Professor Shaheen Hamdy

New study to tackle swallowing problems after stroke

Stroke researchers are to test a new treatment that could help patients with swallowing problems (dysphagia) related to stroke.

Up to 50 per cent of patients with acute stroke develop dysphagia, which can have devastating consequences and even be fatal.

If patients can’t swallow properly, food or drink can pass into the lungs and cause respiratory problems – which can progress to a more serious complication, aspiration pneumonia. They can also develop malnutrition, tend to need longer hospital stays and need more care on discharge.

While some patients recover, 30 to 40 per cent of those affected will have more chronic problems and will have to be fed through a tube into their stomach, often causing them great distress.

It’s already known that a treatment called transcranial direct current stimulation (tDCS) can help stimulate brain activity in the part of the motor cortex area that governs swallowing. If this is applied to the side unaffected by the stroke, it may encourage swallowing areas in that part of the brain to compensate for the loss from the damaged side.

The treatment delivers weak electrical currents through conducting pads precisely positioned on the scalp to target the right area. The treatment doesn’t cause any discomfort and is quick and easy to do at the patient’s bedside.

The new study, led by Professor Shaheen Hamdy at Salford Royal NHS Foundation Trust, will assess different doses of the treatment to see which has the best outcome for patients with sub-acute stroke (that is, within a six-week period after their stroke).

It is funded by the National Institute for Health Research (NIHR) and is a collaboration between Salford Royal and The University of Manchester, where Professor Hamdy is Professor of Neurogastroenterology.

Principal Investigator Professor Hamdy said: “Swallowing problems are very common after stroke and can be devastating for patients, affecting both their quality of life and their medical outcomes.

It can be a life-threatening complication and even when mild,  can be a major factor in patients’ lives.

“Our previous research on tDCS has suggested it could offer a safe and effective treatment and our latest dose response study will help us to establish the best way of using this treatment.”

The NIHR dose ranging study ‘Evaluating brain stimulation for dysphagia after stroke’ will establish best treatment of tDCS in swallowing after stroke by examining outcomes in 48 patients over three years.

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