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Drugs & Aging
Published in: Drugs & Aging 2/2005

01-02-2005 | Review Article

Poststroke Aphasia

Epidemiology, Pathophysiology and Treatment

Author: Dr Marcelo L. Berthier

Published in: Drugs & Aging | Issue 2/2005

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Abstract

Aphasia, the loss or impairment of language caused by brain damage, is one of the most devastating cognitive impairments of stroke. Aphasia is present in 21–38% of acute stroke patients and is associated with high short- and long-term morbidity, mortality and expenditure. Recovery from aphasia is possible even in severe cases. While speech-language therapy remains the mainstay treatment of aphasia, the effectiveness of conventional therapies has not been conclusively proved. This has motivated attempts to integrate knowledge from several domains in an effort to plan more rational therapies and to introduce other therapeutic strategies, including the use of intensive language therapy and pharmacological agents.
Several placebo-controlled trials suggest that piracetam is effective in recovery from aphasia when started soon after the stroke, but its efficacy vanishes in patients with chronic aphasia. Drugs acting on catecholamine systems (bromocriptine, dexamfetamine) have shown varying degrees of efficacy in case series, open-label studies and placebo-controlled trials. Bromocriptine is useful in acute and chronic aphasias, but its beneficial action appears restricted to nonfluent aphasias with reduced initiation of spontaneous verbal messages. Dexamfetamine improves language function in subacute aphasia and the beneficial effect is maintained in the long term, but its use is restricted to highly selected samples.
Pharmacological agents operating on the cholinergic system (e.g. donepezil) have shown promise. Data from single-case studies, case series and an open-label study suggest that donepezil may have beneficial effects on chronic poststroke aphasia. Preliminary evidence suggests that donepezil is well tolerated and its efficacy is maintained in the long term. Randomised controlled trials of donepezil and other cholinergic agents in poststroke aphasia are warranted.
Literature
1.
Wolf PA, Cobb JL, D’Agostino RB. Epidemiology of stroke. In: Barnett HJM, Stein BM, Mohr JP, et al., editors. 2nd ed. Stroke. pathophysiology, diagnosis, and management. New York: Churchill Livingstone, 1992: 3–29
2.
Stegmayr B, Asplund K. Stroke in northern Sweden. Scand J Public Health 2003; Suppl. 61: 60–9
3.
Pedersen PM, Jørgensen HS, Nakayama H, et al. Aphasia in acute stroke: incidence, determinants, and recovery. Ann Neurol 1995; 38: 659–66PubMedCrossRef
4.
Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004; 17(1): 35–43PubMedCrossRef
5.
Laska AC, Hellblom A, Murray V, et al. Aphasia in acute stroke and relation to outcome. J Intern Med 2001 May; 249(5): 413–22PubMedCrossRef
6.
7.
McNeil MR, Pratt SR. Defining aphasia: some theoretical and clinical implications of operating from a formal definition. Aphasiology 2001 Oct–Nov; 15(10/11): 900–11
8.
Wade DT, Hewer RL, David RM, et al. Aphasia after stroke: natural history and associated deficits. J Neurol Neurosurg Psychiatry 1986 Jan; 49: 11–6PubMedCrossRef
9.
Kauhanen ML, Korpelainen JT, Hiltunen P, et al. Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke. Cerebrovasc Dis 2000 Nov–Dec; 10(6): 455–61PubMedCrossRef
10.
Elman RJ, Olgar J, Elman SH. Aphasia: awareness, advocacy, and activism. Aphasiology 2000; 14: 455–9CrossRef
11.
Simmons-Mackie N, Code C, Armstrong E, et al. What is aphasia? Results of an international survey. Aphasiology 2002 Aug; 16(8): 837–48CrossRef
12.
Alexander MP. Aphasia: clinical and anatomical aspects. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 133–49
13.
Godefroy O, Dubois C, Debachy B, et al. Vascular aphasias: main characteristics of patients hospitalized in acute stroke units. Stroke 2002 Mar; 33(3): 702–5PubMedCrossRef
14.
Kertesz A. Aphasia and associated disorders: taxonomy, localization, and recovery. New York: Grune and Stratton, 1979
15.
Perani D, Vallar G, Cappa S, et al. Aphasia and neglect after subcortical stroke. Brain 1987 Oct; 110: 1211–29PubMedCrossRef
16.
Weiller C, Willmes K, Reiche W, et al. The case of aphasia and neglect after striatocapsular infarction. Brain 1993 Dec; 116: 1509–25PubMedCrossRef
17.
18.
Hillis AE, Wityk RJ, Barker PB, et al. Subcortical aphasia and neglect in acute stroke: the role of cortical hypoperfusion. Brain 2002 May; 125: 1094–104PubMedCrossRef
19.
Kang DW, Roh JK, Lee YS, et al. Neuronal metabolic changes in the cortical region after subcortical infarction: a proton MR spectroscopy study. J Neurol Neurosurg Psychiatry 2000 Aug; 69: 222–7PubMedCrossRef
20.
Basso A, Lecours AR, Moraschini S, et al. Anatomoclinical correlations of the aphasias as defined through computerized tomography: exceptions. Brain Lang 1985; 26: 201–29PubMedCrossRef
21.
Willmes K, Poeck K. To what extent can aphasic syndromes be localized? Brain 1993 Dec; 116: 1527–40PubMedCrossRef
22.
Ferro JM, Madureira S. Aphasia type, age and cerebral infarct localisation. J Neurol 1997; 244: 505–9PubMedCrossRef
23.
Berthier ML. Unexpected brain-language relationships in aphasia. Evidence from transcortical sensory aphasia associated with frontal lobe lesions. Aphasiology 2001 Feb; 15: 99–130CrossRef
24.
Nicholas ML, Helm-Estabrooks N, Ward-Lonergan J, et al. Evolution of severe aphasia in the first two years post onset. Arch Phys Med Rehabil 1993 Aug; 74: 830–6PubMedCrossRef
25.
Lendrem W, Lincoln NB. Spontaneous recovery of language in patients with aphasia between 4 and 34 weeks after stroke. J Neurol Neurosurg Psychiatry 1985 Aug; 48: 743–8PubMedCrossRef
26.
Kertesz A. Recovery of aphasia. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 167–82
27.
Ogrezeanu V, Voinescu I, Mihailescu J, et al. ‘Spontaneous’ recovery in aphasics after single ischaemic stroke. Rom J Neurol Psychiatry 1994 Apr–Jun; 32: 79–90
28.
Taylor Sarno M. Recovery and rehabilitation in aphasia. In: Taylor Sarno M, editor. Acquired aphasia. 3rd ed. San Diego (CA): Academic Press, 1998: 595–631CrossRef
29.
Basso A. Aphasia and its therapy. Oxford: Oxford University Press, 2003
30.
Code C, Hemsley G, Herrmann M. The emotional impact of aphasia. Semin Speech Lang 1999; 20(1): 19–31PubMedCrossRef
31.
Starkstein SE, Robinson RG. Depression and aphasia. Aphasiology 1988; 2: 1–20CrossRef
32.
Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry 2003 Aug; 54(3): 376–87PubMedCrossRef
33.
Berthier ML, Starkstein SE, Leiguarda R, et al. Transcortical aphasia: importance of the nonspeech dominant hemisphere in language repetition. Brain 1991; 114: 1409–27PubMedCrossRef
34.
35.
Kreisler A, Godefroy O, Delmaire C, et al. The anatomy of aphasia revisited. Neurology 2000; 54: 1117–23PubMedCrossRef
36.
Axer H, von Keyserlingk AG, Berks G, et al. Supra- and infrasylvian conduction aphasia. Brain Lang 2001; 76: 317–31PubMedCrossRef
37.
Anderson JM, Gilmore R, Roper S, et al. Conduction aphasia and the arcuate fasciculus: a reexamination of the Wernicke-Geschwind Model. Brain Lang 1999; 70: 1–12PubMedCrossRef
38.
Godefroy O, Duhamel A, Leclerc X, et al. Brain-behavioural relationships. Some models and related statistical procedures for the study of brain-damaged patients. Brain 1998 Aug; 121: 1545–56PubMedCrossRef
39.
Berthier ML. Transcortical aphasias: brain damage, behaviour and cognition series. In: Code C, Humphreys G, editors. Hove: Psychology Press, 1999
40.
Berthier ML. Transcortical aphasias. In: Gilman S, Goldstein GW, Waxman SG, editors. 5th ed. San Diego (CA): Arbor Publishing, 2002
41.
Naeser MA, Baker EH, Weissman T. Lesion site patterns in severe, nonverbal aphasia to predict outcome with a computed-assisted treatment program. Arch Neurol 1998 Nov; 55: 1438–48PubMedCrossRef
42.
Cappa SF, Perani D, Grassi F, et al. A PET follow-up study of recovery after stroke in acute aphasics. Brain Lang 1997; 56: 55–67PubMedCrossRef
43.
44.
Small SL, Burton MW. Functional magnetic resonance imaging studies of language. Curr Neurol Neurosci Rep 2002 Nov; 2: 505–10PubMedCrossRef
45.
Kuest J, Karbe H. Cortical activation studies in aphasia. Curr Neurol Neurosci Rep 2002 Nov; 2: 511–5PubMedCrossRef
46.
Heiss W-D, Thiel A, Winhuisen L, et al. Functional imaging in the assessment of capability for recovery after stroke. J Rehabil Med 2003; Suppl. 41: 27–33
47.
Fridriksson J, Holland AL, Coull BM, et al. Aphasia severity: association with cerebral perfusion and diffusion. Aphasiology 2002 Sep; 16(9): 859–72PubMedCrossRef
48.
Hillis AE, Heidler J. Mechanism of early aphasia recovery. Aphasiology 2002 Sep; 16(9): 885–96CrossRef
49.
Grachev ID, Kumar R, Swarnkar A, et al. Effect of posterior temporal-parietal hematoma on orbital frontal chemistry in relation to a cognitive and anxiety state: a combined 1H-MRS and neuropsychological study of an unusual case as compared with healthy subjects. J Chem Neuroanat. 2002 Mar; 23(3): 223–30PubMedCrossRef
50.
Deppe M, Ringelstein EB, Knecht S. The investigation of brain lateralization by transcranial Doppler sonography. Neuroimage 2004; 21(3): 1124–46PubMedCrossRef
51.
Thomas C, Altenmuller E, Marckmann G, et al. Language processing in aphasia: changes in lateralization pattern during recovery reflect cerebral plasticity in adults. Electroencephalogr Clin Neurophysiol 1997 Feb, 97
52.
Kamada K, Sauer M, Möller M, et al. Functional and metabolic analysis of cerebral ischemia using magnetoencephalography and proton magnetic resonance spectroscopy. Ann Neurol 1997 Oct; 42: 554–63PubMedCrossRef
53.
Knecht F, Floel A, Drager B, et al. Degree of language lateralization determines susceptibility to unilateral brain lesions. Nat Neurosci 2002 Jul; 5: 695–9PubMed
54.
Mimura M, Kato M, Kato M, et al. Prospective and retrospective studies of recovery of in aphasia. Changes in cerebral blood flow and language functions. Brain 1998 Nov; 121(11): 2083–94PubMedCrossRef
55.
Robertson IH, Murre JMJ. Rehabilitation of brain damage: brain plasticity and principles of guided recovery. Psychol Bull 1999 Sep; 125: 544–75PubMedCrossRef
56.
57.
Kessler J, Thiel A, Karbe H, et al. Piracetam improves activated blood flow and facilitates rehabilitation of post-stroke aphasic patients. Stroke 2000; 31: 2112–6PubMedCrossRef
58.
Belin P, Van Eeckhout P, Zilbovicius M, et al. Recovery from nonfluent aphasia after melodic intonation therapy: a PET study. Neurology 1996 Jun; 47(6): 1504–11PubMedCrossRef
59.
Warburton E, Price CJ, Swinburn K, et al. Mechanisms of recovery from aphasia: evidence from positron emission tomography. J Neurol Neurosurg Psychaitry 1999 Feb; 66: 155–61CrossRef
60.
Heiss W-D, Kessler J, Thiel A, et al. Differential capacity of left and right hemispheric areas for compensation of poststroke aphasia. Ann Neurol 1999 Apr; 45: 430–8PubMedCrossRef
61.
Cao Y, Vikingstad EM, George KP, et al. Cortical language activation in stroke patients recovering from aphasia with functional MRI. Stroke 1999 Nov; 30: 2331–40PubMedCrossRef
62.
Rosen HJ, Petersen SE, Linenweber MR, et al. Neural correlates of recovery from aphasia after damage to the left inferior frontal cortex. Neurology 2000 Dec; 55: 1883–94PubMedCrossRef
63.
64.
Heiss W-D, Kracht LW, Thiel A, et al. Penumbral probability thresholds of cortical flumazenil binding and blood flow predicting tissue outcome in patients with cerebral ischaemia. Brain 2001 Feb; 124: 20–9PubMedCrossRef
65.
Weiller C, Isensee C, Rijntjes M, et al. Recovery from Wernicke’s aphasia: a positron emission tomography study. Ann Neurol 1995 Jun; 37: 723–32PubMedCrossRef
66.
Buckner RL, Corbetta M, Schatz J, et al. Preserved speech abilities and compensation following prefrontal damage. Proc Natl Acad Sci U S A 1996 Feb; 93: 1249–53PubMedCrossRef
67.
Ohyama M, Senda M, Kitamura S, et al. Role of the nondominant hemisphere and undamaged area during word repetition poststroke aphasics: a PET activation study. Stroke 1996 May; 27: 897–903PubMedCrossRef
68.
Gold BT, Kertesz A. Right hemisphere semantic processing of visual words in an aphasic patient: an fMRI study. Brain Lang 2000 Dec; 73: 456–65PubMedCrossRef
69.
Perani D, Cappa SF, Tettamanti M, et al. A fMRI study of word retrieval in aphasia. Brain Lang 2003 Jun; 85: 357–68PubMedCrossRef
70.
Ansaldo AI, Arguin M, Lecours AR. The contribution of the right cerebral hemisphere to the recovery from aphasia: a single longitudinal case study. Brain Lang 2002 Aug; 82: 206–22PubMedCrossRef
71.
Ansaldo AI, Arguin M, Lecours AR. Initial right hemisphere take-over and subsequent bilateral participation during recovery from aphasia. Aphasiology 2002 Mar; 16: 287–304CrossRef
72.
Shallice T. From neuropsychology to mental structure. Cambridge: Cambridge University Press, 1988CrossRef
73.
McCarthy RA, Warrington EK. Cognitive neuropsychology: a clinical introduction. San Diego (CA): Academic Press, 1990
74.
Saffran EM. Aphasia: cognitive neuropsychological aspects. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 151–65
75.
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil 2000 Dec; 81: 1596–615PubMedCrossRef
76.
77.
Kertesz A. Recovery of aphasia. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 167–82
78.
Grodzinsky Y, Pinango MM, Zurif E, et al. The critical role of group studies in neuropsychology: comprehension regularities in Broca’s aphasia. Brain Lang 1999 Apr; 67: 134–47PubMedCrossRef
79.
Byng S, Black M. What makes a therapy? Some parameters of therapeutic intervention in aphasia. Eur J Disord Commun 1995; 30: 303–16PubMedCrossRef
80.
Raymer AM, González Rothi LJ, Greenwald ML. The role of cognitive models in language rehabilitation. Neurorehabilation 1995; 5: 183–93CrossRef
81.
Best W, Nickels L. From theory to therapy in aphasia: where are we now and where to next? Neuropsychol Rehab 2000; 10(3): 231–47CrossRef
82.
Nickels L. Theoretical and methodological issues in the cognitive neuropsychology of spoken word production. Aphasiology 2002 Jan–Feb; 16: 3–19CrossRef
83.
Goodglass H, Kaplan E. Assessment of aphasia and related disorders. Philadelphia (PA): Lea and Febiger, 1972
84.
Kertesz A. The western aphasia battery. New York: Grune and Stratton, 1982
85.
Porch B. The porch index of communicative abilities. Palo Alto (CA): Consulting Psychologists Press, 1982
86.
Pulvermüller F, Neininger B, Elbert T, et al. Constraint-induced therapy of chronic aphasia after stroke. Stroke 2001; 32: 1621–6PubMedCrossRef
87.
Walker-Batson D, Curtis S, Natarajan R, et al. A double-blind, placebo-controlled study of the use of amphetamine in the treatment of aphasia. Stroke 2001; 32: 2093–8PubMedCrossRef
88.
Berthier ML, Hinojosa J, Martín MC, et al. Open-label study of donepezil in chronic poststroke aphasia. Neurology 2003 Apr, 1218–9
89.
Ellis AW, Young AW. Human Cognitive Neuropsychology. Hove: Lawrence Erlbaum Associates Ltd, 1988
90.
Dell GS. A spreading-activation theory of retrieval in sentence production. Psychol Rev 1986 Jul; 93: 283–321PubMedCrossRef
91.
Levelt WJM, Roelofs A, Meyer AS. A theory of lexical access in speech production. Behav Brain Sci 1999 Feb; 22: 1–38PubMed
92.
Goldrick M, Rapp B. A restricted interaction account (RIA) of spoken word production: the best of both worlds. Aphasiology 2002 Feb; 16: 20–55CrossRef
93.
Kay J, Lesser R, Colthearth M. Psycholinguistic assessments of language processing in aphasia (PALPA). Hove: Lawrence Erlbaum Associates Ltd, 1992
94.
Carlomagno S, Pandolfi M, Labruna L, et al. Recovery from moderate aphasia in the first year poststroke: Effect of type of therapy. Arch Phys Med Rehabil 2001 Aug; 82: 1073–80PubMedCrossRef
95.
Basso A, Caporali A. Aphasia therapy or the importance of being earnest. Aphasiology 2001 Apr; 15(4): 307–32CrossRef
96.
Worrall LE, Holland AL. Editorial: quality of life in aphasia. Aphasiology 2003 Apr; 17(4): 329–32CrossRef
97.
Hilari K, Byng S, Lamping DL, et al. Stroke and aphasia quality of life scale-39 (SAQL-39): evaluation of acceptability, reliability and validity. Stroke 2003 Aug; 34: 1944–50PubMedCrossRef
98.
Goldstein LB. Common drugs may influence motor recovery after stroke: the Sygen in Acute Stroke Study Investigations. Neurology 1995; 45: 865–71PubMedCrossRef
99.
Goldstein LB. Potential effects of common drugs on stroke recovery. Arch Neurol. 1998 Apr; 55(4): 454–6PubMedCrossRef
100.
Basso A, Capitani E, Vignolo LA. Influence of rehabilitation on language skills in aphasic patients: a controlled study. Arch Neurol. 1979 Apr; 36(4): 190–6PubMedCrossRef
101.
David R, Enderby P, Bainton D. Treatment of acquired aphasia: speech therapists and volunteers compared. J Neurol Neurosurg Psychiatry 1982 Nov; 45(11): 957–61PubMedCrossRef
102.
Wertz RT, Weiss DG, Aten JL, et al. Comparison of clinic, home, and deferred language treatment for aphasia: a Veterans Administration Cooperative Study. Arch Neurol. 1986 Jul; 43(7): 653–8PubMedCrossRef
103.
Robey RR. The efficacy of treatment for aphasic persons: a meta-analysis. Brain Lang. 1994 Nov; 47: 582–608PubMedCrossRef
104.
Robey RR. A meta-analysis of clinical outcomes in the treatment of aphasia. J Speech Lang Hear Res. 1998 Feb; 41(1): 172–87PubMed
105.
Robey RR, Schultz MC, Crawford AB, et al. Single-subject clinical-outcome research: designs, data, effect sizes, and analyses. Aphasiology 1999; 16: 445–73CrossRef
106.
Basso A, Marangolo P. Cognitive rehabilitation: the emperor’s new clothes? Neuropsychol Rehab 2000; 10: 219–29CrossRef
107.
Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev 2000; 2: CD000425
108.
Bhogal SK, Teasell RW, Foley NC, et al. Rehabilitation of aphasia: more is better. Top Stroke Rehabil 2003 Summer; 10(2): 66–76PubMedCrossRef
109.
Bhogal SK, Teasell R, Speechley M. Intensity of aphasia therapy, impact on recovery. Stroke 2003 Apr; 34: 987–93PubMedCrossRef
110.
Holland AL, Fromm DS, DeRuyter F, et al. Treatment efficacy: aphasia. J Speech Hear Res 1996 Oct; 39: S27–36PubMed
111.
Howard D. Beyond randomised controlled trials: the case for effective case studies of the effects of treatment in aphasia. Br J Disord Communication 1986; 21: 89–102CrossRef
112.
Nickels L. Therapy for naming disorders: revisiting, revising and reviewing. Aphasiology 2002 Oct–Nov; 16: 935–79CrossRef
113.
Kohn SE, Smith KL, Arsenault JK. The remediation of conduction aphasia via sentence repetition: a case study. Br J Disord Commun. 1990 Apr; 25(1): 45–60PubMedCrossRef
114.
Pulvermüller F, Schönle PW. Behavioral and neuronal changes during treatment of mixed-transcortical aphasia: a case study. Cognition 1993; 48: 139–61PubMedCrossRef
115.
Berthier ML, Moreno I, Hinojosa J, et al. Effects of donepezil and modality-specific therapy on STM-based repetition disorder [abstract]. JINS 2003; 9(4): 544
116.
Nickels L. Improving word finding: practices makes (closer to) perfect? Aphasiology 2002; 16(10/11): 1047–60CrossRef
117.
Franklin S, Buerk F, Howard D. Generalized improvement in speech production for a subject with reproduction conduction aphasia. Aphasiology 2002; 16(10/11): 1087–114CrossRef
118.
Francis DR, Riddoch MJ, Humphreys GW. Cognitive rehabilitation of word meaning deafness. Aphasiology 2001; 15: 749–66CrossRef
119.
Hinojosa J, Moreno-Torres I, Berthier ML. Multimodality therapy for word meaning deafness [abstract]. JINS 2003; 9(4): 545
120.
Aftonomos LB, Steele RD, Wertz RT. Promoting recovery in chronic aphasia with an interactive technology. Arch Phys Med Rehabil. 1997 Aug; 78(8): 841–6PubMedCrossRef
121.
Fink RB, Brecher A, Schwartz MF, et al. A computer-implemented protocol for treatment of naming disorders: evaluation of clinician-guided and partially self-guided instruction. Aphasiology 2002; 16(10/11): 1061–86CrossRef
122.
Aftonomos LB, Appelbaum JS, Steele RD. Improving outcomes for persons with aphasia in advanced community-based treatment programs. Stroke 1999 Jul; 30: 1370–9PubMedCrossRef
123.
Schwartz MF, Fink RB, Saffran EM. The modular treatment of agrammatism. Neuropsychol Rehab 1995; 5: 93–127CrossRef
124.
125.
Bachman D, Morgan A. The role of pharmacotherapy in the treatment of aphasia: preliminary results. Aphasiology 1988; 2: 225–8CrossRef
126.
Small SL. A biological model of aphasia rehabilitation: pharmacological perspectives. Aphasiology 2004; 18(5/6/7): 473–92CrossRef
127.
Shisler RJ, Baylis GC, Frank EM. Pharmacological approaches to the treatment and prevention of aphasia. Aphasiology 2000 Dec; 14(12): 1163–86CrossRef
128.
Bakheit AMO. Drug treatment of post-stroke aphasia. Exp Rev Neurotherap 2004; 4(2): 211–7CrossRef
129.
Noble S, Benfield P. Piracetam. A review of its clinical potential in the management of patients with stroke. CNS Drugs 1998 Jun 9; (6): 497–511
130.
Platt D, Horn J, Summa JD, et al. On the efficacy of piracetam in geriatric patients with acute cerebral ischemia: a clinically controlled double-blind study. Arch Gerontol Geriatr 1993 Mar–Apr; 16: 149–64PubMedCrossRef
131.
Herrschaft H. The efficacy of piracetam in acute cerebral ischemia in man: a clinically-controlled, double-blind study pircetam/10% dextran 40 versus 10% dextran 40/placebo. Symposium Piracetam: 5 years progress in pharmacology and clinics. 1990 Apr 29; Athens: 109–34
132.
Enderby P, Broeckx J, Hospers W, et al. Effect of piracetam on recovery and rehabilitation after stroke: a double-blind, placebo-controlled study. Clin Neuropharmacol 1994; 17(4): 320–31PubMedCrossRef
133.
Huber W, Willmes K, Poeck K, et al. Piracetam as an adjuvant to language therapy for aphasia: a randomized double-blind placebo-controlled pilot study. Arch Phys Med Rehabil 1997 Mar; 78: 245–50PubMedCrossRef
134.
De Dyen P, De Reuck JD, Orgogozo J-M, et al. Treatment of acute ischaemic stroke with piracetam. Stroke 1997 Dec; 28: 2347–52CrossRef
135.
Orgogozo J-M. Piracetam in the treatment of acute stroke. Pharmacopsychiat 1999 Mar; 32: Suppl 1 25–32CrossRef
136.
Greener J, Enderby P, Whurr R. Pharmacological treatment for aphasia following stroke. The Cochrane Database of Syst Rev 2001 (4): CD000424
137.
Flanagan SR. Psychostimulant treatment of stroke and brain injury. CNS Spectrums 2000; 5: 59–69PubMed
138.
MacLennan DL, Nicholas LE, Morley GK, et al. The effects of bromocriptine on speech and language function in a patient with transcortical motor aphasia. In: Prescott TE, editor. Clinical Aphasiology. Vol 20. Boston (MA): College Hill: 1991
139.
Sabe L, Leiguarda R, Starkstein S. An open-label trial of bromocriptine in nonfluent aphasia. Neurology 1992; 42: 1637–8PubMedCrossRef
140.
Gupta S, Mlcoch A. Bromocriptine treatment of nonfluent aphasia. Arch Phys Med Rehabil 1992; 73: 373–6PubMedCrossRef
141.
Sabe L, Salvarezza F, Cuerva AG, et al. A randomized, double-blind, placebo controlled study of bromocriptine in nonfluent aphasia. Neurology 1995; 45: 2272–4PubMedCrossRef
142.
Ozeren A, Sarica Y, Mavi H, et al. Bromocriptine is ineffective in the treatment of chronic nonfluent aphasia. Acta Neurologica Belgium 1995; 95: 235–8
143.
Gupta S, Mlcoch A, Scolaro C, et al. Bromocriptine treatment of nonfluent aphasia. Neurology 1995; 45: 2170–3PubMedCrossRef
144.
Bragoni M, Altieri M, Di Piero V, et al. Bromocriptine and speech therapy in nonfluent aphasia after stroke. Neurol Sci. 2000 Feb; 21: 19–22PubMedCrossRef
145.
Gold M, VanDam D, Silliman ER. An open-label trial of bromocriptine in nonfluent aphasia: a qualitative analysis of word storage and retrieval. Brain Lang 2000; 74: 141–56PubMedCrossRef
146.
Hughes JD, Jacobs DH, Heilman KM. Neuropharmacology and linguistic neuroplasticity. Brain Lang 2000; 71: 96–101PubMedCrossRef
147.
Raymer AM, Bandy D, Adair JC. Effects of bromocriptine in a patient with crossed nonfluent aphasia: a case report. Arch Phys Med Rehabil 2001; 82: 139–44PubMedCrossRef
148.
Fleet WS, Valenstein E, Watson RJ, et al. Dopamine agonist therapy for neglect in humans. Neurology 1987 Nov; 37: 1765–70PubMedCrossRef
149.
Grujic Z, Mapstone M, Gitelman DR, et al. Dopamine agonists reorient visual exploration away from the neglected hemispace. Neurology 1998 Nov; 51: 1395–8PubMedCrossRef
150.
Powell JH, al-Adawi S, Morgan J, et al. Motivational deficits after brain injury: effects of bromocriptine in 11 patients. J Neurol Neurosurg Psychiatry 1996 Apr; 60: 416–21PubMedCrossRef
151.
Leiguarda R, Merello M, Sabe L, et al. Bromocriptine-induced dystonia in patients with aphasia and hemiparesis. Neurology 1993; 43: 2319–22PubMedCrossRef
152.
153.
Breitenstein C, Wailke S, Bushuven S, et al. Effects of d-amphetamine on plasticity of language networks in healthy adults [abstract]. JINS 2003 May; 9: 52
154.
Martinsson L, Eksborg S. Drugs for stroke recovery: the example of amphetamine. Drugs Aging 2004; 21(2): 67–79PubMedCrossRef
155.
Walker-Batson D, Smith P, Curtis S, et al. Amphetamine paired with physical therapy accelerates motor recovery after stroke. Further evidence. Stroke 1995; 26: 2254–9PubMedCrossRef
156.
Bütefisch CM, Davis BC, Sawaki L, et al. Modulation of use-dependent plasticity by d-amphetamine. Ann Neurol 2002; 51: 59–68PubMedCrossRef
157.
Walker-Batson D, Unwin H, Curtis S, et al. Use of amphetamine in the treatment of aphasia. Restorative Neurol Neurosci 1992; 4: 47–50
158.
McNeil MR, Doyle PJ, Spencer KA, et al. A double-blind, placebo-controlled study of pharmacological and behavioural treatment of lexical-semantic deficits in aphasia. Aphasiology 1997; 11(4/5): 385–400CrossRef
159.
Hutchison CW, Nathan PJ, Mrazek L, et al. Cholinergic modulation of early information processing: the effects of donepezil on inspection time. Psychopharmacol 2001 Jun; 155: 440–2CrossRef
160.
Winkler J, Suhr ST, Gage FH, et al. Essential role of neocortical acethylcholine in spatial memory. Nature 1995; 375: 484–7PubMedCrossRef
161.
Selden NR, Gitelman DR, Salamon-Murayama N, et al. Trajectories of cholinergic pathways within the cerebral hemispheres of the human brain. Brain 1998; 121: 2249–57PubMedCrossRef
162.
Baskerville KA, Schweitzer JB, Herron P. Effects of cholinergic depletion on experience-dependent plasticity in the cortex of the rat. Neuroscience 1997; 80: 1159–69PubMedCrossRef
163.
164.
Mendez MF, Younesi FL, Perryman KM. Use of donepezil for vascular dementia: preliminary clinical experience. J Neuropsychiatry Clin Neurosci 1999; 11: 268–70PubMed
165.
Salloway S, Pratt RD, Perdomo CA, et al. Donepezil-treated patients with vascular dementia demonstrate cognitive and global benefits: results from study 308, a 24-week, randomized, double-blind, placebo-controlled trial. Neurobiol Aging 2002; 23Suppl 1: s57, 219
166.
Salloway S, Pratt RD, Perdomo CA, et al. A comparison of the cognitive benefits of donepezil in patients with cortical versus subcortical vascular dementia: a subanalysis of two 24-week, randomized, double-blind, placebo-controlled trials. Neurology 2003 Mar; 60 (5 Suppl 1): A141–A142
167.
Black S, Roman GC, Geldmacher DS, et al. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week multicenter, international, randomised, placebocontrolled clinical trial. Stroke 2003 Oct; 34: 2323–30PubMedCrossRef
168.
Tanaka Y, Miyazaki M, Albert ML. Effect of increased cholinergic activity on naming in aphasia. Lancet 1997; 350: 116–7PubMedCrossRef
169.
Mesulam M, Siddique T, Cohen B. Cholinergic denervation in a pure multi-infarct state: observations on CADASIL. Neurology 2003; 60: 1183–5PubMedCrossRef
170.
Birks JS, Melzer D, Beppu H. Donepezil for mild and moderate Alzheimer’s disease (Cochrane review). Cochrane Database Syst Rev 2000; (4): CD001190
171.
Smith Doody R. Update on Alzheimer drugs (donepezil). Neurology 2003 Sep; 9: 225–9CrossRef
172.
Defilippi JL, Crismon ML. Drug interactions with cholinesterase inhibitors. Drugs Aging 2003; 20(6): 437–44PubMedCrossRef
173.
Griffin SL, van Reekum R, Masanic C. A review of cholinergic agents in the treatment of neurobehavioral deficits following traumatic brain injury. J Neuropsychiatry Clin Neurosci 2003 Winter; 15: 17–26PubMedCrossRef
174.
Akasofu S, Kosasa T, Kimura M, et al. Protective effect of donepezil in a primary culture rat cortical neurons exposed to oxygen-glucose deprivation. Eur J Pharmacol. 2003 Jul 4; 472(1–2): 57–63PubMedCrossRef
175.
Tsz-Ming C, Kaufer DJ. Effects of donepezil on aphasia, agnosia, and apraxia in patients with cerebrovascular lesions [abstract]. J Neuropsychiatry Clin Neurosci 2001; 13: 140
176.
Benke T, Köylü B, Delazer M, et al. Cholinergic treatment of amnesia following basal forebrain lesion due to aneurysm rupture: a pilot study [abstract]. JINS 2003 May; 9: 542
177.
Berthier ML, Pujol J, Gironell A, et al. Beneficial effect of donepezil on sensorimotor function after stroke. Am J Phys Med Rehab 2003 Sep; 82(9): 725–9CrossRef
178.
Valle F, Cuetos F. EPLA: evaluación del procesamiento lingüístico en la afasia. Hove: Lawrence Erlbaum Associates Ltd, 1995
Metadata
Title
Poststroke Aphasia
Epidemiology, Pathophysiology and Treatment
Author
Dr Marcelo L. Berthier
Publication date
01-02-2005
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 2/2005
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.2165/00002512-200522020-00006

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