中风后失语症的当前治疗方法。

Current Approaches to the Treatment of Post-Stroke Aphasia.

作者信息

Fridriksson Julius, Hillis Argye Elizabeth

机构信息

Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

J Stroke. 2021 May;23(2):183-201. doi: 10.5853/jos.2020.05015. Epub 2021 May 31.

Abstract

Aphasia, impairment of language after stroke or other neurological insult, is a common and often devastating condition that affects nearly every social activity and interaction. Behavioral speech and language therapy is the mainstay of treatment, although other interventions have been introduced to augment the effects of the behavioral therapy. In this narrative review, we discuss advances in aphasia therapy in the last 5 years and focus primarily on properly powered, randomized, controlled trials of both behavioral therapies and interventions to augment therapy for post-stroke aphasia. These trials include evaluation of behavioral therapies and computer-delivered language therapies. We also discuss outcome prediction trials as well as interventional trials that have employed noninvasive brain stimulation, or medications to augment language therapy. Supported by evidence from Phase III trials and large meta-analyses, it is now generally accepted that aphasia therapy can improve language processing for many patients. Not all patients respond similarly to aphasia therapy with the most severe patients being the least likely responders. Nevertheless, it is imperative that all patients, regardless of severity, receive aphasia management focused on direct therapy of language deficits, counseling, or both. Emerging evidence from Phase II trials suggests transcranial brain stimulation is a promising method to boost aphasia therapy outcomes.

摘要

失语症是中风或其他神经损伤后出现的语言障碍,是一种常见且往往具有破坏性的病症,几乎会影响到每一项社交活动和互动。行为言语和语言治疗是主要的治疗方法,不过也引入了其他干预措施来增强行为治疗的效果。在这篇叙述性综述中,我们讨论过去5年失语症治疗的进展,主要关注针对中风后失语症的行为治疗和增强治疗效果的干预措施的充分有力、随机对照试验。这些试验包括行为治疗和计算机辅助语言治疗的评估。我们还讨论了结果预测试验以及采用无创脑刺激或药物来增强语言治疗的干预试验。在III期试验和大型荟萃分析的证据支持下,现在人们普遍认为失语症治疗可以改善许多患者的语言处理能力。并非所有患者对失语症治疗的反应都相似,最严重的患者最不可能有反应。然而,至关重要的是,所有患者,无论严重程度如何,都应接受侧重于直接治疗语言缺陷、咨询或两者兼有的失语症管理。II期试验的新证据表明,经颅脑刺激是一种有望提高失语症治疗效果的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfde/8189855/d25b114a2f48/jos-2020-05015f1.jpg

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