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脑卒中后的语言康复。

Language recovery following stroke.

机构信息

a Department of Neurology , University of Alabama at Birmingham , Birmingham , AL, USA.

b Alzheimer's Disease Center , University of Alabama at Birmingham , Birmingham , AL, USA.

出版信息

Clin Neuropsychol. 2019 Jul;33(5):928-947. doi: 10.1080/13854046.2018.1562093. Epub 2019 Jan 30.

Abstract

To review the research literature pertaining to post-stroke language recovery, and to discuss neurocognitive assessment in patients in the context of aphasia, time course of language recovery, factors associated with language recovery, and therapeutic techniques designed to facilitate language recovery. Articles were identified through PubMed, MEDLINE, PsychINFO, and Google Scholar searches. Examples of utilized keywords include "post-stroke aphasia," "post-stroke language recovery," "post-stroke neurocognitive assessment," and "neuropsychology and aphasia." Most language recovery occurs in the first few weeks following stroke, but residual recovery may occur for many years. Although initial aphasia severity is the single largest determinant of post-stroke language recovery, a number of other variables also contribute. Several techniques have been developed to aid in the recovery process including speech-language therapy and noninvasive brain stimulation, although the effectiveness of acute and subacute treatment remains unclear. Some degree of valid neurocognitive assessment is possible in patients with aphasia, and the information gained from such an evaluation can aid the rehabilitative process Significant recovery of language function is possible following a stroke, but prediction of level of recovery in an individual patient is difficult. Information about initial aphasia severity and the integrity of cognitive domains other than language can help guide the rehabilitation team, as well as manage expectations for recovery.

摘要

回顾与脑卒中后语言恢复相关的研究文献,并讨论失语症患者的神经认知评估、语言恢复的时间进程、与语言恢复相关的因素,以及旨在促进语言恢复的治疗技术。文章通过 PubMed、MEDLINE、PsychINFO 和 Google Scholar 检索确定。所使用的关键词示例包括“脑卒中后失语症”、“脑卒中后语言恢复”、“脑卒中后神经认知评估”和“神经心理学和失语症”。大多数语言恢复发生在脑卒中后最初几周,但多年后仍可能有残余恢复。尽管初始失语症严重程度是脑卒中后语言恢复的最大决定因素,但还有许多其他变量也有影响。已经开发了几种技术来辅助恢复过程,包括言语语言治疗和非侵入性脑刺激,但急性和亚急性治疗的效果仍不清楚。失语症患者进行某种程度的有效神经认知评估是可能的,并且从这种评估中获得的信息可以辅助康复过程。脑卒中后语言功能有显著恢复的可能,但预测个体患者的恢复程度是困难的。有关初始失语症严重程度和语言以外的认知领域完整性的信息有助于指导康复团队,以及管理对恢复的期望。

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