by stroke. Researchers inserted a small tube into the throats of 28 stroke patients; half received mild electrical shocks and half received no current. The number of stimulated participants who choked on liquid fell from about two-thirds pre-treatment to about one-quarter post-treatment; there was no change in the group that received no shocks. Patients who received stimulation were discharged from the hospital an average of five days earlier than those who did not.
In developing the treatment, the researchers produced a virtual “stroke” in 13 healthy people through repetitive transcranial magnetic stimulation. The stimulation slowed the activity in brain areas controlling throat muscles and produced a decrease in throat muscle activity and in the number of correctly timed swallows. These effects were abolished with electrical stimulation delivered via the throat tube.
Researchers suggest that electric stimulation of the throat may increase the size of regions in the brain that contribute to the control of swallowing, which may be how stroke patients spontaneously recover swallowing. The procedure may accelerate this process. However, the study was small and preliminary; not all patients improved and there are significant caveats, including the discomfort and invasiveness of the procedure. The researchers are further examining the treatment, which has produced no negative side effects, in a larger study.
Dysphagia After Intubation
A systematic review of the incidence of dysphagia following endotracheal intubation identifies the limitation of the available evidence and highlights the need for high-quality prospective trials. The review appears in the March 2010 issue of Chest.
Researchers conducted the review to determine the incidence of dysphagia following endotracheal intubation, the association between dysphagia and intubation time, and patient characteristics associated with dysphagia. Two reviewers, blinded to each other, selected and reviewed articles that examined adult participants who underwent intubation and clinical assessment for dysphagia. Exclusion criteria were case series (n < 10), dysphagia determined by patient report, and patients with tracheostomies, esophageal dysphagia, and/or diagnoses known to cause dysphagia.
Of the 1,489 citations identified, 288 articles were reviewed and 14 met inclusion criteria. The studies were heterogeneous in design, swallowing assessment, and study outcome. Dysphagia frequency ranged from 3% to 62% and intubation duration from 124.8 to 346.6 mean hours. The highest dysphagia frequencies (62%, 56%, and 51%) occurred following prolonged intubation and included patients across all diagnostic subtypes. All studies were limited by design and risk of bias. Overall quality of the evidence was low, supporting the need for more high-quality prospective trials.
Resources at www.asha.org
ASHA’s webpage on swallowing and feeding disorders has links to a number of resources, including policy documents, special topics, research, ASHA Leader articles, documents on ethics, network opportunities, and ASHA products.
Other Resources
Other documents and information available on the Internet include:
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May 2010
Volume 15, Issue 6