Abstract
Background: Noninvasive brain stimulation (NIBS) hold promise for treating several neurological conditions. Their effects for treatment of dysarthria (a type of motor speech impairment) remain controversial.
Objectives: To collect evidence for NIBS usefulness in treatment of dysarthria through systemic evaluation of original research articles.
Methods: Google Scholar, Embase, Scopus, PubMed, Cochrane and Web of Science were searched to identify studies investigating NIBS and dysarthria as primary inclusion criteria without study’s design and language restrictions. Non-dysarthric population or studies without NIBS were excluded. The risk of bias assessment for each included study was evaluated using an appropriate methodological quality assessment checklist. Speech and voice related outcome measures included perceptual and acoustic analysis of diadochokinetic (DDK), maximum phonation time, kinematic analysis of DDK and voice-related quality of life measures. Post-treatment standardized mean differences between the sham and treatment groups were derived under random effects model. Forest plots yielded the pool effect size where applicable.
Results: Fourteen out of 9244 studies involving 189 patients were included. Nine studies employed transcranial magnetic stimulation and five evaluated transcranial direct current stimulation. Adjuvant speech therapy was provided in six studies. Dysarthrias were resulted after cerebral palsy, cerebrovascular accidents, Parkinson’s Disease, cerebellar ataxia, traumatic brain injury and supranuclear palsy. 83% of the studies found positive effects of NIBS. Post-treatment significant difference between the sham and treatment group were only associated with sequential motion rate (Hedges ’g = 0.79, 95% CI [ 0.075, 1.50] P = 0.03) favoring tDCS.
Conclusion: Most studies identifying NIBS’ benefits did not provide evidence for complete recovery from dysarthria. A final consensus is not raised due to high heterogeneity among study’s’ designs, small sample sizes and inadequate power. Large-scale clinical investigations are required to evaluate the efficacy of NIBS in treating dysarthria.
Objectives: To collect evidence for NIBS usefulness in treatment of dysarthria through systemic evaluation of original research articles.
Methods: Google Scholar, Embase, Scopus, PubMed, Cochrane and Web of Science were searched to identify studies investigating NIBS and dysarthria as primary inclusion criteria without study’s design and language restrictions. Non-dysarthric population or studies without NIBS were excluded. The risk of bias assessment for each included study was evaluated using an appropriate methodological quality assessment checklist. Speech and voice related outcome measures included perceptual and acoustic analysis of diadochokinetic (DDK), maximum phonation time, kinematic analysis of DDK and voice-related quality of life measures. Post-treatment standardized mean differences between the sham and treatment groups were derived under random effects model. Forest plots yielded the pool effect size where applicable.
Results: Fourteen out of 9244 studies involving 189 patients were included. Nine studies employed transcranial magnetic stimulation and five evaluated transcranial direct current stimulation. Adjuvant speech therapy was provided in six studies. Dysarthrias were resulted after cerebral palsy, cerebrovascular accidents, Parkinson’s Disease, cerebellar ataxia, traumatic brain injury and supranuclear palsy. 83% of the studies found positive effects of NIBS. Post-treatment significant difference between the sham and treatment group were only associated with sequential motion rate (Hedges ’g = 0.79, 95% CI [ 0.075, 1.50] P = 0.03) favoring tDCS.
Conclusion: Most studies identifying NIBS’ benefits did not provide evidence for complete recovery from dysarthria. A final consensus is not raised due to high heterogeneity among study’s’ designs, small sample sizes and inadequate power. Large-scale clinical investigations are required to evaluate the efficacy of NIBS in treating dysarthria.
| Original language | English |
|---|---|
| Journal | Brain Stimulation |
| Volume | 16 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 15 Feb 2023 |
| Event | 5th International Brain Stimulation Conference - Lisboa Congress Centre, Lisbon, Portugal Duration: 19 Feb 2023 → 22 Feb 2023 https://www.elsevier.com/events/conferences/international-brain-stimulation-conference |
Keywords
- Dysarthria
- tDCS
- TMS
- neurological disorder