Recovery from Aphasia and Neglect

Ferro, José M.; Mariano, Gabriela; Madureira, Sofia

doi:10.1159/000047571

Cited by 79 publications

(49 citation statements)

References 175 publications

(238 reference statements)

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“…29 Whereas the effect of physiotherapy for the improvement of sensorimotor deficits is unchallenged, the efficacy of speech therapy is still controversial, with several randomized controlled trials yielding no difference in outcome between treated and nontreated groups. 7 Therefore, many trials were undertaken to enhance recovery from aphasia with use of pharmacological agents. 30 -32 In this context, amphetamines were applied for enhancing vigilance by increased noradrenaline levels in the brain, bromocriptine for the selective action of dopamine on language output, 33 and cholinergic substances for the effect on naming.…”

Section: Discussionmentioning

confidence: 99%

“…Positive effects observed in a few cases with various drugs acting by diverging mechanisms [1][2][3][4][5] could usually not be replicated in large clinical trials. 6,7 Piracetam, a ␥-aminobutyric acid derivative with a potential effect on cognitive and mnestic functions, 8 was repeatedly used in the treatment of aphasia: In small placebo-controlled trials, 4.8 g piracetam daily over 6 to 12 weeks improved the performance in subtests of the Aachen Aphasia Test, 9 -11 but the mechanism by which piracetam enhances recovery from aphasia remained a matter of speculation. Because infarcted tissue cannot regenerate, recovery from poststroke aphasia must involve regions outside the morphologically damaged area that regain or take over language functions lost in acute stroke.…”

mentioning

confidence: 99%

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Piracetam Improves Activated Blood Flow and Facilitates Rehabilitation of Poststroke Aphasic Patients

Kessler

Thiel

Karbe

et al. 2000

Stroke

164

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Background and Purpose-In a prospective, double-blind, placebo-controlled study, it was investigated whether piracetam improves language recovery in poststroke aphasia assessed by neuropsychological tests and activation PET measurement of cerebral blood flow. Methods-Twenty-four stroke patients with aphasia were randomly allocated to 2 groups: 12 patients received 2400 mg piracetam twice daily, 12 placebo. Before and at the end of the 6-week treatment period in which both groups received intensive speech therapy, the patients were examined neuropsychologically and studied with H 2 15 O PET at rest and during activation with a word-repetition task. Blood flow was analyzed in 14 language-activated brain regions defined on reconstructed surface views from MRI coregistered to the PET images. Results-Before treatment, both groups were comparable with respect to performance in language tasks and to type and severity of aphasia. In the piracetam group, increase of activation effect was significantly higher (PϽ0.05) in the left transverse temporal gyrus, left triangular part of inferior frontal gyrus, and left posterior superior temporal gyrus after the treatment period compared with the initial measures. The placebo group showed an increase of activation effect only in the left vocalization area. In the test battery, the piracetam group improved in 6 language functions, the placebo group only in 3 subtests. Conclusions-Piracetam as an adjuvant to speech therapy improves recovery of various language functions, and this effect is accompanied by a significant increase of task-related flow activation in eloquent areas of the left hemisphere. (Stroke.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Piracetam Improves Activated Blood Flow and Facilitates Rehabilitation of Poststroke Aphasic Patients

Kessler

Thiel

Karbe

et al. 2000

Stroke

164

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“…17 It was performed at an early stage of stroke (mean, 20.6 days after onset; range, 10 -30 days) and approximately 6 months after onset (mean follow-up period, 171.5 days after onset; range, 93-354 days; 93-180 days, 14 patients; 180 -270 days, 9 patients; 270 -354 days, 2 patients) because most recovery has been known to be achieved during the first 3-6 months after onset. [18][19][20][21][22] Both the reliability and validity of the K-WAB have been well established previously.…”

Section: Language Evaluationmentioning

confidence: 99%

Prediction of Aphasia Outcome Using Diffusion Tensor Tractography for Arcuate Fasciculus in Stroke

Kim

Jang

2012

AJNR Am J Neuroradiol

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“…The presence of neglect has been connected with poor functional recovery and difficulties in activities of daily living (ADL) [6,7,8,9], although controversial findings about the independent effect of neglect on poor functional outcome have been presented [3, 10]. Neglect may recover spontaneously, itsrecovery may be partial, or it may show brief remission periods [11,12,13,14,15]. Some studies suggest that visual neglect resolves within 2 months after onset [13, 16] or between 3 and 6 months after onset [6, 14, 17, 18], while others report that it may persist from 1 year up to several years [8, 19, 20].…”

Section: Introductionmentioning

confidence: 99%

Fluctuation in Spontaneous Recovery of Left Visual Neglect: A 1-Year Follow-Up

et al. 2007

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Spontaneous recovery and possible fluctuation in left visual neglect, and its relation to stroke severity, basic activities of daily living (ADL) and extended ADL were examined at 10 days, at 3, 6, and 12 months after onset. Twenty-one of 56 right hemisphere stroke patients had visual neglect. Three visual neglect recovery groups were identified: continuous, fluctuating and poor recovery. We concentrated on the comparison of the continuous and the fluctuating recovery groups. At the acute phase the fluctuating recovery group had larger infarcts, more severe neglect and stroke, and a lower level of basic ADL compared to the continuous recovery group. In the continuous recovery group stable recovery was detected up to 6 months, whereas in the fluctuating recovery group recovery was incoherent in neglect and in extended ADL. A minimum follow-up period of 6 months including the evaluation of extended ADL is recommended for neglect patients due to possible fluctuation in visual neglect.

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Recovery from Aphasia and Neglect

Cited by 79 publications

References 175 publications

Piracetam Improves Activated Blood Flow and Facilitates Rehabilitation of Poststroke Aphasic Patients

Piracetam Improves Activated Blood Flow and Facilitates Rehabilitation of Poststroke Aphasic Patients

Prediction of Aphasia Outcome Using Diffusion Tensor Tractography for Arcuate Fasciculus in Stroke

Fluctuation in Spontaneous Recovery of Left Visual Neglect: A 1-Year Follow-Up

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