{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:50:16Z","timestamp":1789185016870,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,11]],"date-time":"2013-03-11T00:00:00Z","timestamp":1362960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Oropharyngeal Dysphagia (<jats:styled-content style=\"fixed-case\">OD<\/jats:styled-content>) is both underestimated and underdiagnosed as a cause of malnutrition and respiratory complications following stroke. <jats:styled-content style=\"fixed-case\">OD<\/jats:styled-content> occurs in more than 50% of stroke patients. Aspiration pneumonia (<jats:styled-content style=\"fixed-case\">AP<\/jats:styled-content>) occurs in up to 20% of acute stroke patients and is a major cause of mortality after discharge. Systematic screening for <jats:styled-content style=\"fixed-case\">OD<\/jats:styled-content> should be performed on every patient with stroke before starting oral feeding, followed, if appropriate by clinical and instrumental (videofluroscopy and\/or fiberoptic endoscopy) assessment. Bolus modification with adaptation of texture and viscosity of solids and fluids and postural adjustments should be part of the minimal treatment protocol, but they do not change the impaired swallow physiology nor promote recovery of damaged neural swallow networks in stroke patients. To this purpose, two new neurostimulation approaches are being developed to stimulate cortical neuroplasticity to recover swallowing function: (i) those aimed at stimulating the peripheral oropharyngeal sensory system by chemical, physical or electrical stimulus; and (ii) those aimed at directly stimulating the pharyngeal motor cortex, such as repetitive transcranial magnetic stimulation (<jats:styled-content style=\"fixed-case\">rTMS<\/jats:styled-content>). The study of Park <jats:italic>et\u00a0al<\/jats:italic>. in this issue of <jats:italic>Neurogastroenterology and Motility<\/jats:italic> evaluated the effect of <jats:styled-content style=\"fixed-case\">rTMS<\/jats:styled-content> in dysphagic stroke patients and showed a marked improvement in swallow physiology. Other studies also using <jats:styled-content style=\"fixed-case\">rTMS<\/jats:styled-content> showed plastic changes in pharyngeal motor cortical areas relevant to swallowing function. If further randomized controlled trials confirm these initial results, the neurorehabilitation strategies will be introduced to clinical practice sooner rather than later, improving the recovery of dysphagic stroke patients. Progress at last.<\/jats:p>","DOI":"10.1111\/nmo.12112","type":"journal-article","created":{"date-parts":[[2013,3,13]],"date-time":"2013-03-13T05:11:41Z","timestamp":1363151501000},"page":"278-282","source":"Crossref","is-referenced-by-count":61,"title":["Post\u2010stroke dysphagia: progress at last"],"prefix":"10.1111","volume":"25","author":[{"given":"L.","family":"Rofes","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Vilardell","sequence":"additional","affiliation":[{"name":"Unitat d'Exploracions Funcionals Digestives Department of Surgery Hospital de Matar\u00f3 Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Clav\u00e9","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Barcelona Spain"},{"name":"Unitat d'Exploracions Funcionals Digestives Department of Surgery Hospital de Matar\u00f3 Universitat Aut\u00f2noma de Barcelona Matar\u00f3 Spain"},{"name":"European Society for Swallowing Disorders Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,11]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000190056.76543.eb"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.26291"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0967-5868(03)00022-5"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1991.00530230078026"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03118.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000063373.70993.CD"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.6.1028"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.6.1203"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.98"},{"key":"e_1_2_5_11_1","volume-title":"Diagnosis and Treatment of Neurogenic Dysphagia","author":"Ickenstein GW","year":"2011"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5558-8"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2008.06.011"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.510370"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000323.pub2"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.2001.81.2.929"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm1196-1217"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1997.v113.pm9352847"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.101857"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949610500202"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.4.744"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(98)70081-2"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-009-9239-7"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102011\u2010300753"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1044\/jshr.3803.556"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2202-10-71"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.01.052"},{"key":"e_1_2_5_29_1","first-page":"466","article-title":"Electrical stimulation for swallowing disorders caused by stroke","volume":"46","author":"Freed ML","year":"2001","journal-title":"Respir Care"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.602128"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12063"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-008-9195-7"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2008.01093.x"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.09.040"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9568.2012.08157.x"}],"container-title":["Neurogastroenterology &amp; 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