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Effect of Sub-mental Sensitive Transcutaneous Electrical Stimulation on Pharyngeal Muscles Control : TENSVIRT Study

Not Applicable
Completed
Conditions
Deglutition Disorders
Oropharyngeal Dysphagia
Interventions
Device: Urostim 2 stimulation
Registration Number
NCT02170506
Lead Sponsor
University Hospital, Rouen
Brief Summary

Swallowing is a complex phenomenon that allows oral feeding while protecting the airway. It involves many brain areas, including primary motor and sensory areas. Its dysfunction, called oropharyngeal dysphagia is present in approximately 60% of patients with a stroke. In this case, it is conventionally translated by a swallow response time delay of the swallowing reflex.

Pathophysiology of dysphagia is explained by impairment of the dominant swallowing, function that representation center is bi-hemispheric but asymmetric (Hamdy, 1997). Half of patients with a stroke supra-tentoriel with oropharyngeal dysphagia (about 55 % of strokes) regain normal swallowing in a few weeks ( Barer, 1989). Mechanisms that determine the recovery appear to be related to a reorganization of the motor cortex intact. Patients who retain disorders are those who have not cortical reorganization.

With this in mind a team used different methods known to modulate brain plasticity, which electrotherapy with an application endo- pharyngeal sensory threshold. This stimulation increases the excitability of the cortico- bulbar reflex, which improves swallowing function in the clinical application.

The hypothesis of this work is that the transcutaneous electrical stimulation applied submental, noninvasive technique, would also have an impact on cortical plasticity may explain the improved coordination of swallowing observed in earlier studies (Verin , 2011) ( Gallas , 2010).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  1. Subjects aged over 18 years
  2. Affilitation to social security scheme
  3. Registration in National register of people who participate in biomedical research
  4. Healthy volunteers who provided written informed consent
Exclusion Criteria
  1. Subjects with swallowing disorders
  2. Presence of psychiatric disorders
  3. Skin disorders
  4. Cardiac disorders (non controlled arrythmia, severe heart failure, presence of heart valve)
  5. Submental tumor
  6. Epilepsia, treated or untreated
  7. Presence of neurosurgical clip
  8. Suspicion of digestive fistula
  9. Presence of metal, pacemaker, defibrillator, pump treatment or neurostimulation
  10. Cannabis user, regular use of benzodiazepines
  11. Presence of chronic respiratory, neurological disease, ENT or gastroesophageal disease (cause potentially change swallowing)
  12. Contra-indication to MRI (claustrophobia, metal fragment, cardiac/ENT/neurological implantable device not MRI compatible, osteosynthesis prior to 1980)
  13. Subject reported against the use of Micropaque®
  14. Pregnant or nursing woman, or absence of contraception
  15. Poor understanding of French langage
  16. Person under judicial protection
  17. Person deprive of their liberty by judicial or administrative decision
  18. Participating in a clinical trial within 4 weeks before the pre-inclusion visit

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
submental sensitive transcutaneous electrical stimulation.Urostim 2 stimulationEach Healthy subjects will be his own witness. Urostim 2 stimulation Arm
Primary Outcome Measures
NameTimeMethod
Variation in motor evoked potential amplitude1 month

Our aim was to show that submental sensitive transcutaneous electrical stimulation (SSTES) can modified swallowing function. Primary endpoint is change in motor evoked potential amplitude after submental transcutaneous electrical stimulation

Secondary Outcome Measures
NameTimeMethod
variation of swallow reaction time1 Month

highlighting a change in swallowing with videofluoroscopy studied with electrical stimulation. Secondary endpoints are :

* modification of swallowing cortical area

* variation of swallow reaction time on videofluoroscopy

Trial Locations

Locations (1)

UHRouen

🇫🇷

Rouen, France

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