A Meta-Analysis and Systematic Review of the Effects of Sensory Modulation Treatments for Neurogenic Oropharyngeal Dysphagia

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-07-08 DOI:10.1111/cns.70452

Meng Dai, Ivy Cheng, Ayodele Sasegbon, Wanqi Li, Shaheen Hamdy

{"title":"A Meta-Analysis and Systematic Review of the Effects of Sensory Modulation Treatments for Neurogenic Oropharyngeal Dysphagia","authors":"Meng Dai, Ivy Cheng, Ayodele Sasegbon, Wanqi Li, Shaheen Hamdy","doi":"10.1111/cns.70452","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Oropharyngeal sensory stimulation has been applied broadly in clinical dysphagia management, but evidence remains limited.</p>\n </section>\n \n <section>\n \n <h3> Aims</h3>\n \n <p>We aimed to determine its effectiveness in treating neurogenic dysphagia (ND).</p>\n </section>\n \n <section>\n \n <h3> Material and Methods</h3>\n \n <p>A systematic review and meta-analysis was conducted using studies from PubMed, EMBASE (via Ovid), CINAHL, Web of Science, and the Cochrane Library, searched up to January 2025. We included randomized controlled trials (RCT) comparing sensory stimulations, including electrical and gustatory stimulation, with sham controls or placebo. The outcome measurements included swallowing scales based on clinical and instrumental evaluations.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We included 16 RCTs (620 participants) in the meta-analysis. Overall, sensory stimulation significantly improved ND (<i>n</i> = 17, SMD [95% CI] = 0.80 [0.41, 1.20], <i>p</i> < 0.001; <i>I</i><sup>2</sup> = 71%). Subgroup analysis revealed that the pooled effect size remained significant for electrical stimulation (<i>n</i> = 14, SMD [95% CI] = 0.79 [0.36, 1.23], <i>p</i> < 0.01; <i>I</i><sup>2</sup> = 64%), but not for gustatory stimulation (<i>n</i> = 3, SMD [95% CI] = 0.76 [−1.68, 3.20], <i>p</i> = 0.31; <i>I</i><sup>2</sup> = 90%). The pooled effect sizes for sensory stimulation were significant for both swallowing measurements (<i>n</i> = 14, SMD [95% CI] = 0.75 [0.27, 1.23], <i>p</i> < 0.01; <i>I</i><sup>2</sup> = 76%) and acceleration of decannulation (<i>n</i> = 3, OR [95% CI] = 6.47 [1.10, 38.04], <i>p</i> = 0.05; <i>I</i><sup>2</sup> = 3%).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Oropharyngeal sensory stimulation improves swallowing function and decannulation in ND, with minimal adverse effects. While electrical stimulation shows clear benefits, gustatory effects remain inconclusive. Further studies are warranted to optimize protocols and confirm efficacy.</p>\n </section>\n </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 7","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70452","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CNS Neuroscience & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cns.70452","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Oropharyngeal sensory stimulation has been applied broadly in clinical dysphagia management, but evidence remains limited.

Aims

We aimed to determine its effectiveness in treating neurogenic dysphagia (ND).

Material and Methods

A systematic review and meta-analysis was conducted using studies from PubMed, EMBASE (via Ovid), CINAHL, Web of Science, and the Cochrane Library, searched up to January 2025. We included randomized controlled trials (RCT) comparing sensory stimulations, including electrical and gustatory stimulation, with sham controls or placebo. The outcome measurements included swallowing scales based on clinical and instrumental evaluations.

Results

We included 16 RCTs (620 participants) in the meta-analysis. Overall, sensory stimulation significantly improved ND (n = 17, SMD [95% CI] = 0.80 [0.41, 1.20], p < 0.001; I² = 71%). Subgroup analysis revealed that the pooled effect size remained significant for electrical stimulation (n = 14, SMD [95% CI] = 0.79 [0.36, 1.23], p < 0.01; I² = 64%), but not for gustatory stimulation (n = 3, SMD [95% CI] = 0.76 [−1.68, 3.20], p = 0.31; I² = 90%). The pooled effect sizes for sensory stimulation were significant for both swallowing measurements (n = 14, SMD [95% CI] = 0.75 [0.27, 1.23], p < 0.01; I² = 76%) and acceleration of decannulation (n = 3, OR [95% CI] = 6.47 [1.10, 38.04], p = 0.05; I² = 3%).

Conclusion

Oropharyngeal sensory stimulation improves swallowing function and decannulation in ND, with minimal adverse effects. While electrical stimulation shows clear benefits, gustatory effects remain inconclusive. Further studies are warranted to optimize protocols and confirm efficacy.

Abstract Image

查看原文本刊更多论文

感觉调节治疗神经源性口咽吞咽困难疗效的meta分析和系统综述

口咽感觉刺激已广泛应用于临床吞咽困难的治疗，但证据仍然有限。目的探讨其治疗神经性吞咽困难（ND）的疗效。材料和方法对PubMed、EMBASE（通过Ovid）、CINAHL、Web of Science和Cochrane Library的研究进行系统回顾和荟萃分析，检索截止到2025年1月。我们纳入了比较感觉刺激（包括电刺激和味觉刺激）与假对照或安慰剂的随机对照试验（RCT）。结果测量包括基于临床和仪器评估的吞咽量表。meta分析纳入16项rct（620名受试者）。总体而言，感觉刺激显著改善ND (n = 17, SMD [95% CI] = 0.80 [0.41, 1.20], p < 0.001；i2 = 71%)。亚组分析显示，电刺激的综合效应大小仍然显著(n = 14, SMD [95% CI] = 0.79 [0.36, 1.23], p < 0.01；I2 = 64%),而不是味觉刺激(n = 3, SMD(95%置信区间)= 0.76−1.68、3.20,p = 0.31;i2 = 90%)。感觉刺激的合并效应量在两种吞咽测量中均显著(n = 14, SMD [95% CI] = 0.75 [0.27, 1.23], p < 0.01；I2 = 76%)和脱管加速(n = 3, OR [95% CI] = 6.47 [1.10, 38.04], p = 0.05；i2 = 3%)。结论口咽感觉刺激可改善鼻咽癌患者的吞咽功能和排空，不良反应最小。虽然电刺激显示出明显的好处，但对味觉的影响仍不确定。需要进一步的研究来优化方案并确认疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.