Wang Yinhua, Du Wanliang, Yang Xiaona, Yan Jun, Sun Wei, Bai Jing, Zhou Jiong, Zhou Aihong, Niu Jianping, Li Chuanling, Wang Jian
Department of Neurology Peking University First Hospital Beijing China.
Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China.
Aging Med (Milton). 2021 Nov 26;4(4):325-336. doi: 10.1002/agm2.12183. eCollection 2021 Dec.
This review aimed to explore the concept, etiology, classification, classical cortical mapping, assessment, diagnosis and differential diagnosis, treatment, rehabilitation, mechanism, recovery, prognosis, and influencing factors for Chinese post-stroke aphasia (PSA). The review emphasized the necessity and significance of neuroimaging assessment of brain and blood vessels and neuropsychological assessment in diagnosis and differential diagnosis of Chinese PSA. In addition, it suggested and recommended to use "dichotomies of internal and external, and anterior and posterior" as a starting point, based on the anatomic location of brain and blood vessels and their relationship with language area and language disorder. As a result, the formulated Chinese PSA classification was more suitable to guide the clinical treatment of cerebral stroke. Diagnosis, classification, and differential diagnosis of Chinese PSA types were performed according to the "dichotomy" and "four elements." The formulated "flow diagram" enabled to determine the classification of Chinese PSA types. It was beneficial for patients to establish targeted and individualized rehabilitation training plans. This review introduced the use of memantine, piracetam, donepezil, etc. in PSA treatment, evaluated clinical studies conducted in China and abroad, investigated the mechanism of action related to the use of drugs in PSA treatment, and explored the therapeutic mechanism of rehabilitation training. It suggested the use drugs of memantine, piracetam, donepezil, etc. combine with non-pharmacotherapy and rehabilitation training in clinical studies on PSA treatment and also in practical settings.
本综述旨在探讨中国脑卒中后失语（PSA）的概念、病因、分类、经典皮质映射、评估、诊断与鉴别诊断、治疗、康复、机制、恢复、预后及影响因素。该综述强调了脑与血管的神经影像学评估以及神经心理学评估在中国PSA诊断和鉴别诊断中的必要性和重要性。此外，基于脑与血管的解剖位置及其与语言区和语言障碍的关系，建议并推荐以“内外、前后二分法”为切入点。由此制定的中国PSA分类更适合指导脑卒中的临床治疗。根据“二分法”和“四要素”对中国PSA类型进行诊断、分类和鉴别诊断。所制定的“流程图”能够确定中国PSA类型的分类。这有利于患者制定有针对性的个性化康复训练计划。本综述介绍了美金刚、吡拉西坦、多奈哌齐等药物在PSA治疗中的应用，评估了国内外开展的临床研究，探究了药物在PSA治疗中的作用机制，并探讨了康复训练的治疗机制。建议在PSA治疗的临床研究以及实际应用中，将美金刚、吡拉西坦、多奈哌齐等药物与非药物治疗及康复训练相结合。
