A biological model of aphasia rehabilitation: Pharmacological perspectives

Small, Steven L.

doi:10.1080/02687030444000156

Cited by 21 publications

(18 citation statements)

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“…Conventional speech and language therapy is expensive and timeconsuming, and pharmaceutical adjuncts to therapy to increase effectiveness or efficiency of rehabilitation are desirable. For example, medications to replace or augment depleted neurotransmitters required for synaptic plasticity (which presumably underlies learning and neural reorganization) might improve response to language therapy [22][23][24]. Putting these ideas into effective clinical practice has been more difficult.…”

Section: Aphasia Treatmentmentioning

confidence: 99%

Aphasia and right hemisphere syndromes in stroke

Jordan¹,

Hillis

2005

Curr Neurol Neurosci Rep

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This article highlights the latest findings regarding the effect of acute and chronic stroke on behavior, specifically left hemispheric injury causing aphasia and right hemispheric injury causing neglect, visual-spatial problems, and other cognitive syndromes. We review papers published in the past 2 years pertaining to localization, assessment, recovery, treatment, and outcomes of aphasia and right hemisphere cognitive syndromes following stroke.

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Section: Aphasia Treatmentmentioning

confidence: 99%

Aphasia and right hemisphere syndromes in stroke

Jordan¹,

Hillis

2005

Curr Neurol Neurosci Rep

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“…Although this recovery is accompanied by changes in brain physiology, basic neurobiology has not yet had significant impact on clinical practice, and rehabilitation measures for persons with aphasia remain rooted in educational rather than biological models (Small, 2004a). In this article, we outline a therapeutic approach, based on basic principles from neurophysiology, that we believe can play an important role in the treatment of aphasia.…”

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confidence: 99%

IMITATE: An intensive computer-based treatment for aphasia based on action observation and imitation

et al. 2009

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Background-Neurophysiological evidence from primates has demonstrated the presence of mirror neurons, with visual and motor properties, that discharge both when an action is performed and during observation of the same action. A similar system for observation-execution matching may also exist in humans. We postulate that behavioral stimulation of this parietal-frontal system may play an important role in motor learning for speech and thereby aid language recovery after stroke.

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“…For example, Small(2002, 2004) has advocated for a biological model of aphasia rehabilitation in which the goal of remediation is to alter brain anatomy and physiology so that language function can be restored. Importantly, the efficacy of biological interventions seems to depend on the presence of concomitant behavioral training.…”

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confidence: 99%

Epidural cortical stimulation and aphasia therapy

et al. 2012

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Background There are several methods of delivering cortical brain stimulation to modulate cortical excitability and interest in their application as an adjuvant strategy in aphasia rehabilitation after stroke is growing. Epidural cortical stimulation, although more invasive than other methods, permits high frequency stimulation of high spatial specificity to targeted neuronal populations. Aims First, we review evidence supporting the use of epidural cortical stimulation for upper limb recovery after focal cortical injury in both animal models and human stroke survivors. These data provide the empirical and theoretical platform underlying the use of epidural cortical stimulation in aphasia. Second, we summarize evidence for the application of epidural cortical stimulation in aphasia. We describe the procedures and primary outcomes of a safety and feasibility study (Cherney, Erickson & Small, 2010), and provide previously unpublished data regarding secondary behavioral outcomes from that study. Main Contribution In a controlled study comparing epidural cortical stimulation plus language treatment (CS/LT) to language treatment alone (LT), eight stroke survivors with nonfluent aphasia received intensive language therapy for 6 weeks. Four of these participants also underwent surgical implantation of an epidural stimulation device which was activated only during therapy sessions. Behavioral data were collected before treatment, immediately after treatment, and at 6 and 12 weeks following the end of treatment. The effect size for the primary outcome measure, the Western Aphasia Battery Aphasia Quotient, was benchmarked as moderate from baseline to immediately post-treatment, and large from baseline to the 12-week follow-up. Similarly, effect sizes obtained at the 12-week follow-up for the Boston Naming Test, the Communicative Effectiveness Index, and for correct information units on a picture description task were greater than those obtained immediately post treatment. When effect sizes were compared for individual subject pairs on discourse measures of content and rate, effects were typically larger for the investigational subjects receiving CS/LT than for the control subjects receiving LT alone. These analyses support previous findings regarding therapeutic efficacy of CS/LT compared to LT i.e. epidural stimulation of ipsilesional premotor cortex may augment behavioral speech-language therapy, with the largest effects after completion of therapy. Conclusions Continued investigation of epidural cortical stimulation in combination with language training in post-stroke aphasia should proceed cautiously. Carefully planned studies that customize procedures to individual profiles are warranted. Information from research on non-invasive methods of CS/LT may also inform future studies of epidural cortical stimulation.

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A biological model of aphasia rehabilitation: Pharmacological perspectives

Cited by 21 publications

References 0 publications

Aphasia and right hemisphere syndromes in stroke

Aphasia and right hemisphere syndromes in stroke

IMITATE: An intensive computer-based treatment for aphasia based on action observation and imitation

Epidural cortical stimulation and aphasia therapy

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