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A Review of Biological Interventions in Chronic Aphasia

Aphasia is a common and debilitating condition following stroke. While the gold standard for aphasia treatment is behavioral speech-language therapy, benefits remain modest in chronic stages of recovery. This limitation motivates the pursuit of novel interventions for chronic aphasia. Here, we revie...

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Autores principales: Duncan, E. Susan, Pradeep, Aswathy Anakkathil, Small, Steven L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731673/
https://www.ncbi.nlm.nih.gov/pubmed/33343131
http://dx.doi.org/10.4103/aian.AIAN_549_20
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author Duncan, E. Susan
Pradeep, Aswathy Anakkathil
Small, Steven L.
author_facet Duncan, E. Susan
Pradeep, Aswathy Anakkathil
Small, Steven L.
author_sort Duncan, E. Susan
collection PubMed
description Aphasia is a common and debilitating condition following stroke. While the gold standard for aphasia treatment is behavioral speech-language therapy, benefits remain modest in chronic stages of recovery. This limitation motivates the pursuit of novel interventions for chronic aphasia. Here, we review biological approaches that have been used (or proposed for use, in the case of regenerative and genetic therapies) to treat chronic aphasia. These techniques aim to ameliorate the deficits of aphasia by directly manipulating brain function, rather than training lost or compensatory functions, although many have been used to augment effects of behavioral therapy. Specifically, we explore the most robust designs of transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and pharmacotherapy that have been applied in chronic (≥6 months) post-stroke aphasia. We also consider less investigated approaches including epidural cortical stimulation and photobiomodulation. All methods are currently in nascent phases and restricted to experimental studies and clinical trials. Although the evidence base remains limited, such interventions may ultimately improve language function and quality of life for those living with chronic aphasia. However, it is crucial that application of these methods consider the effects of concomitant speech-language therapy, as biological interventions combined with behaviorally induced experience-dependent plasticity will likely yield the most beneficial and durable outcomes.
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spelling pubmed-77316732020-12-18 A Review of Biological Interventions in Chronic Aphasia Duncan, E. Susan Pradeep, Aswathy Anakkathil Small, Steven L. Ann Indian Acad Neurol AIAN Review Aphasia is a common and debilitating condition following stroke. While the gold standard for aphasia treatment is behavioral speech-language therapy, benefits remain modest in chronic stages of recovery. This limitation motivates the pursuit of novel interventions for chronic aphasia. Here, we review biological approaches that have been used (or proposed for use, in the case of regenerative and genetic therapies) to treat chronic aphasia. These techniques aim to ameliorate the deficits of aphasia by directly manipulating brain function, rather than training lost or compensatory functions, although many have been used to augment effects of behavioral therapy. Specifically, we explore the most robust designs of transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and pharmacotherapy that have been applied in chronic (≥6 months) post-stroke aphasia. We also consider less investigated approaches including epidural cortical stimulation and photobiomodulation. All methods are currently in nascent phases and restricted to experimental studies and clinical trials. Although the evidence base remains limited, such interventions may ultimately improve language function and quality of life for those living with chronic aphasia. However, it is crucial that application of these methods consider the effects of concomitant speech-language therapy, as biological interventions combined with behaviorally induced experience-dependent plasticity will likely yield the most beneficial and durable outcomes. Wolters Kluwer - Medknow 2020-09 2020-09-25 /pmc/articles/PMC7731673/ /pubmed/33343131 http://dx.doi.org/10.4103/aian.AIAN_549_20 Text en Copyright: © 2006 - 2020 Annals of Indian Academy of Neurology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle AIAN Review
Duncan, E. Susan
Pradeep, Aswathy Anakkathil
Small, Steven L.
A Review of Biological Interventions in Chronic Aphasia
title A Review of Biological Interventions in Chronic Aphasia
title_full A Review of Biological Interventions in Chronic Aphasia
title_fullStr A Review of Biological Interventions in Chronic Aphasia
title_full_unstemmed A Review of Biological Interventions in Chronic Aphasia
title_short A Review of Biological Interventions in Chronic Aphasia
title_sort review of biological interventions in chronic aphasia
topic AIAN Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731673/
https://www.ncbi.nlm.nih.gov/pubmed/33343131
http://dx.doi.org/10.4103/aian.AIAN_549_20
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