Pharmacotherapy of aphasia. A critical review.
Pharmacotherapy of aphasia. A critical review.
复制标题
失语症的药物治疗。
DOI：
10.1161/01.str.25.6.1282
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发表时间：
1994
期刊：
影响因子：
8.3
通讯作者：
Small,SL
中科院分区：
文献类型：
--
作者：
Small,SL
沟通障碍是脑血管疾病和其他中枢神经系统疾病的常见后遗症。这些疾病的行为治疗旨在利用大脑未受伤的部分来改善个人的交流生活。虽然药物治疗已经承诺治疗失语症超过50年，但它并没有实现这一承诺。本文回顾了失语症药物治疗的前景和失望。失语症潜在的神经功能缺损的不同理论导致了不同的治疗药理学原理。动物研究表明，皮质卒中后脑儿茶酚胺水平降低，旨在增加脑去甲肾上腺素和多巴胺的治疗可使卒中恢复更快。这些研究导致最近尝试通过给予儿茶酚胺能药物来加速或延长人类中风后的语言和感觉运动康复。当作为行为疗法的辅助治疗时，这种药物疗法似乎有好处，虽然药物疗法不太可能彻底改变失语症的治疗，但它仍然有望作为行为言语和语言疗法的辅助治疗，以减少表现变异性，从而改善轻度至中度语言功能障碍患者的平均表现。有必要用精心设计的方法进行额外的研究，以评估失语症药物治疗的全部潜力。
Communication problems are a common sequela of cerebrovascular disease and other central nervous system disorders. Behavioral treatment of these disorders aims to harness uninjured parts of the brain to improve the communicative life of the individual. While pharmacotherapy has held promise for the treatment of aphasia for over 50 years, it has not fulfilled this promise. This article reviews both the promise and the disappointment of aphasia pharmacotherapy.Diverse theories of the underlying neurological deficits in aphasia have led to different pharmacologic rationales for therapy. Animal studies have demonstrated decreased levels of brain catecholamines after cortical stroke and more rapid stroke recovery with therapy aimed at augmenting brain norepinephrine and dopamine. These studies have led to recent attempts to hasten or extend language and sensorimotor rehabilitation after human stroke by administration of catecholaminergic drugs. When used as an adjunct to behavioral therapy, such pharmacotherapy appears to have benefit.While drug therapy is unlikely to revolutionize the treatment of aphasia, it nonetheless holds promise as an adjunct to behavioral speech and language therapy to decrease performance variability and consequently to improve mean performance in patients with mild to moderate language dysfunction. Additional studies with carefully designed methods are necessary to assess the full potential of aphasia pharmacotherapy.