New Hope for Speech Problems After Stroke
Sept. 6, 2001 -- What's the worst thing that could happen after a stroke? For many, it's losing the ability to speak or communicate -- being fully aware of what's happening, yet unable to express it.
"It is enormously beneficial to improve language recovery after stroke," David Gladstone, MD, a stroke fellow in neurology at the University of Toronto in Canada, tells WebMD.
Surprisingly, a drug related to speed, called dextroamphetamine, may bring new hope to these stroke victims, according to a study reported in the September issue of the journal Stroke.
"When paired with behavioral therapy, low-dose amphetamine accelerated return of language function after stroke in a small number of patients," researcher Delaina Walker-Batson, PhD, tells WebMD.
In the first study of its kind, 10 of 12 patients receiving the drug 30 minutes before speech therapy improved significantly in language function, compared with only two of nine patients who took a placebo instead of the drug.
Although drug treatment continued for only five weeks, patients were still better up to six months later, explains Walker-Batson, a professor of communication sciences and disorders at Texas Women's University in Dallas. Side effects were not a problem in her study.
Amphetamine treatment began two to six weeks after the stroke, unlike current stroke treatments, which must be given within hours, explains Dennis M. Feeney, PhD, a professor of psychology and neurosciences at the University of New Mexico in Albuquerque.
"Brain injury is a dynamic event retaining the capacity for some unknown degree of recovery long after structural damage is complete," Feeney tells WebMD after reviewing the study.
While scientists still don't know how the drug works, it may promote the release of brain chemicals that help new connections form between nerves. Animal and human studies by Feeney and others showed that similar drugs may improve recovery of strength, sensation, and vision following stroke.
Drugs related to amphetamine improve attention and focus in attention deficit disorder, and may work similarly in stroke patients to improve learning with each therapy session.
"People tend to get too little rehabilitation for the brain to reorganize after a stroke," Walker-Batson says. "After a stroke, the brain needs a lot of practice to get better."
All experts interviewed by WebMD agreed that it is still too early, though, to treat stroke patients with amphetamine. Unanswered questions include the best dose, the best time to start treatment, and which of a related family of drugs might work best.
"While quite beneficial for many patients, the effect may be minimal or not effective in others, and much work remains to determine why some patients respond and others do not," Feeney tells WebMD. "Optimal treatment will likely involve a cocktail of nerve chemicals that can be given late following brain trauma or stroke to amplify the brain activity produced by therapy."