IMR Press / FBL / Volume 8 / Issue 6 / DOI: 10.2741/1142

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Article
Treatment of adynamia in aphasia
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1 Dept. of Early Childhood, Speech-Language Pathology, Special Education, Old Dominion University, Norfolk, Virginia 23529-0136, USA
Front. Biosci. (Landmark Ed) 2003, 8(6), 845–851; https://doi.org/10.2741/1142
Published: 1 September 2003
Abstract

Transcortical motor aphasia (TCMA) is an acquired impairment of language expression that occurs following neurologic damage that affects left frontal cortex and spares perisylvian regions. In some individuals with TCMA, verbal expression is rendered nonfluent due to difficulty spontaneously initiating and elaborating upon verbal messages. Nonfluency arises from impaired activation of intended messages and inhibition of competing verbal expressions. This impairment of the intentional aspects of language expression can be termed 'adynamia.' Because adynamic forms of TCMA occur infrequently, few systematic treatment investigations have been reported for this condition. Behavioral treatments have been proposed to engage intact frontal regions to improve the ability to initiate spontaneous verbal expression. Some data suggest that nonsymbolic limb movements performed in the context of speaking activities, a form of what Luria termed gestural reorganization, may improve the adynamic verbal expression. (1) In addition, the influence of pharmacologic treatment with bromocriptine, a dopaminergic agonist, has been considered for its effects on verbal nonfluency in aphasia. Individuals classified as TCMA are more likely to benefit than those with other forms of nonfluent aphasia, suggesting an influence of bromocriptine on circuits necessary to activate spontaneous language. Additional studies are warranted that contrast behavioral and pharmacologic interventions to determine optimal conditions to improve verbal expression in adynamic forms of aphasia.

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