Chapter 3 - Evidence from Basic Neuroscience and Human Studies of Pharmacologic Therapy

Abstract

Aphasia is a major symptom of stroke and shares common neurophysiological and neurochemical features with other stroke consequences. Physiologic events following brain injury complicate the timing for administration of various agents. Drugs that are effective in the very acute or subacute period following injury may be ineffective or even detrimental at later recovery periods. Treatment approaches can be either adaptive or maladaptive. Pharmacological treatment as an adjunct to traditional approaches to the treatment of stroke is not a new idea. Enhanced recovery from hemiplegia after occlusive stroke has been reported using noradrenergic agonists paired with physical therapy. Small pilot studies have explored drugs, such as amphetamine; recovery from hemiplegia after occlusive stroke has been reported using noradrenergic agonists paired with physical therapy. Several laboratories are exploring post-stroke manipulations of brain plasticity following experimental injury in terms of the timing and type of intervention. This chapter reviews theories of neuroplasticity thought to underlie behavioral recovery, animal recovery studies that may have importance in the design of rehabilitation practice, and data from humans on pharmacologic therapy in the treatment of hemiplegia and aphasia.