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Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia
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In: World J Psychiatry (2022)
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Case Report: Barely Able to Speak, Can’t Stop Echoing: Echolalic Dynamic Aphasia in Progressive Supranuclear Palsy
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In: Front Aging Neurosci (2021)
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Pharmacotherapy of Traumatic Childhood Aphasia: Beneficial Effects of Donepezil Alone and Combined With Intensive Naming Therapy
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In: Front Pharmacol (2020)
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Developmental Dynamic Dysphasia: Are Bilateral Brain Abnormalities a Signature of Inefficient Neural Plasticity?
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From dysfunctional to extraordinary verbal repetition abilities: clinical implications and neural features
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Is the emergence of speech errors in chronic post-stroke aphasia a result of ongoing compensatory brain plasticity mechanisms?
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Neural signatures of treatment-induced benefits in apathy and depression amongst persons with aphasia
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Towards a tailored approach to neuroplasticity enhancement based on brain and behavioral predictors of language learning success
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Beneficial effects of pharmacological treatment in post-stroke dynamic aphasia: a behavioural and neuroimaging study
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Abstract:
Introduction : Dynamic Aphasia (DA) is a rare form of language disorder characterized by reduced spontaneous speech with preservation of other language functions. Two types of DA have been described: language-specific type (type I DA) and domain-general type (type II DA). In type I DA, deficits are selective for word and sentence generation, whereas in type II DA impairments affect discourse generation, narrative, fluency, and non-verbal generation tasks. There is little information on the treatment of DA. Although treatment with a cognitive enhancing drug (bromocriptine) improved outcome in previous studies, pharmacological interventions combining two drugs acting on other neurotransmitter systems in DA have not been reported so far. Methods : We report an open-label pharmacological single case study (n = 1) in a male patient with a chronic type I/II DA secondary to an ischemic infarction in the left fronto-opercular and insular regions. After baseline evaluation, the patient received donepezil 5 mg/day (2 months), donepezil 10 mg/day (2 months), donepezil 10 mg/day plus memantine 20 mg/day (4½ months) followed by a washout period (1½ months). No speech-language therapy was used. A comprehensive cognitive and language evaluation was carried out at baseline and at different endpoints. 18FDG-PET was performed at the four timepoints. Results : Donepezil (5 mg/day) significantly improved type I DA features (normalization of verbs generation, p = 0.01), whereas donepezil (10 mg/day) improved some type II features (normalizing spontaneous speech, verbal fluency and improving generation of novel thoughts, p = 0.004), along with improvement of executive-attentional functioning. Combined therapy further enhanced cognitive function, but did not additionally improved DA. 18 FDG-PET revealed significant reductions of perilesional hypometabolic activity mainly after donepezil (10 mg/day) and washout. Discussion : Treatment with donepezil improved language deficits in a patient with chronic post-stroke type I/II DA. Combined therapy (donepezil plus memantine) further enhanced executive-attentional functioning. Beneficial changes were associated with improvements in perilesional metabolic activity. References : Luria AR et al.Acta Neurologica et Psychiatrica (1967). Robinson G et al. Brain (1998). Keywords : Language; patients; single case study; adults; cerebrovascular; behavioural, functional imaging. ; Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.
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Keyword:
Afasia - Congresos; Donepezil; Dynamic Aphasia; Memantine; pharmacological treatment; plasticity
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URL: https://hdl.handle.net/10630/15168
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Ecolalia mitigada y conducta de aproximación: plasticidad compensatoria en los circuitos cerebrales de lenguaje
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Aphasia with anatomical isolation of the language area: A reanalysis on the light of modern neuroimaging techniques
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A reappraisal of echolalia in aphasia: A case-series study with multimodal neuroimaging
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Overrepresentation of verbal repetition deficits in aphasic men with stroke: A systematic literature review and meta-analysis
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Mild Developmental Foreign Accent Syndrome and Psychiatric Comorbidity: Altered White Matter Integrity in Speech and Emotion Regulation Networks
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Relación entre déficits lingüísticos y atencionales en personas con afasia post-ictus: el papel de la modulación colinérgica
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Loss of regional accent after damage to the speech production network
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Repeating with the right hemisphere: reduced interactions between phonological and lexical-semantic systems in crossed aphasia?
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Dissociated repetition deficits in aphasia can reflect flexible interactions between left dorsal and ventral streams and gender-dimorphic architecture of the right dorsal stream
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