ABSTRACT
Objective To investigate the effectiveness of donepezil in the treatment of early post-stroke aphasia (PSA).Methods PSA patients within one month after onset were randomly assigned into either a donepezil group or a control group.On the basis of conventional medication,the donepezil group was given hydrochloride donepezil 5 mg/d.The patients were followed-up after 4 week.The efficacy was evaluated by the Aphasia Battery of Chinese (ABC),the National Institute of Health Stroke Scale (NIHSS),the Stroke Aphasic Depression Questionnaire (SADQ),Chinese version,and the Treatment Emergent Symptom Scale (TESS) before and after treatment.Results A total of 48 PSA patients were enrolled in the study.Both the donepezil group and the control group had 24 patients and they all completed the study.There were no significant differences in age,years of education,NIHSS score,SADQ score,stroke duration,as well as the proportions of male,hypertension,diabetes,hyperlipidemia,heart disease,previous stroke or history of transient ischemic attack,smoking alcohol consumption,type of stroke,and lesion site (all P ＜ 0.01).There were significant differences in each language score before and after treatment both in the donepezil group and in the control group (all P ＜0.01).The difference values of listening comprehension (47.8 ± 24.7 vs.22.0 ± 15.4; t =4.342,P =0.000)and reading comprehension (20.5 ± 14.0 vs.8.1 ± 10.5; t =3.483,P ＜0.01) scores before and after treatment in the donepezil group were significantly higher than those in the control group,while there were no significant differences in the information quantity of speech,fluency,series language,repetition,naming,and reading scores (all P ＞0.05).As compared with the control group,there were significant differences in the difference values of the SADQ scores before and after treatment in the donepezil group (6.2 ±6.0 vs.2.5 ±3.0; t =2.717,P=0.009).No serious adverse reactions were observed in both groups.Conclusions On the basis of conventional stroke treatment,using hydrochloride donepezil in the early PSA patients has promotion effect on the improvement of listening comprehension and reading comprehension of language function.
ABSTRACT
Objective To observe activated cerebral areas during the task of writing in second language by early and late acquisition bilinguals and explore the neuropsychological mechanism. Methods Twelve subjects were divided into group of early acquisition high proficiency bilinguals(EAHP) and group of late acquisition high proficiency bilinguals(LAHP). Each subject carried out the task of pseudo-writing and English writing. After functional imaging,statistical parametric mapping was used to compare data of the two tasks through paired- t test in both two groups. A conjunction analysis was conducted between the two groups also. Areas where the metabolism of glucose changed were analyzed. Then, the corresponding images about activated cerebral regions were obtained.Results Cerebral areas where the metabolism of glucose increased in EAHP: bilateral middle frontal gyrus( Z=4.35/2. 01 ), bilateral cerebellum ( Z = 2.97/2.53 ) and left head of caudate nucleus ( Z = 3.07 ), etc. Cerebral areas where the metabolism of glucose increased in LAHP: right superior frontal gyrus(Z=4.06), right cerebellum( Z=4.63), left putamen(Z=2.70) ,etc. Cerebral areas where the metabolism of glucose increased in compared data of LAHP with data of EAHP: right frontal gyrus ( Z = 2.92 ), right temporal lobe( Z = 2.31 ), etc. Conclusion Extensive cerebral cortex and subcortical structures participate the process of writing in the second language. Age of bilingual acquisition is one of the factors affecting cerebral localization of writing in second language.