Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhang, Jie; Wei, Rui-Li; Chen, Zhongqin; Luo, Benyan

doi:10.1007/s40263-016-0348-1

Cited by 33 publications

(17 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Piracetam has been shown to improve impaired cognitive functions in various conditions in man and in animal models using different conditions of impaired brain function [ 18 – 23 ]. Even if its clinical efficacy is seen controversially, piracetam is still used in many countries to treat cognitive impairment in aging and dementia, following brain injuries and stroke, as well as in mild to moderate dementia [ 19 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

Enhanced Neuroplasticity by the Metabolic Enhancer Piracetam Associated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function

et al. 2016

View full text Add to dashboard Cite

The mitochondrial cascade hypothesis of dementia assumes mitochondrial dysfunction leading to reduced energy supply, impaired neuroplasticity, and finally cell death as one major pathomechanism underlying the continuum from brain aging over mild cognitive impairment to initial and advanced late onset Alzheimer's disease. Accordingly, improving mitochondrial function has become an important strategy to treat the early stages of this continuum. The metabolic enhancer piracetam has been proposed as possible prototype for those compounds by increasing impaired mitochondrial function and related aspects like mechanisms of neuroplasticity. We here report that piracetam at therapeutically relevant concentrations improves neuritogenesis in the human cell line SH-SY5Y over conditions mirroring the whole spectrum of age-associated cognitive decline. These effects go parallel with improvement of impaired mitochondrial dynamics shifting back fission and fusion balance to the energetically more favorable fusion site. Impaired fission and fusion balance can also be induced by a reduction of the mitochondrial permeability transition pore (mPTP) function as atractyloside which indicates the mPTP has similar effects on mitochondrial dynamics. These changes are also reduced by piracetam. These findings suggest the mPTP as an important target for the beneficial effects of piracetam on mitochondrial function.

show abstract

Section: Introductionmentioning

confidence: 99%

Enhanced Neuroplasticity by the Metabolic Enhancer Piracetam Associated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function

et al. 2016

View full text Add to dashboard Cite

show abstract

“…6 If stroke happens at the left side of the brain, the right side of the body has hemiparesis. These patients may have difficulty in talking and understanding (Aphasia), 7 and also difficulty in determining left from right. While if stroke happens at the right side of the brain, the left side of the body has hemiparesis.…”

mentioning

confidence: 99%

Functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis

Bindawas

Mawajdeh

Vennu

et al. 2017

NSJ

View full text Add to dashboard Cite

Objective:To examine the functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis.Methods:In this retrospective study, we included data from the medical record of all 383 patients with uni- or bilateral hemiparesis after stroke who were admitted to King Fahad Medical City-Rehabilitation Hospital between 2008 and 2014 in Riyadh, Kingdom of Saudi Arabia. According to the site of hemiparesis, we classified patients into 3 groups: right hemiparesis (n=208), left hemiparesis (n=157), and bilateral hemipareses (n=18). The patients (n=49) who did not have either site of hemiparesis were excluded. The Functional Independence Measures (FIM) instrument was used to assess the score at admission and discharge. A post hoc test was conducted to examine the functional recovery differences between groups. Multiple regression analyses were used to confirm the findings.Results:Amongst the three groups, there were significant (p<0.05) differences in the total-FIM score as well as motor- and cognitive-FIM sub-scores between admission and discharge of stroke rehabilitation. The differences were significantly greater in the bilateral hemipareses group than in either unilateral hemiparesis group. Multiple regression analyses also confirmed that the site of hemiparesis significantly (p<0.05) differs in the total-FIM score as well as motor-FIM and cognitive-FIM sub-scores.Conclusion:Our results demonstrate that differences in functional recovery after stroke rehabilitation may be influenced by the site of hemiparesis after stroke.

show abstract

“…However, despite not reaching statistical significance, the difference in death rate between groups does give rise to some concerns that there may be an increased risk of death from taking Piracetam. A further review and meta-analysis of Piracetam was conducted by Zhang et al (2016) showing no overall improvement in aphasia severity but pronounced improvement in written language (SMD: 0.35 (0.04 to 0.66); 7 trials, 261 participants). Recommendation: On the whole, drugs cannot yet be recommended to augment the effects of behavioural therapy for aphasia.…”

Section: Pharmacological Treatmentsmentioning

confidence: 99%

Rehabilitation of Communication Disorders

Palmer

Pauranik

2021

Clinical Pathways in Stroke Rehabilitation

View full text Add to dashboard Cite

Speech, communication and language disorders are many and heterogeneous. The modalities of communication affected include spoken understanding and expression, reading, writing and gesture. The three predominant speech and language disorders that can be acquired post-stroke are as follows: AphasiaAphasia is a language disorder affecting understanding of spoken language; the ability to express thoughts verbally, including difficulties with word retrieval (anomia), and sentence production; the ability to read and understand written words and sentences and the ability to write including spelling and structuring written sentences. These difficulties result from damage to the left side of the brain in the majority of people. The extent of impairment to each of the four language domains varies from person to person depending on the locations and extent of neurological damage. Flowers et al. (2013) estimated the incidence of aphasia post-stroke to be 30%. DysarthriaDysarthria is a motor speech disorder resulting from impaired movement of the muscles used for the production of speech. The main parameters of speech are respiration, phonation, resonance, articulation and prosody. One or more of these parameters can be affected leading to reduced speech intelligibility and reduced communication effectiveness. These parameters can be impaired in different ways (for example muscles may be more or less paretic, become hypotonic or hypertonic), and they may each be impaired to different extents. This results in different dysarthria profiles (e.g. Darley et al. 1975). Flowers et al. ( 2013) estimated the incidence of dysarthria post-stroke to be 42%. ApraxiaApraxia of speech (AOS), also known as verbal apraxia or dyspraxia, is also a motor speech disorder. AOS results from a reduction in the ability to co-ordinate the gestures required for speech leading to difficulty producing the right sounds in the right order when speaking. It is characterised by multiple different attempts to articulate words accurately. AOS can occur in isolation, but frequently coincides with expressive aphasia. AOS is acquired with lower frequency following stroke than aphasia or dysarthria.Aphasia, dysarthria and apraxia are not mutually exclusive, and more than one speech and language disorder may need to be treated.Communication impairments affect everyday activity, for example the ability to have conversations, make phone calls, listen to the radio, write letters, construct emails and text messages and read for pleasure, for information or for work. They may also affect the use of sign language for people in the deaf community. In turn, they restrict participation: the ability to carry out pre-stroke employment, loss of roles within the family and community and withdrawal from participating in usual activities both outside of and within the family. These changes affect the wellbeing of both the person with a communication disability and their family/carer with increased frustration, misunderstandings and breakdown/strain on relationships. For the care...

show abstract

Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract: Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials. Its effect on overall linguistic level and written language tends to emerge within a short period and declines thereafter.

Cited by 33 publications

References 40 publications

Enhanced Neuroplasticity by the Metabolic Enhancer Piracetam Associated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function

Enhanced Neuroplasticity by the Metabolic Enhancer Piracetam Associated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function

Functional recovery differences after stroke rehabilitation in patients with uni- or bilateral hemiparesis

Rehabilitation of Communication Disorders

Contact Info

Product

Resources

About