Articles: aphasia-etiology.
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Dysphagia in patients with stroke can cause serious complications, such as aspiration and pneumonia, that often lead to increase in mortality and length of hospitalization. Several screening tests for dysphagia have been developed and are used in clinical practice to prevent dysphagia complications. The Gugging Swallowing Screen is 1 such screening test. It is suggested for use in the assessment of the ability of patients to swallow fluid and non-fluid foods separately. It also promotes effective communication between healthcare providers. ⋯ The Gugging Swallowing Screen is a reliable and sensitive tool for screening dysphagia. Early and systematic assessment can prevent aspiration and pneumonia. However, further studies are needed to confirm the effectiveness of this tool.
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Previous studies indicated inconsistent results for the treatment effect of repetitive transcranial magnetic stimulation (rTMS) on post-stroke aphasics. The study conducted a meta-analysis to evaluate whether the rTMS with different frequencies demonstrated any effect in patients with post-stroke aphasia. ⋯ In conclusion, we provide preliminary evidence that both LF-rTMS and high-frequency-rTMS might be relatively effective and safe treatment for post-stroke aphasics. However, LF-rTMS mainly plays a short-term role in subacute post-stroke aphasics. Longer-term and large-scale studies are essential to explore the effect of rTMS with different frequencies on post-stroke aphasia.
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One of the most frequent symptoms of unilateral stroke is aphasia, the impairment or loss of language functions. Over the past few years, behavioral and neuroimaging studies have shown that rehabilitation interventions can promote neuroplastic changes in aphasic patients that may be associated with the improvement of language functions. ⋯ We discuss a hierarchical model for the plastic changes in language representation that occur in the setting of dominant hemisphere stroke and aphasia. We further argue that TMS and tDCS are potentially promising tools for enhancing functional recovery of language and for further elucidating mechanisms of plasticity in patients with aphasia.
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Cochrane Db Syst Rev · May 2010
Review Meta AnalysisSpeech and language therapy for aphasia following stroke.
Aphasia is an acquired language impairment following brain damage which affects some or all language modalities: expression and understanding of speech, reading and writing. Approximately one-third of people who have a stroke experience aphasia. ⋯ This review shows some indication of the effectiveness of SLT for people with aphasia following stroke. We also observed a consistency in the direction of results which favoured intensive SLT over conventional SLT, though significantly more people withdrew from intensive SLT than conventional SLT. SLT facilitated by a therapist-trained and supervised volunteer appears to be as effective as the provision of SLT by a professional. There was insufficient evidence to draw any conclusions in relation to the effectiveness of one SLT approach over another.
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The best predictor of successful language therapy after stroke is a high intensity of treatment (with 5-10 h training per week). However, the necessity of several hours of language exercises each day draws considerably on attentional and cognitive resources of the patients. Thus, not all aphasic patients may be equally suited for intense training approaches. ⋯ Patients in the acute stage benefit most from intense aphasia treatment, when long-term memory consolidation is relatively preserved. For the chronic stage, indirect evidence suggests that premorbid intelligence as well as attentional functions have positive effects on the success of intense therapy. An empirically based allocation of patients to intense aphasia treatment awaits the results of multicenter trials with sufficiently large sample sizes.