Post-stroke aphasia refers to acquired language disorder caused by stroke , which leads to damage to the language functional area of the dominant cerebral hemisphere, and has different degrees of impairment of the language function of six parts: spontaneous speech, listening and comprehension, retelling, naming, reading and writing.
aphasia is one of the common functional dysfunctions after stroke , and the incidence rate after the first stroke can reach 32%. Although patients with aphasia after acute stroke have a certain degree of spontaneous recovery, most of them still have a certain degree of speech dysfunction. Post-stroke aphasia not only seriously affects patients' communication, but also makes it difficult for patients to understand rehabilitation instructions due to reduced comprehension and difficulty in pronunciation, making it difficult for patients to cooperate with other rehabilitation training, which affects the overall prognosis of stroke.
The earlier the aphasia after stroke, the better the prognosis
The earlier the aphasia after stroke, the better the intervention. It is recommended to screen for stroke aphasia within 24 hours after stroke and wait until the condition is stable.
Early intervention in aphasia , in addition to classic neurorepair treatment and speech and language rehabilitation training, non-invasive brain stimulation techniques mainly based on low-frequency electrical stimulation therapy, repeated transcranial magnetic stimulation and transcranial DC stimulation, as well as drug treatments such as donepezil and memantine are increasingly used in clinical practice.
1. Neurological repair and treatment:
The root cause of aphasia after stroke is to damage the language function of the hemisphere of the brain, so repairing/reconstructing damaged nerves is the most important step. According to clinical data, achieving 15% of the structure can support 80% of the functions. Neurological repair treatment is to restore the neural function by repairing damaged neurons and activate residual nerve fibers to achieve the purpose of reshaping the neural network . Early treatment plays a positive role in the remodeling of neural networks, so it is recommended that patients intervene in treatment after stroke is stable.
2, Language Rehabilitation Training
Language Rehabilitation Training is an effective treatment method with evidence-based medicine . It can improve the language understanding and output function of aphasic patients and enable patients to gradually integrate into their family and social life. Training methods include Schuell stimulation method, cognition-memory-thinking stimulation method, melody tone therapy, communication effect promotion method, compulsory induced speech therapy, word navigation training method, and music therapy. The treatment principle is targeted, from easy to difficult, and repeatedly strengthened.
3, low-frequency electrical stimulation
Transscalp low-frequency electrical stimulation can transmit external stimulation signal to relevant regional brain tissues, thereby adjusting the excitation and inhibition process of cerebral cortex functional nerve cells, improving brain activity, and activate brain language function. Low-frequency electrical stimulation therapy can effectively promote language function recovery, improve patient prognosis and improve quality of life.
4, Repeated Transcranial Magnetic Stimulation,
0 Repeated Transcranial Magnetic Stimulation refers to the repeated application of the pulse magnetic field law that briefly penetrates the skull to a specific cortical area, so that the membrane potential of cortical nerve cells can be changed, thereby generating action potential , causing plastic changes in the brain to restore the patient's language function. Low-frequency repeated transcranial magnetic stimulation treatment can effectively improve the ability of patients with motor aphasia to talk, understand, retell, naming, etc.
5, transcranial DC stimulation
has improved the pronunciation accuracy of patients with chronic aphasia and subacute aphasia, but there is no statistically significant difference in naming and syllable repetition tasks.
6, drug treatment
, drug treatment, such as donepezil, memantine, etc., can appropriately supplement or replace neurotransmitters, improve the damaged neurotransmitter pathways, and alleviate the symptoms of patients with aphasia.
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