Kessler J, Thiel A, Karbe H, Heiss W D
Max-Planck-Institute for Neurological Research, Cologne, Germany.
Stroke. 2000 Sep;31(9):2112-6. doi: 10.1161/01.str.31.9.2112.
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.
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.
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 (P:<0.05) 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.
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.
在一项前瞻性、双盲、安慰剂对照研究中，研究了吡拉西坦是否能通过神经心理学测试和正电子发射断层扫描（PET）测量脑血流来改善中风后失语症患者的语言恢复情况。
24例中风失语患者被随机分为两组：12例患者每日两次服用2400毫克吡拉西坦，12例服用安慰剂。在为期6周的治疗期内，两组患者均接受强化言语治疗，治疗前及治疗结束时，对患者进行神经心理学检查，并在静息状态及进行单词重复任务激活时用H(2)(15)O PET进行研究。在与PET图像配准的MRI重建表面视图上定义的14个语言激活脑区分析血流情况。
治疗前，两组在语言任务表现、失语症类型和严重程度方面具有可比性。与初始测量相比，吡拉西坦组在治疗期后左侧颞横回、左侧额下回三角部和左侧颞上回后部的激活效应增加显著更高（P<0.05）。安慰剂组仅在左侧发声区显示激活效应增加。在测试组中，吡拉西坦组6种语言功能有所改善，安慰剂组仅在3个亚测试中有所改善。
吡拉西坦作为言语治疗的辅助药物可改善多种语言功能的恢复，且这种效应伴随着左半球明确区域与任务相关的血流激活显著增加。
