METAPLASTICITY OF HUMAN SWALLOWING SYSTEM
While working at Professor Shaheen Hamdy’s Gastrointestinal Sciences lab at the University of Manchester in the UK, Dr Cheng pioneered the work in understanding how the human brain can be manipulated to respond better to non-invasive brain stimulation (NIBS). NIBS has been proposed as a treatment of dysphagia, yet the variability in responsiveness has hindered its translation into clinical practice. Through conducting a large, multi-arm study, Dr Cheng derived several robust non-invasive brain stimulation protocols that could improve the reliability of NIBS and enhance treatment outcomes.
NOVEL TREATMENTS (TACS AND TRNS) FOR DYSPHAGIA
Dr Cheng collaborated with the Gastrointestinal Sciences research team at the University of Manchester on the first randomised cross-over study on the effects of transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS), which are two types of NIBS that use electrical current to modulate brain activity, on swallowing in healthy volunteers. They found that 70Hz tACS and tRNS can increase cortical excitability of the pharyngeal motor cortex. This work is important as it provides the theoretical basis for the use of two novel NIBS techniques for neurorehabilitation of dysphagia.
EVIDENCE SYNTHESIS FOR DYSPHAGIA TREATMENTS
In an effort to promote evidence-based practice in dysphagia rehabilitation, Dr Cheng has published several systematic reviews and meta-analyses on the clinical efficacy of neurostimulation, pharmacological and intraoral dysphagia treatments. These reviews provide timely overviews on the current evidence of dysphagia treatments and facilitate decision making in clinical practice.
Cheng I, Sasegbon A, Hamdy S. A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia. Journal of Oral Rehabilitation. 2021 Nov 24:1-11. https://doi.org/10.1111/joor.13274
Cheng I, Sasegbon A, Hamdy S. Effects of pharmacological agents for neurogenic oropharyngeal dysphagia: A systematic review and meta‐analysis. Neurogastroenterology & Motility. 2021 Aug 1:e14220. https://doi.org/10.1111/nmo.14220
Cheng I, Sasegbon A, Hamdy S. Effects of Neurostimulation on Poststroke Dysphagia: A Synthesis of Current Evidence From Randomized Controlled Trials. Neuromodulation: Technology at the Neural Interface. 2020 Dec 10. https://doi.org/10.1111/ner.13327
NEUROSTIMULATION DYSPHAGIA TREATMENTS FOR PATIENTS WITH PARKINSON’S DISEASES
While working at the University of Manchester, Dr Cheng and the Gastrointestinal Sciences research team performed a pilot randomised controlled trial study on the effects of several neurostimulation techniques in Parkinson’s diseases (PD) patients with dysphagia. This study investigated the effects of pharyngeal electrical stimulation (PES), low-frequency and high-frequency rTMS on swallowing function. It found that all three treatments showed therapeutic potential for PD patients with dysphagia and were tolerable to PD patients without adverse effects.
RTMS AS A TREATMENT FOR CHRONIC DYSPHAGIA
Dr Cheng’s PhD study investigated the clinical application of repetitive transcranial magnetic stimulation (rTMS), which is a type of NIBS technique that modulates brain activity by inducing electrical current onto the brain using electromagnetic induction. She performed a randomised controlled trial study with 21 patients with chronic post-stroke dysphagia and studied the effects of rTMS on swallowing biomechanics and swallowing-related quality of life. This work is one of the first studies that focuses on long-term (1 year) treatment outcomes in chronic stroke patients.