Evaluating the impact of transcranial electrical stimulation on post-stroke dysphagia: a systematic review and meta-analysis

Objective To conduct a systematic review and meta-analysis to assess the impact of transcranial electrical stimulation (TES), proposed as a potential therapy for post-stroke dysphagia, on swallowing function in stroke survivors. Methods The PubMed, Embase, Web of Science, and Cochrane Library databases were searched for relevant studies on TES for post-stroke dysphagia. Search results were reviewed following PRISMA guidelines, and the following data were extracted from included studies: study characteristics, demographics, and outcomes. Bias was assessed using the Cochrane tool. Heterogeneity and effect sizes were analysed using I 2 statistics and appropriate effects models. The study protocol was registered with PROSPERO (registration No. CRD42024578243) Results Six randomized controlled trials met the inclusion criteria (I 2 = 0.0%). The meta-analysis indicated a significant improvement in dysphagia with TES (standardized mean difference [SMD] 0.43, 95% confidence interval [CI] 0.13, 0.73). Subgroup analysis suggested that low-intensity TES was effective (SMD 0.46, 95% CI 0.09, 0.82), whereas high-intensity TES showed no significant improvement (SMD 0.37, 95% CI –0.17, 0.91). No publication bias was detected. Conclusion TES may improve swallowing in stroke patients, with potential benefits from low-intensity protocols.