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Article ; Online: Are pharmacotherapeutics effective for treating aphasia?

Dávila, Guadalupe / Berthier, Marcelo L

2024 Volume 24, Issue 3, Page(s) 267–271

Abstract: Introduction: Aphasia is a communication disorder resulting from stroke and/or neurodegenerative conditions which involve the left cerebral hemisphere. It is a debilitating disorder affecting a person's ability to speak, understand, read, and write. Its ...

Abstract	Introduction: Aphasia is a communication disorder resulting from stroke and/or neurodegenerative conditions which involve the left cerebral hemisphere. It is a debilitating disorder affecting a person's ability to speak, understand, read, and write. Its impact on daily life necessitates therapeutic strategies to aid patients with aphasia. Areas covered: In this special report, the authors speculate whether current pharmacotherapeutic strategies are effective in treating aphasia. The authors look at aphasia caused by different conditions and how this could impact therapy before providing the reader with their expert perspectives. The aim of this paper is for the reader to gain a clearer understanding of the efficacy of the current pharmacotherapeutic treatment paradigms as well as potential future developments. Expert opinion: The exploration of pharmacotherapy for aphasia in vascular brain disorders and neurodegenerative diseases has received much attention in recent years with various therapeutic strategies having been put forward. In terms of whether pharmacotherapy is effective for the treatment of aphasia, there is still no clear-cut answer. Further research is needed with more studies requiring a greater emphasis on language and communication deficits. Biomarkers may also help clinicians provide their patients with a more personalized treatment plan.
MeSH term(s)	Humans ; Aphasia/drug therapy ; Aphasia/etiology ; Stroke/complications ; Stroke/drug therapy ; Brain ; Stroke Rehabilitation
Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2112534-X
ISSN	1744-8360 ; 1473-7175
ISSN (online)	1744-8360
ISSN	1473-7175
DOI	10.1080/14737175.2024.2313557
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Article ; Online: Pharmacotherapy for post-stroke aphasia: what are the options?

Berthier, Marcelo L / Dávila, Guadalupe

Expert opinion on pharmacotherapy

2023 Volume 24, Issue 11, Page(s) 1221–1228

Abstract: Introduction: Aphasia is a common, long-lasting aftermath of stroke lesions. There is an increased integration of pharmacotherapy as an adjunctive strategy to speech and language therapy (SLT) for post-stroke aphasia (PSA). Nevertheless, more research ... ...

Abstract	Introduction: Aphasia is a common, long-lasting aftermath of stroke lesions. There is an increased integration of pharmacotherapy as an adjunctive strategy to speech and language therapy (SLT) for post-stroke aphasia (PSA). Nevertheless, more research in pharmacotherapy for acute and chronic PSA is necessary, including the election of drugs that target different neurotransmitter systems and deficits in specific language domains. Areas covered: This article updates the role of pharmacotherapy for PSA, focusing the spotlight on some already investigated drugs and candidate agents deserving of future research. Refining the precision of drug election would require using multimodal biomarkers to develop personalized treatment approaches. There is a solid need to devise feasible randomized controlled trials adapted to the particularities of the PSA population. The emergent role of multimodal interventions combining one or two drugs with noninvasive brain stimulation to augment SLT is emphasized. Expert opinion: Pharmacotherapy can improve language deficits not fully alleviated by SLT. In addition, the 'drug-only' approach can also be adopted when administering SLT is not possible. The primary goal of pharmacotherapy is reducing the overall aphasia severity, although targeting language-specific deficits (i.e. naming, spoken output) also contributes to improving functional communication. Unfortunately, there is still little information for recommending a drug for specific language deficits.
MeSH term(s)	Humans ; Aphasia/drug therapy ; Aphasia/etiology ; Stroke/complications ; Speech Therapy
Language	English
Publishing date	2023-06-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1080/14656566.2023.2221382
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Book ; Online: Language beyond Words: The Neuroscience of Accent

Davila, Guadalupe / Marien, Peter / Moreno-Torres, Ignacio / Berthier, Marcelo L.

2017

Abstract: Language learning also implies the acquisition of a set of phonetic rules and prosodic contours which define the accent in that language. While often considered as merely accessory, accent is an essential component of psychological identity as it ... ...

Abstract	Language learning also implies the acquisition of a set of phonetic rules and prosodic contours which define the accent in that language. While often considered as merely accessory, accent is an essential component of psychological identity as it embodies information on origin, culture, and social class. Speaking with a non-standard (foreign) accent is not inconsequential because it may negatively impact communication and social adjustment. Nevertheless, the lack of a formal definition of accent may explain that, as compared with other aspects of language, it has received relatively little attention until recently. During the past decade there has been increasing interest in the analysis of accent from a neuroscientific perspective. This e-book integrates data from different scientific frameworks. The reader will find fruitful research on new models of accent processing, how learning a new accent proceeds, and the role of feedback on accent learning in healthy subjects. In addition, information on accent changes in pathological conditions including developmental and psychogenic foreign accent syndromes as well as the description of a new variant of foreign accent syndrome is also included. It is anticipated that the articles in this e-book will enhance the understanding of accent as a linguistic phenomenon, the neural networks supporting it and potential interventions to accelerate acquisition or relearning of native accents
Keywords	Neurosciences. Biological psychiatry. Neuropsychiatry ; Science (General)
Size	1 electronic resource (174 p.)
Publisher	Frontiers Media SA
Document type	Book ; Online
Note	English ; Open Access
HBZ-ID	HT020095029
ISBN	9782889451074 ; 2889451070
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Book ; Online: Dissecting the function of networks underpinning language repetition

Ralph, Matthew A. Lambon / Berthier, Marcelo L.

2014

Abstract: In the 19th century, ground-breaking observations on aphasia by Broca and Wernicke suggested that language function depends on the activity of the cerebral cortex. At the same time, Wernicke and Lichtheim also elaborated the first large-scale network ... ...

Abstract	In the 19th century, ground-breaking observations on aphasia by Broca and Wernicke suggested that language function depends on the activity of the cerebral cortex. At the same time, Wernicke and Lichtheim also elaborated the first large-scale network model of language which incorporated long-range and short-range (transcortical connections) white matter pathways in language processing. The arcuate fasciculus (dorsal stream) was traditionally viewed as the major language pathway for repetition, but scientists also envisioned that white matter tracts travelling through the insular cortex (ventral stream) and transcortical connections may take part in language processing. Modern cognitive neuroscience has provided tools, including neuroimaging, which allow the in vivo examination of short- and long-distance white matter pathways binding cortical areas essential for verbal repetition.- However, this state of the art on the neural correlates of language repetition has revealed contradictory findings, with some researchers defending the role of the dorsal and ventral streams, whereas others argue that only cortical hubs (Sylvian parieto-temporal cortex [Spt]) are crucially relevant. An integrative approach would conceive that the interaction between these structures is essential for verbal repetition. For instance, different sectors of the cerebral cortex (e.g., Spt, inferior frontal gyrus/anterior insula) act as hubs dedicated to short-term storage of verbal information or articulatory planning and these areas in turn interact through forward and backward white matter projections. Importantly, white matter pathways should not be considered mere cable-like connections as changes in their microstructural properties correlate with focal cortical activity during language processing tasks. Despite considerable progress, many outstanding questions await response.- The articles in this Research Topic tackle many different and critical new questions, including: (1) how white matter pathways instantiate dialogues between different cortical language areas; (2) what are the specific roles of different white matter pathways in language functions in normal and pathological conditions; (3) what are the language consequences of discrete damage to branches of the dorsal and ventral streams; 4) what are the consequences (e.g., release from inhibition) of damage to the left white matter pathways in contralateral ones and viceversa; (5) how these pathways are reorganised after brain injury; (5) can the involvement/sparing of white matter pathways be used in outcome prediction and treatment response; and (5) can the microstructure of white matter pathways be remodelled with intensive rehabilitation training or biological approaches.This Research Topic includes original studies,-
Keywords	Neurosciences. Biological psychiatry. Neuropsychiatry ; Science (General)
Size	1 electronic resource (134 p.)
Publisher	Frontiers Media SA
Document type	Book ; Online
Note	English ; Open Access
HBZ-ID	HT020090066
ISBN	9782889193646 ; 2889193640
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Book: Transcortical aphasias

Berthier, Marcelo L.

(Brain damage, behaviour and cognition series)

1999

Author's details	Marcelo L. Berthier
Series title	Brain damage, behaviour and cognition series
Keywords	Transkortikale Aphasie
Subject	Lichtheimsche Aphasie
Language	English
Size	XIII, 274 S. : Ill., graph. Darst.
Publisher	Psychology Press
Publishing place	Hove
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT009977730
ISBN	0-86377-840-2 ; 978-0-86377-840-7
Database	Catalogue ZB MED Medicine, Health

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2000 A 157	order for loan	Magazin

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Article ; Online: Echolalia: Paying attention to a forgotten clinical feature of primary progressive aphasia.

Torres-Prioris, María José / Berthier, Marcelo L

European journal of neurology

2021 Volume 28, Issue 4, Page(s) 1102–1103

MeSH term(s)	Aphasia ; Aphasia, Primary Progressive/diagnosis ; Echolalia ; Humans ; Memory Disorders
Language	English
Publishing date	2021-01-22
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1280785-0
ISSN	1468-1331 ; 1351-5101 ; 1471-0552
ISSN (online)	1468-1331
ISSN	1351-5101 ; 1471-0552
DOI	10.1111/ene.14712
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Article ; Online: Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System.

Dávila, Guadalupe / Torres-Prioris, María José / López-Barroso, Diana / Berthier, Marcelo L

CNS drugs

2023 Volume 37, Issue 7, Page(s) 599–637

Abstract: Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests ... ...

Abstract	Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
MeSH term(s)	Humans ; Alzheimer Disease/drug therapy ; Alzheimer Disease/complications ; Cholinergic Agents/therapeutic use ; Brain ; Aphasia/complications ; Aphasia/drug therapy ; Acetylcholine/therapeutic use
Chemical Substances	Cholinergic Agents ; Acetylcholine (N9YNS0M02X)
Language	English
Publishing date	2023-06-21
Publishing country	New Zealand
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1203800-3
ISSN	1179-1934 ; 1172-7047
ISSN (online)	1179-1934
ISSN	1172-7047
DOI	10.1007/s40263-023-01017-4
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Article ; Online: Brain structural and functional correlates of the heterogenous progression of mixed transcortical aphasia.

López-Barroso, Diana / Paredes-Pacheco, José / Torres-Prioris, María José / Dávila, Guadalupe / Berthier, Marcelo L

Brain structure & function

2023 Volume 228, Issue 5, Page(s) 1347–1364

Abstract: Mixed transcortical aphasia (MTCA) is characterized by non-fluent speech and comprehension deficits coexisting with preserved repetition. MTCA may evolve to less severe variants of aphasias or even to full language recovery. Mechanistically, MCTA has ... ...

Abstract	Mixed transcortical aphasia (MTCA) is characterized by non-fluent speech and comprehension deficits coexisting with preserved repetition. MTCA may evolve to less severe variants of aphasias or even to full language recovery. Mechanistically, MCTA has traditionally been attributed to a disconnection between the spared left perisylvian language network (PSLN) responsible for preserved verbal repetition, and damaged left extrasylvian networks, which are responsible for language production and comprehension impairments. However, despite significant advances in in vivo neuroimaging, the structural and functional status of the PSLN network in MTCA and its evolution has not been investigated. Thus, the aim of the present study is to examine the status of the PSLN, both in terms of its functional activity and structural integrity, in four cases who developed acute post-stroke MTCA and progressed to different types of aphasia. For it, we conducted a neuroimaging-behavioral study performed in the chronic stage of four patients. The behavioral profile of MTCA persisted in one patient, whereas the other three patients progressed to less severe types of aphasias. Neuroimaging findings suggest that preserved verbal repetition in MTCA does not always depend on the optimal status of the PSLN and its dorsal connections. Instead, the right hemisphere or the left ventral pathway may also play a role in supporting verbal repetition. The variability in the clinical evolution of MTCA may be explained by the varying degree of PSLN alteration and individual premorbid neuroanatomical language substrates. This study offers a fresh perspective of MTCA through the lens of modern neuroscience and unveils novel insights into the neural underpinnings of repetition.
MeSH term(s)	Humans ; Magnetic Resonance Imaging ; Aphasia/diagnostic imaging ; Aphasia/complications ; Brain/diagnostic imaging ; Stroke ; Neuroimaging
Language	English
Publishing date	2023-05-31
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2273162-3
ISSN	1863-2661 ; 1863-2653
ISSN (online)	1863-2661
ISSN	1863-2653
DOI	10.1007/s00429-023-02655-6
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Article: Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia.

Edelkraut, Lisa / López-Barroso, Diana / Torres-Prioris, María José / Starkstein, Sergio E / Jorge, Ricardo E / Aloisi, Jessica / Berthier, Marcelo L / Dávila, Guadalupe

World journal of psychiatry

2022 Volume 12, Issue 3, Page(s) 450–469

Abstract: Background: Neuropsychiatric symptoms (NPS) have been insufficiently examined in persons with aphasia (PWA) because most previous studies exclude participants with language and communication disorders.: Aim: To report a two-part study consisting of a ...

Abstract	Background: Neuropsychiatric symptoms (NPS) have been insufficiently examined in persons with aphasia (PWA) because most previous studies exclude participants with language and communication disorders. Aim: To report a two-part study consisting of a literature review and an observational study on NPS in post-stroke aphasia. Methods: Study 1 reviewed articles obtained from PubMed, PsycINFO, Google Scholar and Cochrane databases after cross-referencing key words of post-stroke aphasia to NPS and disorders. Study 2 examined language deficits and activities of daily living in 20 PWA (median age: 58, range: 28-65 years; 13 men) with the Western Aphasia Battery-Revised and the Barthel Index, respectively. Informants of these 20 PWA were proxy-evaluated with the Neuropsychiatric Inventory and domain-specific scales, including the Stroke Aphasia Depression Questionnaire-10 item version and the Starkstein Apathy Scale. In addition, an adapted version of the Hospital Anxiety and Depression Scale was directly administered to the PWA themselves. This observational study is based on the baseline assessment of an intervention clinical trial (EudraCT: 2017-002858-36; ClinicalTrials.gov identifier: NCT04134416). Results: The literature review revealed a broad spectrum of NPS in PWA, including depression, anxiety, apathy, agitation/aggression, eating and sleep disorders, psychosis, and hypomania/mania. These findings alert to the need for improving assessment and treatment approaches of NPS taking into consideration their frequent occurrence in PWA. Study 2 showed that the 20 participants had mild- to-moderate aphasia severity and were functionally independent. A wide range of comorbid NPS was found in the post-stroke aphasic population (median number of NPS: 5, range: 1-8). The majority of PWA (75%) had depressive symptoms, followed by agitation/aggression (70%), irritability (70%), anxiety (65%) and appetite/eating symptoms (65%). Half of them also presented symptoms of apathy, whereas euphoria and psychotic symptoms were rare (5%). Domain-specific scales revealed that 45% of participants had apathy and 30% were diagnosed with depression and anxiety. Conclusion: Concurrent NPS are frequent in the chronic period of post-stroke aphasia. Therefore, further research on reliable and valid assessment tools and treatment for this aphasic population is strongly warranted.
Language	English
Publishing date	2022-03-19
Publishing country	United States
Document type	Journal Article
ISSN	2220-3206
ISSN	2220-3206
DOI	10.5498/wjp.v12.i3.450
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Article: Commentary: Visual Feedback of Tongue Movement for Novel Speech Sound Learning.

Berthier, Marcelo L / Moreno-Torres, Ignacio

Frontiers in human neuroscience

2016 Volume 10, Page(s) 662

Language	English
Publishing date	2016-12-23
Publishing country	Switzerland
Document type	Journal Article ; Comment
ZDB-ID	2425477-0
ISSN	1662-5161
ISSN	1662-5161
DOI	10.3389/fnhum.2016.00662
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