Dysphagia after stroke: research advances in treatment interventions

Labeit, Bendix; Michou, Emilia; Trapl-Grundschober, Michaela; Suntrup-Krueger, Sonja; Muhle, Paul; Bath, Philip M; Dziewas, Rainer

Abstract

After a stroke, most patients have dysphagia, which can lead to aspiration pneumonia, malnutrition, and adverse functional outcomes. Protective interventions aimed at reducing these complications remain the cornerstone of treatment. Dietary adjustments and oral hygiene help mitigate the risk of aspiration pneumonia, and nutritional supplementation, including tube feeding, might be needed to prevent malnutrition. Rehabilitative interventions aim to enhance swallowing function, with different behavioural strategies showing promise in small studies. Investigations have explored the use of pharmaceutical agents such as capsaicin and other Transient-Receptor-Potential-Vanilloid-1 (TRPV-1) sensory receptor agonists, which alter sensory perception in the pharynx. Neurostimulation techniques, such as transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and pharyngeal electrical stimulation, might promote neuroplasticity within the sensorimotor swallowing network. Further advancements in the understanding of central and peripheral sensorimotor mechanisms in patients with dysphagia after a stroke, and during their recovery, will contribute to optimising treatment protocols.

Citation

Labeit, B., Michou, E., Trapl-Grundschober, M., Suntrup-Krueger, S., Muhle, P., Bath, P. M., & Dziewas, R. (2024). Dysphagia after stroke: research advances in treatment interventions. Lancet Neurology, 23(4), 418-428. https://doi.org/10.1016/s1474-4422%2824%2900053-x

• Journal Article Type: Review
• Acceptance Date: Jan 31, 2024
• Publication Date: 2024-04
• Deposit Date: Mar 21, 2024
• Publicly Available Date: Oct 31, 2024
• Journal: The Lancet Neurology
• Print ISSN: 1474-4422
• Electronic ISSN: 1474-4465
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 4
• Pages: 418-428
• DOI: https://doi.org/10.1016/s1474-4422%2824%2900053-x
• Keywords: Humans, Malnutrition - complications, Stroke - complications - therapy, Transcranial Direct Current Stimulation - adverse effects, Stroke Rehabilitation, Pneumonia, Aspiration - complications - prevention & control, Deglutition Disorders - etiology - ther
• Public URL: https://nottingham-repository.worktribe.com/output/32749544
• Publisher URL: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(24)00053-X/