Pharmacological approaches to the treatment and prevention of aphasia

Shisler, Rebecca J.; Baylis, Gordon C.; Frank, Elaine M.

doi:10.1080/02687030050205705

Cited by 15 publications

(12 citation statements)

References 102 publications

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“…Third, a further limitation of the above-mentioned trials is that pharmacological interventions were unpaired to SLT (but see Bragoni et al 2000), and thus not promoting activity-dependent plasticity in dopaminergic circuits. These negative outcomes in aphasia treatment with drug delivery alone are consistent with the notion that pharmacological interventions may be more effective when administered in conjunction with behavioral therapy tailored to target specific language deficits (Shisler et al 2000;Lee and Hillis 2008). Therefore, further studies combining bromocriptine with intensive SLT in well-selected populations are warranted.…”

Section: Catecholaminergic Drugssupporting

confidence: 75%

Drug Therapy of Post-Stroke Aphasia: A Review of Current Evidence

et al. 2011

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This review considers the role of drug therapy in the treatment of post-stroke aphasia, the evidence for efficacy of different agents, and the theory-based explanations of drug-related benefits for aphasia rehabilitation. Pharmacological interventions modulating stroke-induced disruption of diverse neurotransmitters may improve language and communication deficits in aphasic patients through facilitation of brain plasticity and long-term potentiation. However, benefits are not evident for all compounds and refinement in clinical trial designs is required. Some pharmacological trials have failed because drug treatment was not combined with speech-language therapy, while other trials combining drugs with intensive model-driven therapies also failed probably because of short-trial duration, inadequate sample selection, or lack of drug action. Preliminary data reveals that combining neuroscience-based intensive aphasia techniques (constraint-induced aphasia therapy) and drugs acting on cholinergic and glutamatergic neurotransmitter systems are associated with better outcomes than other strategies and long-term maintenance of benefits. Although further studies are needed, current state of the evidence suggests that drug therapy may play a key role in the treatment of post-stroke aphasia.

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Section: Catecholaminergic Drugssupporting

confidence: 75%

Drug Therapy of Post-Stroke Aphasia: A Review of Current Evidence

et al. 2011

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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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“…These disappointing results are attributable, in part, to one or more of the methodological issues listed in the Introduction. Nonetheless, better efficacy has been reported in studies in which drug delivery was coupled with evidence-based language treatments (e.g., constraint-induced language therapy), where neuroplasticity was enhanced in behaviorally-stimulated neural networks (see also Lee & Hillis, 2008; Shisler, Baylis, & Frank, 2000). …”

Section: Pharmacotherapy Of Aphasia: Current Perspectivesmentioning

confidence: 99%

Psycholinguistics of aphasia pharmacotherapy: Asking the right questions

2013

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Background Among the obstacles to demonstrating efficacy of pharmacological intervention for aphasia is quantifying patients’ responses to treatment in a statistically valid and reliable manner. In many of the review papers on this topic (e.g., Berthier et al., 2011; de Boissezon, Peran, de Boysson, & Démonet, 2007; Small & Llano, 2009), detailed discussions of various methodological problems are highlighted, with some suggestions on how these shortcomings should be addressed. Given this deep understanding of caveats associated with the experimental design of aphasia pharmacotherapy studies (e.g., Berthier et al., 2011), investigations continue to produce inconsistent results. Aim In this review paper we suggest that inclusion of theory-driven linguistic measures in aphasia pharmacotherapy studies would add an important step toward elucidating precise patterns of improvement in language performance resulting from pharmacotherapeutic intervention. Main Contribution We provide a brief review of the clinical approaches currently used in pharmacotherapy studies of aphasia, which often lack psycholinguistic grounding. We then present ways in which psycholinguistic models can complement this approach, offering a rationale for task selection, and as a result, lead to a better understanding of treatment effects. We then follow with an example of how such an integrative approach can be implemented in studies targeting stress reduction in people with aphasia, via beta-blocking agents, as a means to augment language performance, using the psycholinguistic framework of “linguistic anxiety” outlined in Cahana-Amitay et al, 2011 as our guideline. Conclusion We conclude that the incorporation of psycholinguistic models into aphasia pharmacotherapy studies can increase the resolution with which we can identify functional changes.

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Pharmacological approaches to the treatment and prevention of aphasia

Cited by 15 publications

References 102 publications

Drug Therapy of Post-Stroke Aphasia: A Review of Current Evidence

Drug Therapy of Post-Stroke Aphasia: A Review of Current Evidence

Aphasia and right hemisphere syndromes in stroke

Psycholinguistics of aphasia pharmacotherapy: Asking the right questions

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