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Review
. 2020 Jun;20(6):567-576.
doi: 10.1080/14737175.2020.1763173. Epub 2020 May 12.

Developments in treating the nonmotor symptoms of stroke

Argye E Hillis  1   2   3
Affiliations
Review

Developments in treating the nonmotor symptoms of stroke

Argye E Hillis. Expert Rev Neurother. 2020 Jun.

Abstract

Introduction: Stroke is among the most common causes of disability worldwide. Nonmotor symptoms of stroke are common and disabling. Many are treatable, and intervention improves the quality of life for stroke survivors.

Areas covered: Here the author summarizes the evidence-based treatment of depression and other mood disorders, aphasia, hemispatial neglect, impairments of emotional communication and empathy, deficits in memory and other cognitive functions, sleep disorders, pain, fatigue, and seizures resulting from stroke. The author focuses on treatments supported by randomized controlled trials (RCTs), from the literature cited in Google Scholar, Embase, and Pubmed.

Expert opinion: While behavioral rehabilitation is the most common intervention for many of the sequelae of stroke, relatively small RCTs support the use of noninvasive brain stimulation (transcranial direct current stimulation and transcranial direct current stimulation) and medications that facilitate neural plasticity and recovery. These noninvasive brain stimulation methods remain investigational for post-stroke symptoms. The strongest evidence for pharmacological intervention is in the domains of post-stroke mood disorders and epilepsy, but additional RCTs are needed to confirm the efficacy of selective serotonin reuptake inhibitors and other medications for improving recovery of cognition, language, and energy after stroke.

Keywords: Stroke; aphasia; cognitive impairment; depression; fatigue; medication; rehabilitation; transcranial direct current stimulation.

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Conflict of interest statement

Declaration of interests

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

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