Are pharmacotherapeutics effective for treating aphasia?

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.

KEYWORDS:

• Aphasia
• clinical trials
• neuroplasticity
• neurotransmitters
• alzheimer disease
• primary progressive aphasia
• vascular cognitive impairment

Article highlights

• Aphasia is a communication disorder that hampers almost every aspect of personal life.

• Aphasia is caused by stroke and neurodegeneration in the left cerebral hemisphere.

• Presently, a high proportion of persons with aphasia (PWA), who are eligible for pharmacological research, display mild-to-moderate language deficits.

• There is, consequently, a need for greater attention to be placed on those people with severe and very mild aphasia.

• There are still several unanswered questions concerning the pharmacological treatment and/or management of aphasia.

• Future studies that focus on language and communication are warranted to better elucidate the value of pharmacotherapy for aphasia as well as for future treatment options.

Declaration of interest

M Berthier was provided with an independent research grant by Pfizer and Eisai, Spain, for an investigation wherein the principal investigator designed, conducted, and controlled the study, and where Pfizer, Spain, provided donepezil (protocol: DON-IIG-165; WS3006624). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The authors are funded by the European Social Fund (FEDER) (via grant no. EQC2018-004803-P), the Junta de Andalucía, Spain (via grant no. P20_00501) as well as by Pfizer and Eisai, Spain.