[Neurodynamic speech disorders in the acute ischemic stroke]. / Neirodinamicheskie narusheniya rechi v ostrom periode ishemicheskogo insul'ta.

OBJECTIVE: To identify the features of the clinical picture and evaluate the dynamics of regression of neurodynamic speech disorders in comparison with cortical aphasia in patients with ischemic stroke (IS) in the carotid system. MATERIAL AND METHODS: We examined 268 patients with a median age of 59 (54; 70) years in the acute period of IS in the dominant hemisphere with the presence of cortical aphasia or neurodynamic speech disorders. The degree of speech recovery was characterized by an increase in the score on the Speech Questionnaire (ΔSQ) from 1 to 21 days after the development of IS. The patients were divided into group 1 (n=148) with a low level of recovery (ΔSQ≤6) and group 2 (n=120) with a high level (ΔSQ >6). RESULTS: Of the 268 patients, cortical aphasia was detected in 171 (63.8%) patients, and neurodynamic speech disorders characterized by significant variability of symptoms over the course of hours and days were detected in 97 (36.2%) patients. In patients with cortical aphasia, the majority of patients (63.2%) were classified into group 1, and among patients with neurodynamic speech disorders - into group 2 (58.8%), which showed the stability of the regression dynamics of speech disorders (p=0.001). In patients with cortical lesions the impressive side of speech suffered more often - in this group patients with sensorimotor aphasia predominate. In the case of neurodynamic speech disorders, motor and sensorimotor disorders are observed with approximately the same frequency (p=0.002). CONCLUSION: In comparison with cortical aphasias, the sensory component of speech suffers to a lesser extent in neurodynamic speech disorders. Neurodynamic speech disorders generally recover faster and more fully.

[Features of speech rehabilitation in the acute stroke in different forms of aphasia]. / Osobennosti rechevoi reabilitatsii v ostrom periode insul'ta pri raznykh formakh afaticheskikh rasstroistv.

AIM: To determine the dependence of speech recovery on the type of aphasia in patients with acute ischemic stroke in the carotid territory. MATERIAL AND METHODS: Three hundred and fifty-one patients, aged 61 [55; 72] years, with ischemic stroke were examined. The degree of speech recovery was characterized by an increase in the score on the Speech Questionnaire (SQ) on the 21st day from the beginning of the disease compared to baseline. Patients were divided into 2 groups: low (ΔSQ ≤6) and high (ΔSQ >6) recovery. Speech disorders were represented by motor, sensorimotor and subcortical aphasia. RESULTS: The group ΔSQ ≤6 was dominated by patients with sensorimotor aphasia (n=141, (76,6%)). In the ΔSQ >6 group, motor aphasia was more frequent (119 people (71.3%)), sensorimotor aphasia was observed in 48 patients (28.7%) (p=0.0001). Patients of the group with the worst speech restoration more often had cortical aphasia (n=108; 73.0%), and patients with subcortical aphasia slightly prevailed in the group with the best recovery: 40 (27.0%) in group I and 57 (47.5%) in group II (p=0.001). CONCLUSION: Motor aphasia and subcortical aphasia are associated with good recovery of speech function in the acute period of ischemic stroke.

[Combined neuroprotection in the treatment of post-stroke aphasia]. / Kombinirovannaia neiroprotektsiia v lechenii postinsul'tnykh afazii.

AIM: To evaluate the efficacy of combined neuroprotection in the restoration of speech function in patients with acute ischemic stroke in the carotid region. MATERIAL AND METHODS: The study included 257 patients (median age 60 (55; 72) years) with ischemic stroke and motor or sensorimotor aphasia. The degree of speech recovery was characterized by an increase in the score on the scale of the speech questionnaire (SQ) on the 21st day from the beginning of the disease. Patients were divided into low recovery (ΔSQ ≤6) and high recovery (ΔSQ >6) groups. All patients received neuroprotectors of different groups. RESULTS: The greatest efficacy was shown for cortexin in combination with mexidol: the ΔSQ >6 group included 24 (70.6%) and the group ΔSQ ≤6 10 (29.4%) patients out of 34 patients. The lowest efficacy was observed for gliatilin in monotherapy: an increase was ≤6 points in 24 (68.6%) patients and >6 points in 11 (31.4%), and for combinations of ceraxon and mexidol: 26 (61.9%) and 6 (38.1%) patients with low- and high level of speech recovery, respectively (p=0.041). CONCLUSION: Combined neuroprotective therapy using drugs with neuromodulatory and antioxidant effects (cortexin and mexidol) in the acute period of ischemic stroke is effective in the treatment of post-stroke aphasia.

[The restoration of speech in patients with aphasia depending on the manifestations of carotid atherosclerosis in stroke]. / Vosstanovlenie rechevykh funktsii u bol'nykh s postinsul'tnoi afaziei v zavisimosti ot vyrazhennosti ateroskleroticheskogo porazheniya tserebral'nykh arterii.

AIM: To study an effect of stenosing lesions of carotid arteries on the recovery of speech functions in acute stroke patients. MATERIAL AND METHODS: Medical histories of 253 patients (median age 58 [52,63]) with acute left hemispheric ischemic and hemorrhagic stroke and motor or sensorimotor aphasia were analyzed. The severity of atherosclerotic lesion of brachiocephalic arteries was assessed using color duplex scanning. According to the results of duplex scanning, patients were divided into 3 groups: 1 - without stenosis of extracranial arteries; 2 - with ≤50% stenosis of carotid arteries; 3 - with >50% stenosis of carotid arteries. RESULTS: Stenosis greater than 50% (group 3) was a predictor of the poor recovery of speech function while stenosis less than 50% (groups 1 and 2) had no effect on the outcome. CONCLUSION: The severe atherosclerosis of carotid arteries had a negative effect on speech recovery in acute stroke patients.

[The effect of cellex on cognitive and speech impairments in the acute stage of stroke].

OBJECTIVE: To study the effect of cellex on the recovery of cognitive and speech functions in the acute stage of stroke. MATERIAL AND METHODS: A multicenter comparative open clinical study of the efficacy and safety of cellex in treatment of patients with acute stroke was carried out in 6 clinical sites. The study involved 180 patients, including 147 (81.7%) with ischemic stroke and 33 (18.3%) with hemorrhagic stroke. Celex was introduced subcutaneously in dose 0.1 mg once a day during the first 10 days and from 21 to 27th days. RESULTS AND CONCLUSION: The rapid and complete recovery of neurological and cognitive functions was observed. The more marked dynamics was seen in patients with greater initial stroke severity and with large hemisphere lesions.