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Breakout 3.2 - Adult – Neuro: Cortical Stimulation; Pharyngeal Stim and NMES for Stroke

About This Course
This course is pre-recorded so you can take the course at your own pace. If you have already registered, please access  your CE videos & documents within "MY PROFILE" and then "GROUPS" (you will need to sign in to access).


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Session Preview
Pharyngeal electrical stimulation (PES) has been shown to facilitate activation of cortico-bulbar pathways, to modulate the widely distributed cortical swallowing network and to enhance peripheral sensory feedback. Recently, PES has been used to treat dysphagia in severely affected tracheostomized stroke patients. This presentation will summarize the physiological mechanism of action and give an overview of recently finished and ongoing clinical trials involving PES.





Sandeep Kumar, MD
Dr. Kumar is a stroke neurologist with an expertise in medical and neurological complications of stroke. He is currently an Associate Professor of Neurology at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.  He has made several contributions to the field of neurology and stroke. The most noteworthy amongst them have been in stroke prevention, brain neuroimaging, atypical stroke syndromes, stroke complications and stroke recovery. He and his colleagues were the first to systematically collect and describe the features of a previously unrecognized type of subarachnoid hemorrhage, convexal subarachnoid hemorrhage, which is now acknowledged as a major sub-type of a non-aneurysmal subarachnoid hemorrhage. He has had many original works on brain magnetic resonance imaging techniques in acute stroke including a widely cited work on radiological signature of acute ischemic stroke lesion patterns in patients who wake up with an acute stroke.

Dr. Kumar has had a longstanding interest in the field of neuroplasticity, the fundamental processes underlying learning and the capacity of human brain to regain functions after an injury. This path led him to the problem of dysphagia after stroke. He was one of the first investigators to use the technique of transcranial direct current stimulation (tDCS) for dysphagia recovery in acute ischemic stroke patients. He along with Dr. Susan Langmore and other colleagues recently concluded a phase-2 trial of TDCS for facilitating dysphagia recovery after stroke (FEASt trial), funded by the NIH. He has made several contributions in the field of stroke related dysphagia.

Dr. Kumar also serves as a co-investigator for the NINDS Stroke Trials Network, which aims to promote collaboration across institutions to identify promising stroke treatments that can be investigated in phase 3 clinical trials. He has served as a co-investigator for several multicenter stroke trials including IRIS, IDEF and ARCARDIA. He is also an enthusiastic educator and is actively involved in teaching and mentoring residents, students and stroke fellows, including guidance in their research endeavors and manuscript writing.  He has received awards for his teaching efforts and has been a regular invitee at different national and international forums to speak on wide ranging topics in clinical and stroke neurology.


Rainer Dziewas, MD
Rainer Dziewas is a Professor of Neurology at the university hospital Münster, Germany, where he is the head of the stroke unit and neurological intensive care unit. Professor Dziewas is Fellow of the European Stroke Organization, board member of the European Society for Swallowing Disorders (ESSD) and vice-chairman of the German Dysphagia Society. His research focusses on both the central organisation of swallowing and modern approaches to the evaluation and management of dysphagia. Capitalizing on the excellent time resolution of magnetoencephalography his group studied the cortical control of deglutition in health and different neurological diseases. In the clinical context he made use of fiberoptic endoscopic evaluation of swallowing (FEES) to systematically study stroke-related dysphagia and to deduce appropriate treatment strategies. His group uses new neurostimulation techniques such as transcranial direct current stimulation and pharyngeal electrical stimulation in basic science and clinical trials. Prof. Dziewas significantly contributed to the development of the German FEES-curriculum and the ESSD-FEES accreditation program. Prof. Dziewas is head of the guideline committee „Neurogenic Dysphagia“ of the German Society of Neurology and head of the guideline committee „Diagnosis and treatment of post-stroke dysphagia“ of the European Stroke Organization. Prof. Dziewas has published more 120 peer-reviewed original articles, 2 books and 9 book chapters.


Sandeep Kumar
Financial Disclosure: Dr. Kumar is employed by the Beth Israel Deaconess Medical Center and receives a salary.
Non-Financial Disclosure : No relevant non-financial disclosure exists.

Rainer Dziewas
Financial Disclosure: Dr. Dziewas is employed by the University Hospital of Munster and receives a salary. He also receives an honorarium from Nestle, Olympus and Nutricia for speaking on dysphagia.
Non-Financial Disclosure: No relevant non-financial disclosure exists.


The presentation is approximately one hour and thirty minutes.


Learning Objectives
After completing this session you will be able to:

  • I dentify the physiological mechanisms of action of PES.
  • Evaluate the results of the PHAST-TRAC-trial.
  • Discuss whether PES could be a treatment option for their patient cohorts.


Certificate of Completion

  • You will receive your certificate for this course upon completion of the online Learning Assessment. You will find your certificate within your profile under "Professional Development". 
  • Your ASHA CEU credits will be processed through the American Board of Swallowing and Swallowing Disorders. Reporting dates are the following: May 30th, June 30th, July 31st and September 30th. After September 30th, reporting dates will be at the end of every quarter. 

This course is offered for .15 ASHA CEUs (Advanced Level; Professional area). 


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