Current opinion in neurology
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Curr. Opin. Neurol. · Dec 2007
ReviewRecovery and treatment of aphasia after stroke: functional imaging studies.
In this review of papers published between May 2006 and May 2007, we discuss functional neuroimaging studies of recovery and treatment of patients with aphasia after stroke. ⋯ Recent studies of aphasia recovery allow a deeper appreciation of the changing neuronal activation patterns associated with time after stroke. The distinction between neuronal reorganization that does and does not sustain recovery in the chronic phase after stroke, either spontaneous or in response to treatment, remains controversial and further studies are necessary. Clinical diagnosis and treatment of aphasia requires many more longitudinal studies with larger patient numbers and more detailed behavioural and lesion characterization of stroke patients.
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Patients in a vegetative or minimally conscious state continue to pose problems in terms of diagnosis, prognosis and treatment. Despite recent waves of international media attention following Terri Schiavo's death and the 'miracle recovery' of Terry Wallis, research efforts aimed at increasing our knowledge about brain function in these conditions remain scarce and must address a series of difficulties, including financial and ethical barriers. Here we review current possibilities and limitations of clinical and para-clinical assessment of chronic disorders of consciousness. ⋯ Consciousness is a subjective experience whose study has remained within the purview of philosophy for millennia. That has finally changed, and empirical evidence from functional neuroimaging offers a genuine glimpse at a solution to the infamous mind-body conundrum. New technological and scientific advances offer the neurological community unique ways to improve our understanding and management of vegetative and minimally conscious patients.
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Curr. Opin. Neurol. · Dec 2007
ReviewDeep brain stimulation and cognition: moving from animal to patient.
Brain electrical stimulation has been proposed as a strategy to improve chronically impaired cognitive function. This brief review places a small number of recent studies into a broader historical context and identifies important challenges for further development of this area of research. ⋯ This area of research offers the promise of new avenues to engage patients with nonprogressive brain injuries who, at present, have rather limited therapeutic options. These efforts, however, will require careful attention to issues of research and clinical ethics and study design.