Supporting Post-Stroke Language and Cognition with Pharmacotherapy: Tools for Each Phase of Care.
Supporting Post-Stroke Language and Cognition with Pharmacotherapy: Tools for Each Phase of Care.
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DOI：
10.1007/s11910-023-01273-3
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发表时间：
2023-06
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
--
作者：
人们对药物疗法治疗中风后出现的语言缺陷的可能性抱有极大的热情。言语语言治疗仍然是最常用和最有力的治疗方法，但患者接受必要的康复治疗的众多障碍促使了一个相对温和但被高度引用的证据体的创建，以支持使用药物治疗直接治疗中风后失语症或增加传统的中风后失语症治疗。在这篇综述中，我们调查了在卒中治疗的各个阶段中使用药物治疗来保护和支持语言和认知的情况，讨论了关键的正在进行的临床试验，并确定了未来可能成为新兴干预措施的目标。最近的试验已将重点从短期药物治疗支持治疗的慢性阶段转移到长期接近药物维持开始更尖锐。最近在超急性中风护理方面的创新，如替奈普酶、神经保护剂和血清素再摄取抑制剂的急性启动，是正在进行的研究的重要领域，它们补充了正在进行的对后期治疗的有效佐剂的研究。目前在美国还没有批准治疗失语症的药物。然而，药物干预可能对中风治疗的所有阶段都有益处。
There is enormous enthusiasm for the possibility of pharmacotherapies to treat language deficits that can arise after stroke. Speech language therapy remains the most frequently utilized and most strongly evidenced treatment, but the numerous barriers to patients receiving the therapy necessary to recover have motivated the creation of a relatively modest, yet highly cited, body of evidence to support the use of pharmacotherapy to treat post-stroke aphasia directly or to augment traditional post-stroke aphasia treatment. In this review, we survey the use of pharmacotherapy to preserve and support language and cognition in the context of stroke across phases of care, discuss key ongoing clinical trials, and identify targets that may become emerging interventions in the future. Recent trials have shifted focus from short periods of drug therapy supporting therapy in the chronic phase to longer terms approaching pharmacological maintenance beginning more acutely. Recent innovations in hyperacute stroke care, such as tenecteplase, and acute initiation of neuroprotective agents and serotonin reuptake inhibitors are important areas of ongoing research that complement the ongoing search for effective adjuvants to later therapy. Currently there are no drugs approved in the United States for the treatment of aphasia. Nevertheless, pharmacological intervention may provide a benefit to all phases of stroke care.
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Lenzi, GL
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