Combining Bromocriptine and Speech and Language Therapy in the Treatment of a Person with Aphasia: A Clinical Study

摘要

The dopaminergic neural pathways play a key role in controlling initiation and maintenance ofcomplex motor routines, attention switching and goal-directed behaviour and motivation (Albert etal., 1988). Damage to such regions can reduce the drive to generate speech, produce deficits infocusing attention and controlling cognition related to speech and language processes as well asdecrease motivation (Alexander, 2006). Bromocriptine is a postsynaptic dopamine D2 receptoragonist and has several roles including regulation of reward, attention, learning, mood andmovement.The effects of bromocriptine use with people with aphasia have been variable (Berthier &Pulvermuller, 2011). Improvements in verbal fluency, response latency and confrontation namingtasks have been shown in single case studies of transcortical motor aphasia, adynamic aphasia andBroca’s aphasia (Albert et al.,1988; Berthier & Pulvermuller, 2011; Berthier, 1999; Raymer et al.2001). Benefits reported in single case, case-series and open-label studies have not be replicated inrandomised controlled trials (Sabe et al.,1995, Ashtary et al., 2006). There is also evidence that thisdrug is not suitable for all aphasia subtypes or for those with more severe aphasias (Berthier, 1999).