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Vagus nerve stimulation in dysphagia (Yuan et al., 2019)

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posted on 09.09.2019 by Ying Yuan, Jie Wang, Dongyu Wu, Dahua Zhang, Weiqun Song
Purpose: Severe dysphagia with weak pharyngeal peristalsis after dorsal lateral medullary infarction (LMI) requires long-term tube feeding. However, no study is currently available on therapeutic effectiveness in severe dysphagia caused by nuclear damage of vagus nerve after dorsal LMI. The purpose of the present investigation was to explore the potential of transcutaneous vagus nerve stimulation (tVNS) to improve severe dysphagia with weak pharyngeal peristalsis after dorsal LMI.
Method: We assessed the efficacy of 6-week tVNS in a 28-year-old woman presented with persisting severe dysphagia after dorsal LMI who had been on nasogastric feeding for 6 months. tVNS was applied for 20 min twice a day, 5 days a week, for 6 weeks. The outcome measures included saliva spitted, Swallow Function Scoring System, Functional Oral Intake Scale, Clinical Assessment of Dysphagia With Wallenberg Syndrome, Yale Pharyngeal Residue Severity Rating Scale, and upper esophagus X-ray examination.
Results: After tVNS, the patient was advanced to a full oral diet without head rotation or spitting. No saliva residue was found in the valleculae and pyriform sinuses. Contrast medium freely passed through the upper esophageal sphincter.
Conclusion: Our findings suggest that tVNS might provide a useful means for recovery of severe dysphagia with weak pharyngeal peristalsis after dorsal LMI.

Supplemental Material S1. Clinical Assessment of Dysphagia With Wallenberg Syndrome (CADWS).

Yuan, Y., Wang, J., Wu, D., Zhang, D., & Song, W. (2019). Effect of transcutaneous vagus nerve stimulation in dysphagia after lateral medullary infarction: A case report. American Journal of Speech-Language Pathology, 28(4), 1381–1387. https://doi.org/10.1044/2019_AJSLP-18-0262

Funding

This work was supported by research funds provided by the National Natural Science Foundation of China (Grants 81171011, 81272173, and 81572220, awarded to Dongyu Wu; and 81171024, 81371194, and 81671048, awarded to Weiqun Song) and the Science and Technology Projects of Beijing (Grants Z121107001012144 and Z171100001017111, awarded to Dongyu Wu and Z171100001017028, awarded to Ying Yuan).

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