Your competent? doctor has been using Cerebrolysin for years now, correct?
Speech Therapy Combined With Cerebrolysin in Enhancing Nonfluent Aphasia Recovery After Acute Ischemic Stroke: ESCAS Randomized Pilot Study
Abstract
BACKGROUND:
Stroke-induced
aphasia significantly impacts communication and quality of life.
Despite the standard treatment being speech and language therapy,
outcomes vary, highlighting the need for additional therapies.
Cerebrolysin, a neuroprotective and neurotrophic agent, has shown
potential in stroke management. This study addresses the notable gap in
research about the combined use of Cerebrolysin and speech therapy,
evaluating their synergistic potential in the treatment of aphasia.
METHODS:
The
ESCAS trial (The Efficacy and Safety of Cerebrolysin in the Treatment
of Aphasia After Acute Ischemic Stroke), a prospective,
randomized-controlled, double-blinded study was conducted in 2 Romanian
stroke centers. Participants included those with left middle cerebral
artery territory ischemic stroke and nonfluent aphasia, enrolled 3 to 5
days poststroke. Inclusion criteria were right-handedness and Romanian
as the mother tongue. Participants received Cerebrolysin or a placebo
combined with speech and language therapy in 10-day cycles over 3
intervals, and evaluations were done at baseline, 30, 60, and 90 days
respectively. The main outcome measure was Western Aphasia Battery for
language function. Changes at days 30, 60, and 90 compared with baseline
were quantified, and the effect estimand used was the difference in
means between groups. Secondary outcome measurements were the National
Institutes of Health Stroke Scale for neurological deficit, the modified
Rankin Scale for global disability, and the Barthel Index for
activities of daily living.
RESULTS:
Out
of 132 enrolled patients, 123 were included in the intention-to-treat
analysis, and 120 in the per-protocol analysis. Overall, both groups
showed improvement at subsequent visits compared with the baseline for
Western Aphasia Battery and the National Institutes of Health Stroke
Scale. The Cerebrolysin group showed greater improvements in Western
Aphasia Battery (visit 4 mean increase of 35.579±16.316 [95% CI,
31.289–39.869] points; P<0.001) compared with the placebo group (20.774±12.486 [95% CI, 17.603–23.945] points; P<0.001), a difference in means of 14.805 (95% CI, 9.521–20.089) points (P<0.001).
The Cerebrolysin group also showed significant improvements (higher
decreases) in National Institutes of Health Stroke Scale scores compared
with the placebo group (2.085 [95% CI, 1.076–3.094] points; P<0.001). Safety analysis raised no concerns (number of patients with adverse events P=0.105, number of adverse events per patient P=0.134).
Additionally, the Cerebrolysin group showed greater improvements in
functional independence (Barthel Index) and a trend toward reduced
disability (modified Rankin Scale) compared with the placebo group.
CONCLUSIONS:
Cerebrolysin
combined with speech and language therapy offers promising potential
for enhancing recovery in poststroke nonfluent aphasia. Significant
improvements were observed in language and neurological deficits,
underscoring the importance of adjunctive therapies in nonfluent aphasia
rehabilitation. Further research with larger cohorts is needed to fully
establish the efficacy of this combination therapy.
REGISTRATION:
URL: https://www.isrctn.com; Unique identifier: ISRCTN54581790.
Graphical Abstract
No comments:
Post a Comment