[Pharmacotherapy for aphasia]

Abstract

Classification of aphasia is divided according to clinical symptoms, anatomical analysis or neural network. Research of the past 20 years in basic neuroscience and aphasia rehabilitation has created opportunities for fundamentally different approaches to aphasia therapy, based on applied neurobiology. The idea of treating aphasia with neurotranmitter stimulating agents has historical roots dating to ancient times. Since Albert reported that bromocriptine may improve language deficits in patients with nonfluent aphasia, pharmacotherapy for aphasia is noted. However its effect is contoversial. We hypothesize improvement in naming ability by 1) selectively increasing dopamine to enhance activation and initiation of verbal output, and 2) selectively increasing cholinergic activity to enhance verbal memory. We also hypothesize that the balance of dopaminergic system and cholinergic system controls language function. In most of our recent studies on the pharmacotherapy of aphasia, we made the following observations: 1) we found improvement in either verbal fluency or naming or both; 2) improvement tended be most prominent in patients with mild to moderate severity of aphasia, rather than in patients with severe aphasia; 3) improvement tended to be correlated with reduction in perseveration; 4) improvement was found with dopaminergic, cholinergic, and serotonergic agents.