1 Charité Universitätsmedizin Berlin, Department of Psychiatry, Berlin, Germany.
2 Charité Universitätsmedizin Berlin, Department of Neurology, Berlin, Germany.
Neurorehabil Neural Repair. 2017 Dec;31(12):1053-1062. doi: 10.1177/1545968317744275. Epub 2017 Dec 1.
Patients with brain lesions and resultant chronic aphasia frequently suffer from depression. However, no effective interventions are available to target neuropsychiatric symptoms in patients with aphasia who have severe language and communication deficits.
The present study aimed to investigate the efficacy of 2 different methods of speech and language therapy in reducing symptoms of depression in aphasia on the Beck Depression Inventory (BDI) using secondary analysis (BILAT-1 trial).
In a crossover randomized controlled trial, 18 participants with chronic nonfluent aphasia following left-hemispheric brain lesions were assigned to 2 consecutive treatments: (1) intensive language-action therapy (ILAT), emphasizing communicative language use in social interaction, and (2) intensive naming therapy (INT), an utterance-centered standard method. Patients were randomly assigned to 2 groups, receiving both treatments in counterbalanced order. Both interventions were applied for 3.5 hours daily over a period of 6 consecutive working days. Outcome measures included depression scores on the BDI and a clinical language test (Aachen Aphasia Test).
Patients showed a significant decrease in symptoms of depression after ILAT but not after INT, which paralleled changes on clinical language tests. Treatment-induced decreases in depression scores persisted when controlling for individual changes in language performance.
Intensive training of behaviorally relevant verbal communication in social interaction might help reduce symptoms of depression in patients with chronic nonfluent aphasia.
患有脑部病变和由此导致的慢性失语症的患者经常会出现抑郁症状。然而，对于那些存在严重语言和沟通障碍的失语症患者，目前还没有有效的干预措施可以针对其神经精神症状。
本研究旨在通过二次分析（BILAT-1 试验），使用贝克抑郁量表（BDI）评估 2 种不同的言语和语言治疗方法对失语症患者抑郁症状的疗效。
在一项交叉随机对照试验中，18 名左侧大脑半球病变后出现慢性非流利性失语症的患者被分配到 2 种连续治疗方法中：（1）强化语言动作疗法（ILAT），强调在社交互动中使用交际语言；（2）强化命名疗法（INT），这是一种以话语为中心的标准方法。患者被随机分为 2 组，以平衡的方式接受这两种治疗方法。两种干预措施均每天应用 3.5 小时，持续 6 个工作日。主要结局指标包括 BDI 上的抑郁评分和临床语言测试（亚琛失语症测试）。
患者在接受 ILAT 后抑郁症状显著减轻，但在接受 INT 后没有减轻，这与临床语言测试的变化相平行。在控制个体语言表现变化的情况下，治疗引起的抑郁评分下降持续存在。
在社交互动中强化与行为相关的言语沟通训练可能有助于减轻慢性非流利性失语症患者的抑郁症状。
