Advertisement

Drugs & Aging

, Volume 22, Issue 2, pp 163–182 | Cite as

Poststroke Aphasia

Epidemiology, Pathophysiology and Treatment
  • Marcelo L. Berthier
Review Article

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.

Keywords

Bromocriptine Aphasia Piracetam Spontaneous Speech Nonfluent Aphasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The author would like to thank Robert G. Robinson, MD, Cristóbal Carnero, MD and the anonymous referees for detailed and helpful comments on an earlier version of this article.

No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.

References

  1. 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: 3–29Google Scholar
  2. 2.
    Stegmayr B, Asplund K. Stroke in northern Sweden. Scand J Public Health 2003; Suppl. 61: 60–9Google Scholar
  3. 3.
    Pedersen PM, Jørgensen HS, Nakayama H, et al. Aphasia in acute stroke: incidence, determinants, and recovery. Ann Neurol 1995; 38: 659–66PubMedCrossRefGoogle Scholar
  4. 4.
    Pedersen PM, Vinter K, Olsen TS. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004; 17(1): 35–43PubMedCrossRefGoogle Scholar
  5. 5.
    Laska AC, Hellblom A, Murray V, et al. Aphasia in acute stroke and relation to outcome. J Intern Med 2001 May; 249(5): 413–22PubMedCrossRefGoogle Scholar
  6. 6.
    Albert ML. Treatment of aphasia. Arch Neurol 1998; 55: 1417–9PubMedCrossRefGoogle Scholar
  7. 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): 900–11Google Scholar
  8. 8.
    Wade DT, Hewer RL, David RM, et al. Aphasia after stroke: natural history and associated deficits. J Neurol Neurosurg Psychiatry 1986 Jan; 49: 11–6PubMedCrossRefGoogle Scholar
  9. 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): 455–61PubMedCrossRefGoogle Scholar
  10. 10.
    Elman RJ, Olgar J, Elman SH. Aphasia: awareness, advocacy, and activism. Aphasiology 2000; 14: 455–9CrossRefGoogle Scholar
  11. 11.
    Simmons-Mackie N, Code C, Armstrong E, et al. What is aphasia? Results of an international survey. Aphasiology 2002 Aug; 16(8): 837–48CrossRefGoogle Scholar
  12. 12.
    Alexander MP. Aphasia: clinical and anatomical aspects. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 133–49Google Scholar
  13. 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): 702–5PubMedCrossRefGoogle Scholar
  14. 14.
    Kertesz A. Aphasia and associated disorders: taxonomy, localization, and recovery. New York: Grune and Stratton, 1979Google Scholar
  15. 15.
    Perani D, Vallar G, Cappa S, et al. Aphasia and neglect after subcortical stroke. Brain 1987 Oct; 110: 1211–29PubMedCrossRefGoogle Scholar
  16. 16.
    Weiller C, Willmes K, Reiche W, et al. The case of aphasia and neglect after striatocapsular infarction. Brain 1993 Dec; 116: 1509–25PubMedCrossRefGoogle Scholar
  17. 17.
    Nadeau SE, Crosson B. Subcortical aphasia. Brain Lang 1997 Jul; 58: 355–402PubMedCrossRefGoogle Scholar
  18. 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: 1094–104PubMedCrossRefGoogle Scholar
  19. 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: 222–7PubMedCrossRefGoogle Scholar
  20. 20.
    Basso A, Lecours AR, Moraschini S, et al. Anatomoclinical correlations of the aphasias as defined through computerized tomography: exceptions. Brain Lang 1985; 26: 201–29PubMedCrossRefGoogle Scholar
  21. 21.
    Willmes K, Poeck K. To what extent can aphasic syndromes be localized? Brain 1993 Dec; 116: 1527–40PubMedCrossRefGoogle Scholar
  22. 22.
    Ferro JM, Madureira S. Aphasia type, age and cerebral infarct localisation. J Neurol 1997; 244: 505–9PubMedCrossRefGoogle Scholar
  23. 23.
    Berthier ML. Unexpected brain-language relationships in aphasia. Evidence from transcortical sensory aphasia associated with frontal lobe lesions. Aphasiology 2001 Feb; 15: 99–130CrossRefGoogle Scholar
  24. 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: 830–6PubMedCrossRefGoogle Scholar
  25. 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: 743–8PubMedCrossRefGoogle Scholar
  26. 26.
    Kertesz A. Recovery of aphasia. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 167–82Google Scholar
  27. 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: 79–90Google Scholar
  28. 28.
    Taylor Sarno M. Recovery and rehabilitation in aphasia. In: Taylor Sarno M, editor. Acquired aphasia. 3rd ed. San Diego (CA): Academic Press, 1998: 595–631CrossRefGoogle Scholar
  29. 29.
    Basso A. Aphasia and its therapy. Oxford: Oxford University Press, 2003Google Scholar
  30. 30.
    Code C, Hemsley G, Herrmann M. The emotional impact of aphasia. Semin Speech Lang 1999; 20(1): 19–31PubMedCrossRefGoogle Scholar
  31. 31.
    Starkstein SE, Robinson RG. Depression and aphasia. Aphasiology 1988; 2: 1–20CrossRefGoogle Scholar
  32. 32.
    Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry 2003 Aug; 54(3): 376–87PubMedCrossRefGoogle Scholar
  33. 33.
    Berthier ML, Starkstein SE, Leiguarda R, et al. Transcortical aphasia: importance of the nonspeech dominant hemisphere in language repetition. Brain 1991; 114: 1409–27PubMedCrossRefGoogle Scholar
  34. 34.
    Taubner RW, Raymer AM, Heilman KM. Fronto-opercular aphasia. Brain Lang 1999; 70: 240–61PubMedCrossRefGoogle Scholar
  35. 35.
    Kreisler A, Godefroy O, Delmaire C, et al. The anatomy of aphasia revisited. Neurology 2000; 54: 1117–23PubMedCrossRefGoogle Scholar
  36. 36.
    Axer H, von Keyserlingk AG, Berks G, et al. Supra- and infrasylvian conduction aphasia. Brain Lang 2001; 76: 317–31PubMedCrossRefGoogle Scholar
  37. 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: 1–12PubMedCrossRefGoogle Scholar
  38. 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: 1545–56PubMedCrossRefGoogle Scholar
  39. 39.
    Berthier ML. Transcortical aphasias: brain damage, behaviour and cognition series. In: Code C, Humphreys G, editors. Hove: Psychology Press, 1999Google Scholar
  40. 40.
    Berthier ML. Transcortical aphasias. In: Gilman S, Goldstein GW, Waxman SG, editors. 5th ed. San Diego (CA): Arbor Publishing, 2002Google Scholar
  41. 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: 1438–48PubMedCrossRefGoogle Scholar
  42. 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: 55–67PubMedCrossRefGoogle Scholar
  43. 43.
    Weiller C. Imaging recovery from stroke. Exp Brain Res 1998; 123: 13–7PubMedCrossRefGoogle Scholar
  44. 44.
    Small SL, Burton MW. Functional magnetic resonance imaging studies of language. Curr Neurol Neurosci Rep 2002 Nov; 2: 505–10PubMedCrossRefGoogle Scholar
  45. 45.
    Kuest J, Karbe H. Cortical activation studies in aphasia. Curr Neurol Neurosci Rep 2002 Nov; 2: 511–5PubMedCrossRefGoogle Scholar
  46. 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: 27–33Google Scholar
  47. 47.
    Fridriksson J, Holland AL, Coull BM, et al. Aphasia severity: association with cerebral perfusion and diffusion. Aphasiology 2002 Sep; 16(9): 859–72PubMedCrossRefGoogle Scholar
  48. 48.
    Hillis AE, Heidler J. Mechanism of early aphasia recovery. Aphasiology 2002 Sep; 16(9): 885–96CrossRefGoogle Scholar
  49. 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): 223–30PubMedCrossRefGoogle Scholar
  50. 50.
    Deppe M, Ringelstein EB, Knecht S. The investigation of brain lateralization by transcranial Doppler sonography. Neuroimage 2004; 21(3): 1124–46PubMedCrossRefGoogle Scholar
  51. 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, 97Google Scholar
  52. 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: 554–63PubMedCrossRefGoogle Scholar
  53. 53.
    Knecht F, Floel A, Drager B, et al. Degree of language lateralization determines susceptibility to unilateral brain lesions. Nat Neurosci 2002 Jul; 5: 695–9PubMedGoogle Scholar
  54. 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): 2083–94PubMedCrossRefGoogle Scholar
  55. 55.
    Robertson IH, Murre JMJ. Rehabilitation of brain damage: brain plasticity and principles of guided recovery. Psychol Bull 1999 Sep; 125: 544–75PubMedCrossRefGoogle Scholar
  56. 56.
    Kolk HHJ. Multiple route plasticity. Brain Lang 2000 Jan; 71: 129–31PubMedCrossRefGoogle Scholar
  57. 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: 2112–6PubMedCrossRefGoogle Scholar
  58. 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): 1504–11PubMedCrossRefGoogle Scholar
  59. 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: 155–61CrossRefGoogle Scholar
  60. 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: 430–8PubMedCrossRefGoogle Scholar
  61. 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: 2331–40PubMedCrossRefGoogle Scholar
  62. 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: 1883–94PubMedCrossRefGoogle Scholar
  63. 63.
    Baron J-C. Marchal G. Ischémic core and penumbra in human stroke. Stroke 1999 May; 30: 1150–3PubMedCrossRefGoogle Scholar
  64. 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: 20–9PubMedCrossRefGoogle Scholar
  65. 65.
    Weiller C, Isensee C, Rijntjes M, et al. Recovery from Wernicke’s aphasia: a positron emission tomography study. Ann Neurol 1995 Jun; 37: 723–32PubMedCrossRefGoogle Scholar
  66. 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: 1249–53PubMedCrossRefGoogle Scholar
  67. 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: 897–903PubMedCrossRefGoogle Scholar
  68. 68.
    Gold BT, Kertesz A. Right hemisphere semantic processing of visual words in an aphasic patient: an fMRI study. Brain Lang 2000 Dec; 73: 456–65PubMedCrossRefGoogle Scholar
  69. 69.
    Perani D, Cappa SF, Tettamanti M, et al. A fMRI study of word retrieval in aphasia. Brain Lang 2003 Jun; 85: 357–68PubMedCrossRefGoogle Scholar
  70. 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: 206–22PubMedCrossRefGoogle Scholar
  71. 71.
    Ansaldo AI, Arguin M, Lecours AR. Initial right hemisphere take-over and subsequent bilateral participation during recovery from aphasia. Aphasiology 2002 Mar; 16: 287–304CrossRefGoogle Scholar
  72. 72.
    Shallice T. From neuropsychology to mental structure. Cambridge: Cambridge University Press, 1988CrossRefGoogle Scholar
  73. 73.
    McCarthy RA, Warrington EK. Cognitive neuropsychology: a clinical introduction. San Diego (CA): Academic Press, 1990Google Scholar
  74. 74.
    Saffran EM. Aphasia: cognitive neuropsychological aspects. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 151–65Google Scholar
  75. 75.
    Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil 2000 Dec; 81: 1596–615PubMedCrossRefGoogle Scholar
  76. 76.
    Blumstein SE. A perspective on the neurobiology of language. Brain Lang 1997; 60: 335–46PubMedCrossRefGoogle Scholar
  77. 77.
    Kertesz A. Recovery of aphasia. In: Feinberg TE, Farah MJ, editors. Behavioral neurology and neuropsychology. New York: McGraw-Hill, 1997: 167–82Google Scholar
  78. 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: 134–47PubMedCrossRefGoogle Scholar
  79. 79.
    Byng S, Black M. What makes a therapy? Some parameters of therapeutic intervention in aphasia. Eur J Disord Commun 1995; 30: 303–16PubMedCrossRefGoogle Scholar
  80. 80.
    Raymer AM, González Rothi LJ, Greenwald ML. The role of cognitive models in language rehabilitation. Neurorehabilation 1995; 5: 183–93CrossRefGoogle Scholar
  81. 81.
    Best W, Nickels L. From theory to therapy in aphasia: where are we now and where to next? Neuropsychol Rehab 2000; 10(3): 231–47CrossRefGoogle Scholar
  82. 82.
    Nickels L. Theoretical and methodological issues in the cognitive neuropsychology of spoken word production. Aphasiology 2002 Jan–Feb; 16: 3–19CrossRefGoogle Scholar
  83. 83.
    Goodglass H, Kaplan E. Assessment of aphasia and related disorders. Philadelphia (PA): Lea and Febiger, 1972Google Scholar
  84. 84.
    Kertesz A. The western aphasia battery. New York: Grune and Stratton, 1982Google Scholar
  85. 85.
    Porch B. The porch index of communicative abilities. Palo Alto (CA): Consulting Psychologists Press, 1982Google Scholar
  86. 86.
    Pulvermüller F, Neininger B, Elbert T, et al. Constraint-induced therapy of chronic aphasia after stroke. Stroke 2001; 32: 1621–6PubMedCrossRefGoogle Scholar
  87. 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: 2093–8PubMedCrossRefGoogle Scholar
  88. 88.
    Berthier ML, Hinojosa J, Martín MC, et al. Open-label study of donepezil in chronic poststroke aphasia. Neurology 2003 Apr, 1218–9Google Scholar
  89. 89.
    Ellis AW, Young AW. Human Cognitive Neuropsychology. Hove: Lawrence Erlbaum Associates Ltd, 1988Google Scholar
  90. 90.
    Dell GS. A spreading-activation theory of retrieval in sentence production. Psychol Rev 1986 Jul; 93: 283–321PubMedCrossRefGoogle Scholar
  91. 91.
    Levelt WJM, Roelofs A, Meyer AS. A theory of lexical access in speech production. Behav Brain Sci 1999 Feb; 22: 1–38PubMedGoogle Scholar
  92. 92.
    Goldrick M, Rapp B. A restricted interaction account (RIA) of spoken word production: the best of both worlds. Aphasiology 2002 Feb; 16: 20–55CrossRefGoogle Scholar
  93. 93.
    Kay J, Lesser R, Colthearth M. Psycholinguistic assessments of language processing in aphasia (PALPA). Hove: Lawrence Erlbaum Associates Ltd, 1992Google Scholar
  94. 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: 1073–80PubMedCrossRefGoogle Scholar
  95. 95.
    Basso A, Caporali A. Aphasia therapy or the importance of being earnest. Aphasiology 2001 Apr; 15(4): 307–32CrossRefGoogle Scholar
  96. 96.
    Worrall LE, Holland AL. Editorial: quality of life in aphasia. Aphasiology 2003 Apr; 17(4): 329–32CrossRefGoogle Scholar
  97. 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: 1944–50PubMedCrossRefGoogle Scholar
  98. 98.
    Goldstein LB. Common drugs may influence motor recovery after stroke: the Sygen in Acute Stroke Study Investigations. Neurology 1995; 45: 865–71PubMedCrossRefGoogle Scholar
  99. 99.
    Goldstein LB. Potential effects of common drugs on stroke recovery. Arch Neurol. 1998 Apr; 55(4): 454–6PubMedCrossRefGoogle Scholar
  100. 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): 190–6PubMedCrossRefGoogle Scholar
  101. 101.
    David R, Enderby P, Bainton D. Treatment of acquired aphasia: speech therapists and volunteers compared. J Neurol Neurosurg Psychiatry 1982 Nov; 45(11): 957–61PubMedCrossRefGoogle Scholar
  102. 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): 653–8PubMedCrossRefGoogle Scholar
  103. 103.
    Robey RR. The efficacy of treatment for aphasic persons: a meta-analysis. Brain Lang. 1994 Nov; 47: 582–608PubMedCrossRefGoogle Scholar
  104. 104.
    Robey RR. A meta-analysis of clinical outcomes in the treatment of aphasia. J Speech Lang Hear Res. 1998 Feb; 41(1): 172–87PubMedGoogle Scholar
  105. 105.
    Robey RR, Schultz MC, Crawford AB, et al. Single-subject clinical-outcome research: designs, data, effect sizes, and analyses. Aphasiology 1999; 16: 445–73CrossRefGoogle Scholar
  106. 106.
    Basso A, Marangolo P. Cognitive rehabilitation: the emperor’s new clothes? Neuropsychol Rehab 2000; 10: 219–29CrossRefGoogle Scholar
  107. 107.
    Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev 2000; 2: CD000425Google Scholar
  108. 108.
    Bhogal SK, Teasell RW, Foley NC, et al. Rehabilitation of aphasia: more is better. Top Stroke Rehabil 2003 Summer; 10(2): 66–76PubMedCrossRefGoogle Scholar
  109. 109.
    Bhogal SK, Teasell R, Speechley M. Intensity of aphasia therapy, impact on recovery. Stroke 2003 Apr; 34: 987–93PubMedCrossRefGoogle Scholar
  110. 110.
    Holland AL, Fromm DS, DeRuyter F, et al. Treatment efficacy: aphasia. J Speech Hear Res 1996 Oct; 39: S27–36PubMedGoogle Scholar
  111. 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: 89–102CrossRefGoogle Scholar
  112. 112.
    Nickels L. Therapy for naming disorders: revisiting, revising and reviewing. Aphasiology 2002 Oct–Nov; 16: 935–79CrossRefGoogle Scholar
  113. 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): 45–60PubMedCrossRefGoogle Scholar
  114. 114.
    Pulvermüller F, Schönle PW. Behavioral and neuronal changes during treatment of mixed-transcortical aphasia: a case study. Cognition 1993; 48: 139–61PubMedCrossRefGoogle Scholar
  115. 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): 544Google Scholar
  116. 116.
    Nickels L. Improving word finding: practices makes (closer to) perfect? Aphasiology 2002; 16(10/11): 1047–60CrossRefGoogle Scholar
  117. 117.
    Franklin S, Buerk F, Howard D. Generalized improvement in speech production for a subject with reproduction conduction aphasia. Aphasiology 2002; 16(10/11): 1087–114CrossRefGoogle Scholar
  118. 118.
    Francis DR, Riddoch MJ, Humphreys GW. Cognitive rehabilitation of word meaning deafness. Aphasiology 2001; 15: 749–66CrossRefGoogle Scholar
  119. 119.
    Hinojosa J, Moreno-Torres I, Berthier ML. Multimodality therapy for word meaning deafness [abstract]. JINS 2003; 9(4): 545Google Scholar
  120. 120.
    Aftonomos LB, Steele RD, Wertz RT. Promoting recovery in chronic aphasia with an interactive technology. Arch Phys Med Rehabil. 1997 Aug; 78(8): 841–6PubMedCrossRefGoogle Scholar
  121. 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): 1061–86CrossRefGoogle Scholar
  122. 122.
    Aftonomos LB, Appelbaum JS, Steele RD. Improving outcomes for persons with aphasia in advanced community-based treatment programs. Stroke 1999 Jul; 30: 1370–9PubMedCrossRefGoogle Scholar
  123. 123.
    Schwartz MF, Fink RB, Saffran EM. The modular treatment of agrammatism. Neuropsychol Rehab 1995; 5: 93–127CrossRefGoogle Scholar
  124. 124.
    Albert ML, Bachman D, Morgan A, et al. Pharmacotherapy of aphasia. Neurology 1988; 38: 877–9PubMedCrossRefGoogle Scholar
  125. 125.
    Bachman D, Morgan A. The role of pharmacotherapy in the treatment of aphasia: preliminary results. Aphasiology 1988; 2: 225–8CrossRefGoogle Scholar
  126. 126.
    Small SL. A biological model of aphasia rehabilitation: pharmacological perspectives. Aphasiology 2004; 18(5/6/7): 473–92CrossRefGoogle Scholar
  127. 127.
    Shisler RJ, Baylis GC, Frank EM. Pharmacological approaches to the treatment and prevention of aphasia. Aphasiology 2000 Dec; 14(12): 1163–86CrossRefGoogle Scholar
  128. 128.
    Bakheit AMO. Drug treatment of post-stroke aphasia. Exp Rev Neurotherap 2004; 4(2): 211–7CrossRefGoogle Scholar
  129. 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): 497–511Google Scholar
  130. 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: 149–64PubMedCrossRefGoogle Scholar
  131. 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: 109–34Google Scholar
  132. 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): 320–31PubMedCrossRefGoogle Scholar
  133. 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: 245–50PubMedCrossRefGoogle Scholar
  134. 134.
    De Dyen P, De Reuck JD, Orgogozo J-M, et al. Treatment of acute ischaemic stroke with piracetam. Stroke 1997 Dec; 28: 2347–52CrossRefGoogle Scholar
  135. 135.
    Orgogozo J-M. Piracetam in the treatment of acute stroke. Pharmacopsychiat 1999 Mar; 32: Suppl 1 25–32CrossRefGoogle Scholar
  136. 136.
    Greener J, Enderby P, Whurr R. Pharmacological treatment for aphasia following stroke. The Cochrane Database of Syst Rev 2001 (4): CD000424Google Scholar
  137. 137.
    Flanagan SR. Psychostimulant treatment of stroke and brain injury. CNS Spectrums 2000; 5: 59–69PubMedGoogle Scholar
  138. 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: 1991Google Scholar
  139. 139.
    Sabe L, Leiguarda R, Starkstein S. An open-label trial of bromocriptine in nonfluent aphasia. Neurology 1992; 42: 1637–8PubMedCrossRefGoogle Scholar
  140. 140.
    Gupta S, Mlcoch A. Bromocriptine treatment of nonfluent aphasia. Arch Phys Med Rehabil 1992; 73: 373–6PubMedCrossRefGoogle Scholar
  141. 141.
    Sabe L, Salvarezza F, Cuerva AG, et al. A randomized, double-blind, placebo controlled study of bromocriptine in nonfluent aphasia. Neurology 1995; 45: 2272–4PubMedCrossRefGoogle Scholar
  142. 142.
    Ozeren A, Sarica Y, Mavi H, et al. Bromocriptine is ineffective in the treatment of chronic nonfluent aphasia. Acta Neurologica Belgium 1995; 95: 235–8Google Scholar
  143. 143.
    Gupta S, Mlcoch A, Scolaro C, et al. Bromocriptine treatment of nonfluent aphasia. Neurology 1995; 45: 2170–3PubMedCrossRefGoogle Scholar
  144. 144.
    Bragoni M, Altieri M, Di Piero V, et al. Bromocriptine and speech therapy in nonfluent aphasia after stroke. Neurol Sci. 2000 Feb; 21: 19–22PubMedCrossRefGoogle Scholar
  145. 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: 141–56PubMedCrossRefGoogle Scholar
  146. 146.
    Hughes JD, Jacobs DH, Heilman KM. Neuropharmacology and linguistic neuroplasticity. Brain Lang 2000; 71: 96–101PubMedCrossRefGoogle Scholar
  147. 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: 139–44PubMedCrossRefGoogle Scholar
  148. 148.
    Fleet WS, Valenstein E, Watson RJ, et al. Dopamine agonist therapy for neglect in humans. Neurology 1987 Nov; 37: 1765–70PubMedCrossRefGoogle Scholar
  149. 149.
    Grujic Z, Mapstone M, Gitelman DR, et al. Dopamine agonists reorient visual exploration away from the neglected hemispace. Neurology 1998 Nov; 51: 1395–8PubMedCrossRefGoogle Scholar
  150. 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: 416–21PubMedCrossRefGoogle Scholar
  151. 151.
    Leiguarda R, Merello M, Sabe L, et al. Bromocriptine-induced dystonia in patients with aphasia and hemiparesis. Neurology 1993; 43: 2319–22PubMedCrossRefGoogle Scholar
  152. 152.
    Raymer AM. Treatment of adynamia in aphasia. Front Biosci 2003 Sep; 8: s845–51PubMedCrossRefGoogle Scholar
  153. 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: 52Google Scholar
  154. 154.
    Martinsson L, Eksborg S. Drugs for stroke recovery: the example of amphetamine. Drugs Aging 2004; 21(2): 67–79PubMedCrossRefGoogle Scholar
  155. 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: 2254–9PubMedCrossRefGoogle Scholar
  156. 156.
    Bütefisch CM, Davis BC, Sawaki L, et al. Modulation of use-dependent plasticity by d-amphetamine. Ann Neurol 2002; 51: 59–68PubMedCrossRefGoogle Scholar
  157. 157.
    Walker-Batson D, Unwin H, Curtis S, et al. Use of amphetamine in the treatment of aphasia. Restorative Neurol Neurosci 1992; 4: 47–50Google Scholar
  158. 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): 385–400CrossRefGoogle Scholar
  159. 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: 440–2CrossRefGoogle Scholar
  160. 160.
    Winkler J, Suhr ST, Gage FH, et al. Essential role of neocortical acethylcholine in spatial memory. Nature 1995; 375: 484–7PubMedCrossRefGoogle Scholar
  161. 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: 2249–57PubMedCrossRefGoogle Scholar
  162. 162.
    Baskerville KA, Schweitzer JB, Herron P. Effects of cholinergic depletion on experience-dependent plasticity in the cortex of the rat. Neuroscience 1997; 80: 1159–69PubMedCrossRefGoogle Scholar
  163. 163.
    Mesulam MM. From sensation to cognition. Brain 1998 Jun; 121: 1013–52PubMedCrossRefGoogle Scholar
  164. 164.
    Mendez MF, Younesi FL, Perryman KM. Use of donepezil for vascular dementia: preliminary clinical experience. J Neuropsychiatry Clin Neurosci 1999; 11: 268–70PubMedGoogle Scholar
  165. 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, 219Google Scholar
  166. 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–A142Google Scholar
  167. 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: 2323–30PubMedCrossRefGoogle Scholar
  168. 168.
    Tanaka Y, Miyazaki M, Albert ML. Effect of increased cholinergic activity on naming in aphasia. Lancet 1997; 350: 116–7PubMedCrossRefGoogle Scholar
  169. 169.
    Mesulam M, Siddique T, Cohen B. Cholinergic denervation in a pure multi-infarct state: observations on CADASIL. Neurology 2003; 60: 1183–5PubMedCrossRefGoogle Scholar
  170. 170.
    Birks JS, Melzer D, Beppu H. Donepezil for mild and moderate Alzheimer’s disease (Cochrane review). Cochrane Database Syst Rev 2000; (4): CD001190Google Scholar
  171. 171.
    Smith Doody R. Update on Alzheimer drugs (donepezil). Neurology 2003 Sep; 9: 225–9CrossRefGoogle Scholar
  172. 172.
    Defilippi JL, Crismon ML. Drug interactions with cholinesterase inhibitors. Drugs Aging 2003; 20(6): 437–44PubMedCrossRefGoogle Scholar
  173. 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: 17–26PubMedCrossRefGoogle Scholar
  174. 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): 57–63PubMedCrossRefGoogle Scholar
  175. 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: 140Google Scholar
  176. 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: 542Google Scholar
  177. 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): 725–9CrossRefGoogle Scholar
  178. 178.
    Valle F, Cuetos F. EPLA: evaluación del procesamiento lingüístico en la afasia. Hove: Lawrence Erlbaum Associates Ltd, 1995Google Scholar

Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Marcelo L. Berthier
    • 1
  1. 1.Centro de Investigaciones Médico-Sanitarias (CIMES)University of MalagaMalagaSpain

Personalised recommendations