The neuropsychiatric spectrum: Multidomain evaluation and treatment in post-stroke aphasia.

Abstract

This doctoral dissertation investigates the intricate domain of neuropsychiatric symptoms (NPS) in individuals grappling with post-stroke aphasia (PSA), a condition stemming from brain stroke. Stroke represents a substantial global burden of disability, and PSA introduces linguistic and psychological dimensions to the challenges faced by survivors. Comprising three interconnected studies, this thesis delves into the realm of NPS in PSA and explores potential therapeutic approaches. Study 1 involves a comprehensive literature review, summarizing the existing knowledge regarding NPS in PSA, including their prevalence, contributing factors, assessment tools, underlying mechanisms, and available interventions. It also delves into the feasibility of assessing a broader spectrum of NPS in 20 individuals with chronic PSA. Study 2 introduces a proof-of-concept case-controlled investigation, centering on individuals with fluent PSA in the chronic stage. This study examines the effectiveness of a two-week Intensive Language-Action Therapy (ILAT) in mitigating aphasia severity and alleviating depressive symptoms. Study 3 extends the research through a 10-week open-label intervention trial, involving Donepezil pharmacotherapy alone and in combination with ILAT. This study assesses changes in aphasia severity, depression, and apathy scores, as well as structural and functional brain modifications resulting from these interventions.