{"id":9560,"date":"2019-05-14T16:25:27","date_gmt":"2019-05-14T16:25:27","guid":{"rendered":"https:\/\/www.deutera.com\/uncategorized\/neurostimolazione-per-migliorare-la-disfagia-cosa-sappiamo\/"},"modified":"2020-11-30T14:52:36","modified_gmt":"2020-11-30T14:52:36","slug":"neurostimulation-to-treat-dysphagia-what-is-known","status":"publish","type":"post","link":"https:\/\/www.deutera.com\/en\/specials\/neurostimulation-to-treat-dysphagia-what-is-known\/","title":{"rendered":"Neurostimulation to treat dysphagia: what is known"},"content":{"rendered":"<p><em>Swallowing involves 26 muscles and is a delicate process that is precisely controlled by the brain. In stroke cases, it is one of the processes most likely to be damaged. There are a number of approaches in the treatment of dysphagia, in other words difficulty in swallowing normally, which emerges following a heart attack or due to neurodegenerative disorders. Rehabilitation and the use of thickening products to facilitate the ingestion of food are the most common. A recent study examined the possibility of intervening directly on cerebral tissue, with the use of neurostimulation techniques.<\/em><\/p>\n<p>In the wake of a stroke, the brain engages <strong>self-repair strategies<\/strong> in an attempt to eliminate or at least reduce damage to cerebral tissue. The process involves complex cellular mechanisms which are still not completely understood. In recent years, science has focused on techniques of non-invasive <strong>neurostimulation<\/strong>. This involves<strong> technology that allows a more in-depth examination of the delicate functions that are activated in the encephalon following a stroke or trauma.<\/strong> Furthermore, a number of researchers have begun to consider these techniques as a way <strong>to intervene directly on the damaged tissue<\/strong> and favour repair, thus reducing the disorders caused by cerebral damage, above all dysphagia.<\/p>\n<p>The study that we are presenting, which was published by the University of Manchester, is a review of <strong>what the scientific world has so far discovered regarding the use of two different neurostimulation techniques: transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS).\u00a0<\/strong>TMS consists in the<strong> application of an electromagnetic field<\/strong> through the positioning of a device on the head, <strong>external to the cranium.<\/strong> This generates electrical currents that stimulate neural activity, without the need for invasive surgery. TDCS, which is also <strong>non-invasive and applied externally to the cranium<\/strong>, is based on the use of large electrodes positioned on the scalp and connected to a generator. It uses low-intensity electricity, unlike TMS, which uses a higher level of voltage. Both methods have demonstrated <strong>promising results<\/strong> in various studies carried out on<strong> stroke patients<\/strong>.\u00a0<strong>The difficulty in swallowing<\/strong> suffered by these people was in fact <strong>reduced following the application of neurostimulation<\/strong>, which has the considerable advantage of being neither invasive nor painful.<\/p>\n<p>However, the <strong>mechanism<\/strong> through which these procedures modify cerebral activity <strong>is not yet clear<\/strong>. Furthermore, it is unclear whether it is preferable to stimulate only the cerebral hemisphere that has been damaged, or both. Further study is required, which may lead in the future to a new therapeutic tool to add to the forms of rehabilitation currently in use in order to tackle dysphagia in an increasingly complete manner.<\/p>\n<p><em><strong>Valentina Torchia<\/strong><\/em><em>, Scientific Journalist and Medical Biotechnician, holder of a master\u2019s degree in Communication and Health in Contemporary Media.<\/em><\/p>\n<p>Source: Dysphagia. 2017; 32(2): 209\u2013215.<\/p>\n<p>Dopo un ictus, il cervello ricorre a <strong>strategie di auto-riparazione<\/strong>, per tentare di eliminare o almeno di ridurre il danno al tessuto cerebrale. Si tratta di complessi meccanismi cellulari, ancora non del tutto conosciuti. Negli ultimi anni, i riflettori della scienza si sono puntati su tecniche di <strong>neuromodulazione<\/strong> non invasiva: si tratta di <strong>tecnologie che permettono di indagare pi\u00f9 a fondo le delicate funzioni che si attivano nell\u2019encefalo dopo un ictus o un trauma<\/strong>. Non solo, alcuni ricercatori hanno cominciato a pensare a queste tecniche come uno <strong>strumento per intervenire direttamente sul tessuto danneggiato<\/strong> e favorirne la riparazione, riducendo cos\u00ec i disturbi che si verificano dopo un danno cerebrale, primo fra tutti la disfagia.<\/p>\n<p>Lo studio che vi presentiamo, pubblicato da studiosi dell\u2019Universit\u00e0 di Manchester, \u00e8 una raccolta di <strong>quanto la scienza ha scoperto fino ad oggi sull\u2019utilizzo di due diverse tecniche di neuromodulazione: la stimolazione diretta transcranica con correnti continue (tDCS) e la stimolazione magnetica transuranica (TMS). <\/strong>La TMS consiste <strong>nell\u2019applicazione di un campo elettromagnetico<\/strong> grazie al posizionamento della strumentazione sul capo, <strong>all\u2019esterno del cranio<\/strong>. In questo modo, si generano correnti elettriche che vanno a stimolare l\u2019attivit\u00e0 neuronale, senza il bisogno di un intervento invasivo. La TDCS, anch\u2019essa <strong>non invasiva e applicata all\u2019esterno del cranio<\/strong>, si basa sull\u2019utilizzo di elettrodi di grandi dimensioni, posati sullo scalpo e collegati a un generatore di corrente. Si utilizza elettricit\u00e0 a bassa intensit\u00e0, diversamente dalla TMS, dove il voltaggio \u00e8 superiore. Entrambe queste metodiche hanno dimostrato <strong>risultati promettenti<\/strong>, in diversi studi <strong>su pazienti affetti da ictus.<\/strong> <strong>Le difficolt\u00e0 di deglutizione <\/strong>presenti in queste persone sono infatti<strong> migliorate dopo l\u2019applicazione della neurostimolazione<\/strong>, che ha l\u2019enorme vantaggio di non essere n\u00e9 invasiva n\u00e9 dolorosa per chi vi si sottopone.<\/p>\n<p>Tuttavia, <strong>il meccanismo<\/strong> attraverso cui queste procedure vadano a modificare l\u2019attivit\u00e0 del tessuto cerebrale danneggiato <strong>non \u00e8 ancora chiaro<\/strong>. Inoltre, non \u00e8 certo se sia meglio stimolare solo l\u2019emisfero cerebrale dove si \u00e8 verificato il danno, oppure entrambi. Sono necessari ulteriori studi, che potranno portare, in futuro, a un nuovo strumento terapeutico che potr\u00e0 aggiungersi alle strategie di riabilitazione gi\u00e0 in uso, per affrontare la disfagia in modo sempre pi\u00f9 completo.<\/p>\n<p><strong><em>Valentina Torchia<\/em><\/strong><em>, Giornalista Scientifica e Biotecnologa Medica, Master in Comunicazione e Salute nei Media contemporanei.<\/em><\/p>\n<p>Fonte: Dysphagia. 2017; 32(2): 209\u2013215.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Swallowing involves 26 muscles and is a delicate process that is precisely controlled by the brain. In stroke&#8230;<\/p>\n","protected":false},"author":3,"featured_media":9213,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[116],"tags":[],"class_list":["post-9560","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-specials"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/posts\/9560","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/comments?post=9560"}],"version-history":[{"count":3,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/posts\/9560\/revisions"}],"predecessor-version":[{"id":9945,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/posts\/9560\/revisions\/9945"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/media\/9213"}],"wp:attachment":[{"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/media?parent=9560"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/categories?post=9560"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deutera.com\/en\/wp-json\/wp\/v2\/tags?post=9560"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}