Basso Anna, Forbes Margaret, Boller François
Department of Neuropsychology, Milan University, Milan, Italy.
Handb Clin Neurol. 2013;110:325-34. doi: 10.1016/B978-0-444-52901-5.00027-7.
Aphasia is one of the most striking cognitive sequels of strokes and other cerebral lesions, and attempts to rehabilitate aphasic patients have been undertaken for many years. Following a brief overview of the epidemiology and the clinical characteristics of aphasia, the chapter presents the major traditional approaches to rehabilitation. They include the stimulation approach (also called classic), the behavior modification approach, Luria's approach (functional reorganization), the pragmatic approach, as well as the neurolinguistic approach. The next section illustrates some of the current approaches to aphasia rehabilitation, specifically the syndromic approach (also called neoassociationist), the cognitive neuropsychological approach, and the social approach. The chapter then provides examples of specific methods. While all intervention strategies may be classified, more or less correctly, into one or another of the above categories, it is not possible to mention the hundreds of specific interventions to be found in the literature, some of which have been described only briefly and in reference to a single case. The chapter concludes with a review of efficacy studies on aphasia therapy. Despite some opinions to the contrary, the current consensus is that sufficient experimental evidence of efficacy exists to recommend treatment of aphasia.
失语症是中风和其他脑部病变最显著的认知后遗症之一,多年来人们一直在尝试对失语症患者进行康复治疗。在简要概述失语症的流行病学和临床特征之后,本章介绍了主要的传统康复方法。这些方法包括刺激法(也称为经典法)、行为矫正法、鲁利亚法(功能重组法)、实用法以及神经语言学方法。下一节阐述了当前一些失语症康复方法,特别是综合征法(也称为新联想主义法)、认知神经心理学方法和社会方法。本章随后给出了具体方法的示例。虽然所有干预策略或多或少都能正确地归类到上述某一类别中,但文献中存在数百种具体干预措施,无法一一提及,其中一些仅在单个病例中被简要描述过。本章最后回顾了失语症治疗的疗效研究。尽管存在一些相反的观点,但目前的共识是,有足够的疗效实验证据推荐对失语症进行治疗。