Combined Dextroamphetamine and Transcranial Direct Current Stimulation in Poststroke Aphasia
Combined Dextroamphetamine and Transcranial Direct Current Stimulation in Poststroke Aphasia
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DOI：
10.1097/phm.0000000000000780
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发表时间：
2017-10-01
影响因子：
3
通讯作者：
Francisco, Gerard E.
中科院分区：
文献类型：
--
作者：
Keser, Zafer;Dehgan, Michelle Weber;Francisco, Gerard E.
人们越来越需要各种有效的辅助治疗方案来恢复中风后的语言功能。药物结合非侵入性脑刺激治疗中风后失语症的报道尚未见报道。在这项“概念验证”研究中，我们旨在测试由右旋苯丙胺、经颅直流电刺激以及言语和语言治疗组成的联合干预在非流利性失语症患者中的安全性。10名患有慢性非流利性失语的受试者接受了两个实验，分别在两天内接受右旋安非他明或安慰剂、经颅直流电刺激以及言语和语言治疗。修订的西方失语症成套测验被用来监测言语表现的变化。未观察到严重不良反应。服用安非他明后，血压没有明显升高，言语和语言能力也没有明显下降。西方失语症成套测验--修订后的失语商和语商在积极实验中有统计学意义的提高。主动实验与安慰剂实验失语商和语商的比例变化比较，差异有统计学意义。我们的研究表明，三联疗法是安全可行的，而且似乎对中风所致的慢性非流利性失语患者的言语和语言能力有积极的影响。
There is a growing need for various effective adjunctive treatment options for speech recovery after stroke. A pharmacological agent combined with noninvasive brain stimulation has not been previously reported for poststroke aphasia recovery. In this "proof of concept" study, we aimed to test the safety of a combined intervention consisting of dextroamphetamine, transcranial direct current stimulation, and speech and language therapy in subjects with nonfluent aphasia. Ten subjects with chronic nonfluent aphasia underwent two experiments where they received dextroamphetamine or placebo along with transcranial direct current stimulation and speech and language therapy on two separate days. The Western Aphasia Battery-Revised was used to monitor changes in speech performance. No serious adverse events were observed. There was no significant increase in blood pressure with amphetamine or deterioration in speech and language performance. Western Aphasia Battery-Revised aphasia quotient and language quotient showed a statistically significant increase in the active experiment. Comparison of proportional changes of aphasia quotient and language quotient in active experiment with those in placebo experiment showed significant difference. We showed that the triple combination therapy is safe and implementable and seems to induce positive changes in speech and language performance in the patients with chronic nonfluent aphasia due to stroke.