Pharmacotherapy of Aphasia

Abstract

M efforts have been undertaken at helping patients with aphasia recover from their deficits by using various rehabilitation techniques. A number of studies have also been carried out to investigate the role of pharmacological agents in the treatment of aphasia. Aphasia can result from a variety of injuries to the brain, including trauma and stroke. However, most of the research has focused on stroke due to the focal nature of the lesions and the vascular territories resulting in a more homogeneous patient population for study. Therefore, any possible benefits for people with traumatic brain injury must be extrapolated from the studies on subjects with stroke. A number of drugs have been developed for the treatment of Alzheimer’s disease. The N-methyl-D-aspartic acid receptor antagonists have also demonstrated benefits in patients with vascular dementia on batteries of cognitive tests that prominently feature language,1 suggesting that benefits might also result for patients undergoing rehabilitation for aphasia. Studies with cholinesterase inhibitors have also demonstrated significant benefits in patients with vascular dementia, and specifically in the treatment of patients with aphasia.2,3 A derivative of gamma aminobutyric acid, piracetam, with reported benefits for cognition and memory, has also been examined in the treatment of patients with aphasia. Significant benefits have been observed in these patients a few weeks to 3 years after onset of aphasia, at a dose of 2.4 mg twice a day.4 Use of piracetam in aphasia is also associated with an increase in language task– related activation on functional neuroimaging.5 How-