Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2001;2001(4):CD000424.
doi: 10.1002/14651858.CD000424.

Pharmacological treatment for aphasia following stroke

J Greener  1 , P Enderby, R Whurr
Affiliations

Pharmacological treatment for aphasia following stroke

J Greener et al. Cochrane Database Syst Rev. 2001.

Abstract

Background: Aphasia describes language impairment associated with a brain lesion.

Objectives: The objective of this review was to assess the effects of drugs on language abilities when given to people with aphasia following stroke.

Search strategy: We searched the Cochrane Stroke Group Register (last searched: May 2001), and reference lists of relevant articles to December 1998. We also contacted academic institutions and other researchers to identify further published and unpublished trials. MEDLINE was searched from 1966-1998, and CINAHL from 1982-1998. We searched the International Journal of Disorders of Communication by hand (known by other names in the past), from 1969 to 1998.

Selection criteria: Randomised controlled trials comparing: ~bullet~Any drug given to improve language, versus no treatment, or versus placebo ~bullet~Any drug given to improve language versus speech and language therapy ~bullet~One drug given to improve language versus another drug given with the same aim

Data collection and analysis: The principal reviewer collected the data, and assessed the quality of the trials with independent data checking and methodological advice. If we could not perform a statistical combination of different studies, we sought missing data. Failing that we provided a description. We sought missing data from authors, or where appropriate, a drug company.

Main results: We considered fifty two studies in detail, from which we identified ten trials suitable for the review. In most cases the methodological quality was unassessable, and only one trial reported sufficient detail for us to complete a description and analysis. This study did lose a large number of patients during its course. Drugs used in the trials identified were piracetam, bifemalane, piribedil, bromocriptine, idebenone, and Dextran 40. We found weak evidence that patients were more likely to have improved on any language measure at the end of the trial if they had received treatment with piracetam (odds ratio 0.46, 95% confidence interval 0.3 to 0.7). The evidence is considered weak because of the large numbers of drop outs from the trials identified, who were lost to follow up. Patients who were treated with piracetam were no more likely (considering statistical significance) than those who took a placebo to experience unwanted effects, including death (odds ratio 1.29, 95% confidence interval for difference 0.9 to 1.7). However, the differences in death rates between the two groups, even though not not statistically significant, do give rise to some concerns that there may be an increased risk of death from taking piracetam. We could not determine if drug treatment is more effective than speech and language therapy. We could not determine whether one drug is more effective than another.

Reviewer's conclusions: The main conclusion of this review is that drug treatment with piracetam may be effective in the treatment of aphasia after stroke. Further research is needed to explore the effects of drugs for aphasia, in particular piracetam. If a trial is done, this must be large enough to have adequate statistical power. The safety of the drug should be of primary interest. Researchers should examine the long term effects of this treatment, and whether it is more effective than speech and language therapy.

PubMed Disclaimer

Conflict of interest statement

The principal reviewer no longer practices speech and language therapy. The other two reviewers are both speech and language therapists with many years experience in the treatment of aphasia after stroke. Professor Enderby was an investigator in the Enderby 1994 trial.

Figures

1.1
1.1. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 1 number of patients with aphasia not improved at end of study.
1.2
1.2. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 2 number of patients with aphasia not resolved by 12 weeks on AAT.
1.3
1.3. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 3 number of patients with aphasia not resolved by 24 weeks on AAT.
1.4
1.4. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 4 number of all patients still aphasic on FAST scale at day 29 of study.
1.5
1.5. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 5 number of all patients still aphasic on FAST scale at day 84 of study.
1.6
1.6. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 6 number of patients with early treatment still aphasic on FAST scale at day 29 of study.
1.7
1.7. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 7 number of patients with early treatment still aphasic on FAST scale at day 84 of study.
1.8
1.8. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 8 difference in aphasia scale scores before and after treatment.
1.9
1.9. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 9 spontaneous language rating (1) at week 12.
1.10
1.10. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 10 spontaneous language rating (1) at week 24.
1.11
1.11. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 11 spontaneous language rating (2) at week 12.
1.12
1.12. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 12 spontaneous language rating (2) at week 24.
1.13
1.13. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 13 spontaneous language rating (3) at week 12.
1.14
1.14. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 14 spontaneous language rating (3) at week 24.
1.15
1.15. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 15 spontaneous language rating (4) at week 12.
1.16
1.16. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 16 spontaneous language rating (4) at week 24.
1.17
1.17. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 17 spontaneous language rating (5) at week 12.
1.18
1.18. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 18 spontaneous language rating (5) at week 24.
1.19
1.19. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 19 spontaneous language rating (6) at week 12.
1.20
1.20. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 20 spontaneous language rating (6) at week 24.
1.21
1.21. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 21 score on token test at 12 weeks.
1.22
1.22. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 22 score on token test at 24 weeks.
1.23
1.23. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 23 score on repetition test at 12 weeks.
1.24
1.24. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 24 score on repetition test at 24 weeks.
1.25
1.25. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 25 score on written language test at 12 weeks.
1.26
1.26. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 26 score on written language test at 24 weeks.
1.27
1.27. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 27 score on confrontation naming test at 12 weeks.
1.28
1.28. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 28 score on confrontation naming test at 24 weeks.
1.29
1.29. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 29 score on comprehension test at 12 weeks.
1.30
1.30. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 30 score on comprehension test at 24 weeks.
1.34
1.34. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 34 Orgogozo Scale at end of 4 weeks.
1.35
1.35. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 35 number of deaths, any type of patient, at end of trial.
1.36
1.36. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 36 number of dropouts, any cause, by end of trial (ie people not included in test score analyses)..
1.37
1.37. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 37 number of patients experiencing adverse events, including death, at end of trial.
1.38
1.38. Analysis
Comparison 1 Piracetam compared with placebo, Outcome 38 number of deaths of aphasic patients at end of study.
6.1
6.1. Analysis
Comparison 6 Dextran 40 compared with placebo, Outcome 1 number of patients worsened or not improved on four item language scale at end of trial.
6.2
6.2. Analysis
Comparison 6 Dextran 40 compared with placebo, Outcome 2 number of patients died/experienced an adverse effect.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Bakchine 1990 {published data only}
    1. Bakchine S Fiorelli M. Double blind placebo controlled study of Pirebedil in aphasic patients with pure subcortical extrathalamic vascular lesions: Clinical assessment and metabolic imaging with PET scan. Journal of Neurology 1990;Vol 237:S107.
De Reuck 1995 {published and unpublished data}
    1. Deyn P P, Reuck J. Piracetam in acute stroke study. Unpublished 1995.
    1. Deyn P, Reuck J, Milonas I, Vlietinck B, Deberdt W. Piracetam acute stroke study. European Journal of Neurology 1996;3(Supp 5):37.
    1. Deyn P, Orgogozo JM, Reuck J. Acute treatment of stroke. PASS group. Piracetam acute stroke study (letter). Lancet 1998;352(9124):326. - PubMed
    1. Deyn PP. The piracetam in acute stroke study. European Journal of Neurology 1995;2(Supp2):7.
    1. Deyn PP, Reuck J, Orgogozo JM, Deberdt W, for the Piracetam Study Group. The piracetam in acute stroke study. Stroke 1996;27(1):33 (Abstr 165).
Enderby 1994 {published and unpublished data}
    1. Broeckx J. Piracetam in post stroke rehabilitation: a three month, double‐blind, parallel group, multicentre study to compare the efficacy and safety of piracetam versus placebo in facilitating the rehabilitation process in patients recovering from ischemic infarction or intracerebral haemorrhage in the carotid areas. External report MRCE93B1101, UCB Pharma, Belgium 1994.
    1. Deberdt W. Interaction between psychological and pharmacological treatment in cognitive impairment. Life Sciences 1994;55(25/26):2057‐2066. - PubMed
    1. Enderby P. The efficacy and safety of piracetam in the rehabilitation of stroke patients.. Racagni G, Brunello N, Langer SZ (eds) Recent advances in the treatment of neurodegenerative disorders and cognitive dysfunction. International Academic Biomedical Drug Research 1994;7:249‐255.
    1. Enderby P, Broeckx J, Hospers W, et al. Effect of piracetam on recovery and rehabilitation after stroke: A double blind, placebo controlled study. Clinical Neuropharmacology 1994;17(4):320‐331. - PubMed
    1. Schildermans F, Broeckx J, Hospers W, Deberdt W. Efficacy of piracetam in the rehabilitation of stroke patients. Proceedings of 2nd International Conference on Stroke, Geneva, Switzerland. World Federation of Neurology, 1993.
Gupta 1995 {published data only}
    1. Gupta SR, Mlcoch AG, Scolaro C, Moritz T. Bromocriptine treatment of non‐fluent aphasia. Neurology 1995;45:2170‐2173. - PubMed
Herrschaft 1988 {published data only}
    1. Herrschaft H. Die Wirkamseit von Piracetam bie der acuten zerebralen Ischamie des Menschen. Medizinische Klinik 1983;20:667‐677. - PubMed
Platt 1993 {published data only}
    1. Platt D, Horn J, Summa J‐D, et al. On the efficacy of piracetam in gerietric patients with acute cerebral ischemia: A clinically controlled double blind study. Archives of Gerontology and Geriatrics 1993;16:149‐164. - PubMed
    1. Platt D, Horn J, Summa J‐D, Schmitt‐Ruth R, Reinlein B, et al. Zur Wirkamseit von Piracetam bei geriatrischen Patienten mit akuter zerebraler Ischamie. Die Medizinische Welt 1992;43:181‐190.
Poeck 1993 {published and unpublished data}
    1. Deberdt W. Interaction between psychological and pharmacological treatment in cognitive impairment. Life Sciences 1994;55(25/26):2057‐2066. - PubMed
    1. Deberdt W, Poeck K, Huber W. Piracetam as an add‐on treatment to intensive speech therapy for aphasia. Meeting of the European Federation of Neurological Societies. 1993:S 89.
    1. Huber W, Willmes K, Poeck K. Piracetam as an add‐on treatment to intensive speech therapy. Journal of Neurology 1994;241(suppl 1):S152.
    1. Huber W, Willmes K, Poeck K, Bleyman B, Deberdt W. Piracetam as an adjuvent to language therapy for aphasia: a randomised double‐blind placebo‐controlled pilot study. Archives of Physical Medicine and Rehabilitation 1997;78(3):245‐50. - PubMed
    1. Poeck K, Deberdt W. Uberprufung der wirking von Piracetam bei der logopadischen intensivtherapie von chronisch aphaschen patienten. Unpublished report, UCB Pharma,. UCB Pharma, 1993:1‐22.
Price 1992 {published data only}
    1. Price J, Kheyferts S, Reding MJ. The effect of Idebenone on recovery from stroke. Neurology 1992;42 (Suppl 3):328. Neurology 1992;42 Suppl 3:328.
Spudis 1973 {published data only}
    1. Spudis E, Torre E, Pikula L. Management of completed strokes with Dextran 40. A community hospital failure. Stroke 1974;4:895‐897. - PubMed
Tanaka 1997 {published data only}
    1. Tanaka Y, Miyazaki M, Albert ML. Effects of cholinergic activity on naming in aphasia. Lancet 1997;350:116‐117. - PubMed

References to studies excluded from this review

Admani 1978 {published data only}
    1. Admani AK. New approach to treatment of recent stroke. BMJ Dec 16 1978;2(6153):1678‐9. - PMC - PubMed
Albert 1988 {published data only}
    1. Albert ML, Bachmann DL, Morgan A, Helm‐Estabrooks N. Pharmacotherapy for aphasia. Neurology 1988;38(6):877‐879. - PubMed
Albert 1992 {published data only}
    1. Albert M, McNamara P, Rosen J, Siu C. Pharmacotherapy for nonfluent aphasia. Neurology 1992;42(suppl 30):181 (abstract).
Anonymous 1990 {published data only}
    1. Anonymous. Randomised, double‐blind, placebo controlled trial of nimipodine in acute stroke. Lancet 1990;336(8725):1205‐9. - PubMed
Bachman 1988 {published data only}
    1. Bachman DL, Morgan A. The role of pharmacotherapy in the treatment of aphasia: preliminary results. Aphasiology 1988;2(3/4):225‐228.
Bergmann 1951 {published data only}
    1. Bermann PS, Green M. Aphasia: effect of intravenous sodium amytal. Neurology 1951;1:471‐5. - PubMed
Beyreder 1983 {published data only}
    1. Beyreder J. Use of pentoxifyllene in the treatment of acute cerebral insufficiency. European Neurology 1983;22(suppl 1):116‐123. - PubMed
Bragoni 1997 {published data only}
    1. Bragoni M, Peiro V, Cacioppo M, Padrovani A, et al. Non fluent stable chronic aphasia: effects of bromocriptine and speech therapy. Neurology 1997;48:A214.
    1. Bragoni M, Piero V, Capocci MM, et al. Bromocriptine and speech therapy: a possible treatment of stroke patients with non‐fluent chronic aphasia. Journal of Neural Transmission 1996;103:23.
Capon 1990 {published data only}
    1. Capon A, Lehert P, Opsomer L. Naftidrofuryl in the treatment of sub‐acute stroke. Journal of Cardiovascular Pharmacology 1990;16(suppl 3):S63‐66. - PubMed
Clark 1979 {published data only}
    1. Clark A, Manikar GD. d‐Amphetamine in elderly patients refractory to rehabilitation procedures. Journal of the American Geriatrics Society 1979;27(4):174‐177. - PubMed
Darley 1977 {published data only}
    1. Darley FL, Keith RL, Sasanuma S. The effect of alerting and tranquillizing drugs upon the performance of aphasic patients. Clinical Aphasiology 1977;7:91‐96.
Dekoninck 1987 {published data only}
    1. Dekoninck WJ, Jocquet P, Jacquy J, Henriet M. Comparative study of the clinical effects of vincamine + glycerol vs glycerol + placebo in acute phase of stroke. Arzeimittel Forschung 1978;28(11):1654‐1657. - PubMed
Ducarne 1986 {published data only}
    1. Ducarne H. Evaluation of a vasoactive ubstance, naftidrofuryl, during the rehabilitation phase after an ischaemic insult. Current Medical Research and Opinion 1986;10(1):58‐71. - PubMed
Feeney 1990 {published data only}
    1. Feeney DM, Westerberg VS. Norepinephrine and brain damage: alpha noradrenergic pharmacology alters functional recovery. Canadian Journal of Psychology 1990;44(2):233‐52. - PubMed
Franke 1996 {published data only}
    1. Franke CL, Palm R, Dalby M, Schoonderwaldt HC, Hantson L, et al. Fluarizine in stroke treatment (FIST); a double blind, placebo controlled trial in Scandinavia and the Netherlands. Acta Neurologica Scandinavia 1996;93(1):56‐60. - PubMed
Frei 1987 {published data only}
    1. Frei A, Cottier C, Wunderlich P, Ludin E. Glycerol and dextran combined in the therapy of acute stroke. A placebo‐controlled, double‐blind trial with a planned interim analysis. Stroke 1987;18(2):373‐9. - PubMed
Gelmers 1988 {published data only}
    1. Gelmers HJ, Gorter K, Weerdt CJ, Weizer HJ. A controlled trial of nimodipine in acute ischemic stroke. New England Journal of Medicine 1988;318(4):203‐7. - PubMed
Gelmers 1990 {published data only}
    1. Gelmers HJ, Hennerici M. Effect of nimipodine on acute ischaemic stroke. Pooled results from five randomized trials. Stroke 1990;21(12 suppl):81‐4. - PubMed
Gupta 1992 {published data only}
    1. Gupta S, Mlcoch A. Bromocriptine treatment of nonfluent aphasia. Archives of Physical and Medical Rehabilitation 1992;73:373‐76. - PubMed
Hartmann 1993 {published data only}
    1. Hartmann A, Dettmers C, Lagreze H, Tsuda Y. Blood flow and clinical course in patients with ischaemic stroke without cerebrospecific therapy. Acta Neurochirugica Supplementum 1993;57:130‐135. - PubMed
Hrbek 1978 {published data only}
    1. Hrbek J, Macakova J, Komenda S, Dostalova K, Medek A, Navratil J. Effects of pyrithioxine, centrophenoxine, and piracetam on verbal learning. Activitas Nervosa Superior (Praha) 1978;20(4):260‐1. - PubMed
Hulser 1988 {published data only}
    1. Hulser PJ, Bernhart H, Marbach C, Kornhuber HH. Treatment with an i.v. calcium overload blocker (flunarizine) in acute stroke. A pilot study. European Archives of Psychiatry and Neurological Sciences 1988;237(50):253‐7. - PubMed
IASSG 1988 {published data only}
    1. Anonymous. Haemodilition in acute stroke: results of the Italian haemodilution trial. Italian Acute Stroke Study Group. Lancet 1988;1(8581):318‐21. - PubMed
Jacobs 1996 {published data only}
    1. Jacobs DH, Shuren J, Gold M, et al. Physostigmine pharmacotherapy for anomia. Neurocase 1996;2:83‐91.
Kabasawa 1994 {published data only}
    1. Kabasawa H, Matsubara M, Kamimoto K, Hibino H, Banno T, Nagai H. Effects of bifemalane on cerebral circulation and metabolism in patients with aphasia. Clinical Therapeutics 1994;16:471‐82. - PubMed
Kartin 1979 {published data only}
    1. Kartin P, Povse M, Skondia V. Clinical study of piracetam in patients with subacute cerebrovascular accidents. Acta Therapeutica 1979;5:235‐243.
Kaste 1976 {published data only}
    1. Kaste M, Fogelholm R, Waltimo O. Combined dexamethasone and low‐molecular‐weight dextran in acute brain infarction: double blind study. BMJ 1976;2(6049):1409‐10. - PMC - PubMed
Koller 1990 {published data only}
    1. Koller M, Heanny P, Hess K, Weniger D, Zangger P. Adjusted hypervolemic hemodilution in acute ischemic stroke. Stroke 1990;21(10):1429‐34. - PubMed
Markov 1973 {published data only}
    1. Markov G. The treatment of aphasia and dysarthria using psychoforin (Tofranil) and Myocalm. Zhural Nevpatologi i Psikhatri s‐s korsova 1973;73(4):512‐3. - PubMed
McNeil 1997 {published data only}
    1. McNeil MR, Doyle PJ, Spencer KA, Goda AJ, Flores D, Small SL. A double‐blind, placebo controlled study of pharmacological and behavioural treatment of lexical‐semantic deficits in aphasia. Aphasiology 1997;11(4/5):385‐400.
Motomura 1993 {published data only}
    1. Motomura S. Aphasia in stroke‐ pathogenesis, recovery and treatment. Nippon Rinsho 1993;Suppl:278‐290. - PubMed
Muller 1994 {published data only}
    1. Muller U, Zeigler W, Cramon DY. Amphetamine in apraxia of speech.. Neuropsychopharmacology 1994;10(35, Part 2):226S (Abst. P174‐56).
Ozeren 1995 {published data only}
    1. Ozeren A, Sarica Y, Mavi H, Demikiran M. Bromocriptine is ineffective in the treatmnt of chronic nonfluent aphasia. Acta Neurologica Belga 1995;95(4):235‐8. - PubMed
Patten 1972 {published data only}
    1. Patten BM, Mendel J, Bruun B, Curtin W, Carter S. Double‐blind study of the effects of dexamethasone on acute stroke. Neurology 1972;22:377‐383. - PubMed
Popa 1989 {published data only}
    1. Popa G, Popa C, Stanescu A, Ionescu G, Lugoji G, Radula D, Popescu A. Haemodilution therapy in acute iscaemic stroke. Neurologie et Psychiatrie 1989;2792:79‐90. - PubMed
Porch 1981 {published data only}
    1. Porch B, Feeney D. Effects of antihypertensive drugs on recovery from aphasia. Clinical Aphasiology Proceedings. 1981:187‐200.
Porch 1985 {published data only}
    1. Porch B, Wyckes J, Feeney DM. Haloperidol, thiazides and some hypertensives slow recovery from aphasia. Proceedings from the annual meeting of the Society for Neuroscience. 1985:52 (abst).
Roquefeuil 1975 {published data only}
    1. Roquefeuil E, Escuret E. Etude metabolique du Piracetam en reanimation neuro‐chirugicale. Agressologie 1975;16:43‐62. - PubMed
Sabe 1992 {published data only}
    1. Sabe L, Leiguarda R, Starkstein SE. An open‐label trial of bromocriptine in nonfluent aphasia. Neurology 1992;73:373‐376. - PubMed
Sabe 1995 {published data only}
    1. Sabe L, Salvarezza F, Cuerva A, Leiguarda R, Starkstein S. A randomised double blind placebo controlled study of bromocriptine in nonfluent aphasia. Neurology 1995;45(12):2272‐2274. - PubMed
Sarno 1972 {published data only}
    1. Sarno JE, Rusk HA, Diller L, Sarno MT. The effect of hyperbaric oxygen on the mental and verbal ability of stroke patients. Stroke 1972;3:10. - PubMed
    1. Sarno M, Sarno J, Diller L. The effect of hyperbaric oxygen on communication function in adults with aphasia secondary to stroke. Journal of Speech and Hearing Research 1972;14:42‐48. - PubMed
Schneider 1986 {published data only}
    1. Schneider R, Brockmann M, Keisewetter H, et al. Behandlung lakunarer Infarkte mit Pentoxyfyllin. Medwelt 1986;37:1340‐1343.
Sciclounoff 1934 {published data only}
    1. Sciclounoff F. L'acetylcholine dans le traitement de l'ictus hemiplegique. La Presse Medicale 14 July 1934;56:1140‐1142.
SSSG 1997 {published data only}
    1. Anonymous. Multicenter trial of hemodilution in acute ischemic stroke. I. Results in the total patient population. Scandinavian Stroke Study Group. Stroke 1987;18(4):691‐9. - PubMed
Steiner 1986 {published data only}
    1. Steiner TJ, Clifford Rose F. Towards a model stroke trial. Neuroepidemiology 1986;5:121‐147. - PubMed
Steiner 1994 {published data only}
    1. Steiner 1994. Praxiline in stroke treatment in Northern Europe (PRISTINE). (Abstract) Stroke 1994;25(6):1318.
    1. Steiner T. Personal correspondence 1995.
    1. Steiner T. Personal correspondence 1996.
Strand 1984 {published data only}
    1. Strand T, Aspund MD, Eriksson S, Hagg E, et al. A randomised controlled trial of hemodilution therapy in acute ischemic stroke. Stroke 1984;15(6):980‐989. - PubMed
Voinescu 1978 {published data only}
    1. Voinescu I, Georghita N. Adjuvent drug therapy with psychologopaedic rehabilitation of aphasic patients. R Roum Med, Neurol Psychiat 1987;16:155‐161. - PubMed
Walker‐Batson 1991 {published data only}
    1. Walker‐Batson D, Devous MD, Curtis S, Unwin H, Greenlee RG. Response to amphetamine to facilitate recovery from aphasia subsequent to stroke. Clinical Aphasiology 1991;21:137‐143.
Walker‐Batson 1992 {published data only}
    1. Walker‐Batson D, Unwin H, Curtis S, Allen E, Wood M, et al. Use of amphetamine in the treatment of aphasia. Restorative Neurology and Neuroscience 1992;4:47‐50. - PubMed
Walker‐Batson 1995 {published data only}
    1. Walker‐Batson D, Smith P, Curtis MA, Unwin H, Greenlee R. Amphetamine paired with physical therapy accelerates motor recovery after stroke. Stroke 1995;26(12):2254‐2259. - PubMed
West 1965 {published data only}
    1. West R, Stockel S. The effect of meprobamate on recovery from aphasia. Journal of Speech and Hearing Research 1965;8:57‐62. - PubMed
Willmes 1984 {published data only}
    1. Willmes K, Poeck K. Ergebnisse einer multizentrischen Untersuchung uber die Spontanprognose von Aphasien vaskularer Atiologie. Nervenarzt 1984;55:62‐71. - PubMed
Witzmann 1977 {published data only}
    1. Witzmann von HK, Blechacz W. On the role of vincamine in the therapy of cerebrovascular diseases and impairment of cerebral function. Arzneimittel Forschung 1977;27(6A):1238‐1247. - PubMed
Zeigler 1993 {published data only}
    1. Zeigler W, Muller U. Amphetamine in apraxia of speech. Proceedings of the International Congress on stroke rehabiltation. 1993:71.

References to studies awaiting assessment

Wade 1994 {published data only}
    1. Wade D. Personal communication 1999.
    1. Wade D. Piracetam in post stroke aphasia. Unpublished protocol 1994.
Walker‐Batson 2001 {published and unpublished data}
    1. Walker‐Batson D. Unpublished paper 2001.
    1. Walker‐Batson D. Use of amphetamine in the treatment of aphasia. Unpublished book chapter.

Additional references

Bachman 1990
    1. Bachman DL, Albert ML. The pharmacotherapy of aphasia: historical perspectives. Aphasiology 1990;4:407‐413.
Chouinard 1983
    1. Chouinard G, Annable L, Ross‐Chouinard A, Olivier M, Fontaine F. Piracetam in elderly psychiatric patients with mild diffuse cerebral impairment. Psychopharmacology (Berlin) 1983;81:100‐6. - PubMed
Creytens 1980
    1. Creytens G. Nouveautes dans la traitement de la pathologie cerebrale. Acta Ther 1980;6:33‐53.
Enderby 1986
    1. Enderby P, Philipp R. Speech and language handicap: Towards knowing the size of the problem. British Journal of Disorders of Communication 1986;21(2):151‐165. - PubMed
Enderby 1987
    1. Enderby P, Wood DT, Hewer RL. The Frenchay Aphasia Test: a short simple test for aphasia appropriate for non‐specialists. International Rehabilitation Medicine 1987;8(4):166‐170. - PubMed
Enderby 1989
    1. Enderby P, Davies P. Communication disorders: Planning a service to meet the needs. British Journal of Disorders of Communication 1989;24(3):301‐331. - PubMed
Giurgea 1976
    1. Giurgea C. Piracetam: nootropic pharmacology of neurointegrative activity. Current Developments in Psychopharmacology. Vol. 3, New York: Spectrum Publications, 1976:222‐273.
Goldberg 1990
    1. Goldberg E. Contemporary Neuropsychology and the Legacy of Luria. Hove and London: Lawrence Earlbaum Associates, 1990.
Goodlass 1972
    1. Goodlass HK, Kaplan E. The Assessment of Aphasia and Related Disorders. Philadelphia: Lea and Febiger, 1972.
Greener 2001
    1. Greener J, Enderby P, Whurr R. Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews 1999, Issue 4. [Art. No.: CD000425. DOI: 10.1002/14651858.CD000425] - PubMed
Hamilton 1960
    1. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56‐62. - PMC - PubMed
Huber 1983
    1. Huber W, Poeck K, Willmes K. Der Aachen Aphasie Test. Gottingen: Hogrefe, 1983.
Kaplan 1983
    1. Kaplan E, Goodlass H, Weintraub S. The Boston Naming Test. Philadelphia: Lea and Febiger, 1983.
Kertesz 1982
    1. Kertesz A. Western Aphasia Battery. New York: Grune and Stratton, 1982.
Kurianski 1976
    1. Kurianski J, Gurland B. The performance test of activities of daily living. International Journal of Aging and Human Development 1976;7:343‐352. - PubMed
Mackenzie 1992
    1. Mackenzie C. The diversity of speech and language therapy services for aphasic adults in the United Kingdom. Disability and Rehabilitation 1992;14(3):146‐151. - PubMed
Mahoney 1965
    1. Mahoney FI, Barthel DW. Functional Evaluation: The Barthel Index. A simple index of independence useful in scoring improvement in the rehabilitation of chronically ill. Maryland State Medical Journal 1965;14:62‐65. - PubMed
Methe 1993
    1. Methe, S, Huber, W, Paradis M. in Paradis M, editor. Foundation of Aphasia Rehabilitation. Oxford: Pergamon Press, 1993.
Orgogozo 1986
    1. Orgogozo J‐M, Capildeo R, Anagnostou, Juge O, Pere JJ, et al. Development of a neurological score for the evaluation of sylvian infarctions [French]. Presse Medical 1983;12(48):3039‐44. - PubMed
Pederson 1995
    1. Pederson PM, Jorgenson HS, Nakayama H, Raasschou HO, Olsen TS. Aphasia in Acute Stroke:incidence, determinants, and recovery. Ann Neurol 1995;38:659‐666. - PubMed
Rey‐Osterrieth 1944
    1. Osterrieth P, Rey A. Le test de copie d'une figure complex. Archives de Psychologie 1944;30:205‐221.
Ricci 2000
    1. Ricci S, Celani MG, Cantisani AT, Righetti E. Piracetam for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2000, Issue 4. [Art. No.: CD000419. DOI: 10.1002/14651858.CD000419] - PubMed
SLTA 1977
    1. SLTA Committee. Standard Language Test of Aphasia: manual of directions. 2. Tokyo: Homeido, 1977.
Small 1994
    1. Small S. Pharmacotherapy of aphasia. Stroke 1994;25(6):281‐289. - PubMed
Steginck 1972
    1. Stegink, KJ. The clinical use of piracetam, a new nootropic drug. Arzniemittelforsch 1972;22:975‐7. - PubMed
Stolyarova 1978
    1. Stolyarova L, Kadykov A, Kisrenev B, Varykin YU, Yurchenko Z, Davylov V. The role of piracetam in complex rehabilitation therapy of patients with residual manifestations of a cerebral stroke. Proceedings of a symposium: Nootropil in Neurological and Psychiatric Practice. Moscow, 1978:74‐7.
Wade 1986
    1. Wade DT, Langton‐Hewer R, David RM, Enderby PM. Aphasia after stroke: Natural history and associated deficits. Journal of Neurology Neurosurgery and Psychiatry 1986;49(1):11‐6. - PMC - PubMed
Wechsler 1987
    1. Wechsler D. Memory Scale ‐ Revised. New York: Psychological Corporation, 1987.
Whiting 1985
    1. Whiting SE, Lincoln NB, Bhavani G, Cockburn J. The Rivermead Perceptual Assessment Battery. Windsor: NFER Nelson, 1985. - PubMed
WHO 1986
    1. World Health Organisation. International classification of diseases: 1975 Revision. Geneva: WHO, 1986.
Whurr 1992
    1. Whurr R, Lorch M, Nye CA. Meta‐analysis of studies carried out between 1946 and 1988 concerned with the efficacy of speech and language therapy treatment for aphasic patients. European Journal of Disorders of Communication 1992;27(1):1‐18. - PubMed
Wilsher 1987
    1. Wilsher C. Piracetam and dyslexia ‐ effects on reading tests. Journal of Clinical Psychopharmacology 1987;7:230‐7. - PubMed

Publication types

MeSH terms