Dávila, GuadalupeMoyano, María PilarEdelkraut, LisaMoreno-Campos, LorenaBerthier, Marcelo L.Torres-Prioris, María JoséLópez-Barroso, Diana2022-05-202022-05-202020-07-31Dávila G, Moyano MP, Edelkraut L, Moreno-Campos L, Berthier ML, Torres-Prioris MJ, López-Barroso D. Pharmacotherapy of Traumatic Childhood Aphasia: Beneficial Effects of Donepezil Alone and Combined With Intensive Naming Therapy. Front Pharmacol. 2020 Jul 31;11:1144http://hdl.handle.net/10668/3652At present, language therapy is the only available treatment for childhood aphasia (CA). Studying new interventions to augment and hasten the benefits provided by language therapy in children is strongly needed. CA frequently emerges as a consequence of traumatic brain injury and, as in the case of adults, it may be associated with dysfunctional activity of neurotransmitter systems. The use of cognitive-enhancing drugs, alone or combined with aphasia therapy, promotes improvement of language deficits in aphasic adults. In this study we report the case of a 9-year-old right-handed girl, subject P, who had chronic anomic aphasia associated with traumatic lesions in the left temporal-parietal cortex. We performed a single-subject, open-label study encompassing administration of the cholinergic agent donepezil (DP) alone during 12 weeks, followed by a combination of DP and intensive naming therapy (INT) for 2 weeks and thereafter by a continued treatment of DP alone during 12 weeks, a 4-week washout period, and another 2 weeks of INT. Four comprehensive language and neuropsychological evaluations were performed at different timepoints along the study, and multiple naming evaluations were performed after each INT in order to assess performance in treated and untreated words. Structural magnetic resonance imaging (MRI) was performed at baseline. MRI revealed two focal lesions in the left hemisphere, one large involving the posterior inferior and middle temporal gyri and another comprising the angular gyrus. Overall, baseline evaluation disclosed marked impairment in naming with mild-to-moderate compromise of spontaneous speech, repetition, and auditory comprehension. Executive and attention functions were also affected, but memory, visuoconstructive, and visuoperceptive functions were preserved. Treatment with DP alone significantly improved spontaneous speech, auditory comprehension, repetition, and picture naming, in addition to processing speed, selective, and sustained attention. Combined DP-INT further improved naming. After washout of both interventions, most of these beneficial changes remained. Importantly, DP produced no side effects and subject P attained the necessary level of language competence to return to regular schooling. In conclusion, the use of DP alone and in combination with INT improved language function and related cognitive posttraumatic deficits in a child with acquired aphasia. Further studies in larger samples are warranted.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/LanguageChildhood aphasiaAnomiaTraumatic brain injuryDonepezilPharmacological treatmentIntensive naming therapyLenguajeAfasiaLesiones traumáticas del encéfaloDonepeziloPreparaciones farmacéuticasInfanciaPruebas del lenguajeNiñoMedical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Communication::LanguageMedical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Neurologic Manifestations::Neurobehavioral Manifestations::Communication Disorders::Language Disorders::AnomiaMedical Subject Headings::Chemicals and Drugs::Pharmaceutical PreparationsMedical Subject Headings::Psychiatry and Psychology::Behavioral Disciplines and Activities::Psychological Tests::Language TestsMedical Subject Headings::Persons::Persons::Age Groups::ChildMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Rehabilitation::Rehabilitation of Speech and Language Disorders::Speech TherapyMedical Subject Headings::Phenomena and Processes::Musculoskeletal and Neural Physiological Phenomena::Nervous System Physiological Phenomena::Nervous System Physiological Processes::SpeechMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Rehabilitation::Rehabilitation of Speech and Language Disorders::Language TherapyMedical Subject Headings::Psychiatry and Psychology::Psychological Phenomena and Processes::Mental Processes::Cognition::ComprehensionMedical Subject Headings::Diseases::Nervous System Diseases::Neurologic Manifestations::Neurobehavioral Manifestations::Communication Disorders::Language Disorders::Speech Disorders::AphasiaMedical Subject Headings::Psychiatry and Psychology::Psychological Phenomena and Processes::Psychophysiology::Arousal::AttentionMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Neurotransmitter Agents::Cholinergic Agentsresearch article32848757Acceso abierto10.3389/fphar.2020.011441663-9812PMC7411310