TY - JOUR
T1 - Biological approaches to aphasia treatment
AU - Small, Steven L.
AU - Llano, Daniel A.
N1 - Funding Information:
This work was supported by the National Institute of Deafness and Other Communication Disorders of the National Institutes of Health under grants R21/R33 DC008638 and R01 DC07488, by the James S. McDon-nell Foundation award to the Brain Network Recovery Group (BrainNRG), and by Mr. William Rosing. This support is gratefully acknowledged.
PY - 2009
Y1 - 2009
N2 - In this review, we discuss the basic mechanisms of neural regeneration and repair and attempt to correlate findings from animal models of stroke recovery with clinical trials for aphasia. Several randomized controlled clinical trials involving manipulation of different neurotransmitter systems, including noradrenergic, dopaminergic, cholinergic, and glutamatergic systems, have shown signals of efficacy. Biological approaches such as anti-Nogo and cell replacement therapy have shown efficacy in preclinical models but have yet to reach proof of concept in the clinic. Finally, noninvasive cortical stimulation techniques have been used in a few small trials and have shown promising results. It appears that the efficacy of all these platforms can be potentiated through coupling with concomitant behavioral intervention. Given this array of potential mechanisms that exist to augment and/or stimulate neural reorganization after stroke, we are optimistic that approaches to aphasia therapy will transition from compensatory models to models in which brain reorganization is the goal.
AB - In this review, we discuss the basic mechanisms of neural regeneration and repair and attempt to correlate findings from animal models of stroke recovery with clinical trials for aphasia. Several randomized controlled clinical trials involving manipulation of different neurotransmitter systems, including noradrenergic, dopaminergic, cholinergic, and glutamatergic systems, have shown signals of efficacy. Biological approaches such as anti-Nogo and cell replacement therapy have shown efficacy in preclinical models but have yet to reach proof of concept in the clinic. Finally, noninvasive cortical stimulation techniques have been used in a few small trials and have shown promising results. It appears that the efficacy of all these platforms can be potentiated through coupling with concomitant behavioral intervention. Given this array of potential mechanisms that exist to augment and/or stimulate neural reorganization after stroke, we are optimistic that approaches to aphasia therapy will transition from compensatory models to models in which brain reorganization is the goal.
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U2 - 10.1007/s11910-009-0066-x
DO - 10.1007/s11910-009-0066-x
M3 - Review article
C2 - 19818231
AN - SCOPUS:70350169896
SN - 1528-4042
VL - 9
SP - 443
EP - 450
JO - Current neurology and neuroscience reports
JF - Current neurology and neuroscience reports
IS - 6
ER -