卒中后失语治疗研究进展

Research progress in the treatment of post-stroke aphasia

全球范围内每年新发卒中病例超过1000万例,其中卒中后失语(PSA)患者约占1/3。有21%~40%卒中患者存在持续性失语症状,语言功能受损导致PSA患者日常生活沟通能力明显下降,而且不良或无效沟通常常会引发抑郁情绪。PSA已成为卒中后无法实现独立生活和死亡的独立预测因素。因此,高效合理的PSA康复手段显得尤为重要。目前,言语语言治疗仍是失语症的首选治疗方法,非侵入性脑部刺激可作为增强疗效的辅助手段。现有循证证据表明,基于“中枢-外周-中枢”闭环理论的言语语言治疗联合非侵入性脑部刺激可获得更好的临床疗效。本文从外周干预、中枢干预以及闭环干预的角度梳理了现有的研究证据,对PSA的治疗研究进展进行综述,旨在为PSA康复工作思路提供参考。

Globally,there are more than 10 million new stroke cases every year,and about 1/3 of patients have post-stroke aphasia(PSA).About 21%-40%of stroke patients have persistent aphasia symptoms.The impairment of language function lead to a significant decreases of the daily communication ability of PSA patients,and poor or ineffective communication often lead to depression.PSA has become an independent predictor and death after stroke.Therefore,efficient and reasonable rehabilitation methods for PSA are particularly important.At present,speech-language therapy is still the first choice for aphasia,and non-invasive brain stimulation can be used as an auxiliary means to enhance the curative effect.Existing evidence-based evidence shows that speech-language therapy based on"peripheral central peripheral"closed-loop theory combined with non-invasive brain stimulation can obtain better clinical efficacy.This paper summarized the existing research evidences from the perspectives of peripheral intervention,central intervention,and closed-loop intervention,and reviewed the research progress on the treatment of PSA,aiming to provide reference for the rehabilitation work of PSA.