New approach to the rehabilitation of post-stroke focal cognitive syndrome: Effect of levodopa combined with speech and language therapy on functional recovery from aphasia

Seniów, Joanna; Litwin, M.; Litwin, Tomasz; Leśniak, Marcin; Członkowska, Anna

doi:10.1016/j.jns.2009.02.336

Cited by 66 publications

(53 citation statements)

References 25 publications

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“…Two clinical trials have been performed with divergent outcomes. A randomized double-blind, placebo-controlled study showed that a single dose of levodopa (100 mg) preceding every session of language training improved verbal fluency and repetition better than placebo, a benefit that was most robust in patients with frontal lobe lesions (Seniów et al 2009). By contrast, negative results were reported in a double-blind, placebo-controlled multiple case study with intrasubject crossover design (Leemann et al 2010).…”

Section: Catecholaminergic Drugsmentioning

confidence: 99%

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 Drugsmentioning

confidence: 99%

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

et al. 2011

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“…Studies that showed a significant effect of MPH and LD on mood and cognition recruited patients early after stroke onset, i.e. 3–40 days after the stroke, while in our study patients entered the trial on average 65.6 days after stroke onset [11,41,42]. Nevertheless, the studies up to now are limited in a number of ways, and definitive conclusions cannot yet be drawn.…”

Section: Discussionmentioning

confidence: 90%

Effect of Methylphenidate and/or Levodopa Combined with Physiotherapy on Mood and Cognition after Stroke: A Randomized, Double-Blind, Placebo-Controlled Trial

Delbari¹,

Roghani

Lökk

2011

Eur Neurol

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Background/Aim: Stimulant medications can enhance mood and cognition in stroke rehabilitation, but human clinical trial results are inconclusive. We sought to prospectively study the effects of levodopa (LD) and/or methylphenidate (MPH) in combination with physiotherapy on mood and cognition following stroke in human subjects. Methods: Ischemic stroke patients were enrolled in our study 15 to 180 days after stroke onset. The patients were randomized into four medication groups (MPH, LD, MPH + LD, or placebo) and received a 15-day course of medication therapy (1 dose daily) and 45-min standard physiotherapy treatment daily. Mood and cognitive function were assessed at the study onset and 15, 90 and 180 days after study enrollment. Results: The strongest improvement of mood and cognition was found between baseline and the first follow-up immediately after the intervention. A significant improvement in mood was also found in the combined treatment group (MPH + LD) at 90 and 180 days, compared to the placebo group. Conclusions: A 15-day course of daily MPH + LD combined with physiotherapy over a 3-week period was safe and significantly improved mood status in ischemic stroke patients. Future studies are needed which determine the optimal therapeutic window for and dosage of psychostimulants as well as identify those stroke patients who might benefit the most from treatment.

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“…It has been suggested in recent studies that cognitive impairment and dementia may be reduced by satisfactory control of hypertension and by using drugs such as acetylcholinesterase inhibitors commonly used in Alzheimer's disease (donepezil, galantamine, rivastigmine) [61,62]. A step forward in the pharmaceutical approach to post-stroke cognitive impairment, mainly related to language function, luency and repetition, has been a randomized, placebo-controlled, double-blind study with levodopa which reported positive results [63].…”

Section: Cognitive Dysfunctionmentioning

confidence: 99%

Intracerebral Hemorrhage: Issues in Rehabilitation

Dadlani¹,

Agrawal²

2017

Hemorrhagic Stroke - An Update

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While the advancements in the management of the spontaneous intracerebral hemorrhage (SICH) have resulted an increase in survival, this has also resulted in the number of survivors with signiicant functional morbidity that require long-term care and rehabilitation services. SICH can lead to various impairments, and the deicits related to SICH may include impairment in motor and sensory functions, emotional labiality, language dysfunctions, perception deicits and cognitive dysfunctions. In the present chapter, we present an overview of the issues in rehabilitation which are faced by medical personnel's while managing the patients with SICH.

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New approach to the rehabilitation of post-stroke focal cognitive syndrome: Effect of levodopa combined with speech and language therapy on functional recovery from aphasia

Cited by 66 publications

References 25 publications

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

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

Effect of Methylphenidate and/or Levodopa Combined with Physiotherapy on Mood and Cognition after Stroke: A Randomized, Double-Blind, Placebo-Controlled Trial

Intracerebral Hemorrhage: Issues in Rehabilitation

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