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Brain Stimul. 2012 Jul;5(3):364-368. doi: 10.1016/j.brs.2011.04.003. Epub 2011 May 10.

Epidural electrical stimulation to improve chronic poststroke aphasia: a 5-year follow-up.

Author information

1
CHU de Caen, Service de Neurochirurgie, Caen, F-14000, France. Electronic address: anne.balossier@free.fr.
2
CHU de Caen, Laboratoire d'Explorations Fonctionnelles du Système Nerveux, Caen, F-14000, France; Université de Caen Basse-Normandie, UFR de Médecine, Caen, F-14000, France.
3
CHU de Caen, Service de Neurologie, Caen, F-14000, France.
4
INSERM, INSERM U919, Serine Proteases and Pathophysiology of the Neurovascular Unit, Université de Caen Basse-Normandie, GIP Cyceron, Caen, F-14073, France.
5
CHU de Caen, Service de Neurochirurgie, Caen, F-14000, France; Université de Caen Basse-Normandie, UFR de Médecine, Caen, F-14000, France; INSERM, INSERM U919, Serine Proteases and Pathophysiology of the Neurovascular Unit, Université de Caen Basse-Normandie, GIP Cyceron, Caen, F-14073, France.

Abstract

BACKGROUND:

Aphasia is an incapacitating deficit experienced by almost 25% of patients after a left hemispheric ischemic stroke. Spontaneous recovery is considered to be limited to a period of 3 to 6 months. Although speech therapy performed during the first weeks may speed up this process and enhance its outcome, beyond this period it fails to change the global prognosis.

OBJECTIVE:

We report a case of an unusual recovery of nonfluent chronic poststroke aphasia subsequent to extradural cortical stimulation.

METHODS:

A right-handed woman experienced aphasia and drug-resistant central poststroke facial pain after a left superficial Sylvian ischemic stroke at the age of 58 years old. Four years after the stroke, the patient was included in a clinical trial to establish the efficiency of epidural electric stimulation on neuropathic pain. As an improvement in her language performance was noted, a speech evaluation was added to the initial protocol to quantify the benefit. Twelve months after the surgical implantation, pain and language performance were assessed in a double-blind manner during two consecutive 1-month periods when the stimulator was randomly enabled or disabled. The same evaluation was performed after 5 years of stimulation.

RESULTS:

Eventually, epidural electric stimulation significantly and sustainably improved her lexical access and speech fluency.

CONCLUSIONS:

Cortical stimulation may offer a new approach for the treatment of late chronic poststroke aphasia.

PMID:
22037142
DOI:
10.1016/j.brs.2011.04.003
[Indexed for MEDLINE]

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