BACKGROUND: Nearly 15 million @entity1 suffer from @entity64 every year worldwide, with about 20% of the survivors retaining chronic aphasic symptoms. Spontaneous recovery is limited to 3 to 6 months. Cortical stimulation techniques have been proposed to enhance the recovery process. OBJECTIVE: The goal of this study was to evaluate the benefit of epidural cortical stimulation for the treatment of @entity2026 , based on a systematic review of the literature. METHODS: An extensive PubMed search was performed for English language articles published from 1990 to 2014 with the keywords (cortical OR epidural) AND stimulation AND @entity64 AND ( @entity2026 OR language OR speech). The criteria analyzed included the type of study, epidemiology of @entity1 , @entity64 , @entity2026 , stimulation protocol, concurrent rehabilitation therapies, language evaluations, results observed, and follow-up. RESULTS: Seven cases were reported to date (3 case reports, 1 randomized controlled trial). All @entity1 experienced nonfluent @entity2026 following an @entity385 . All four studies reported encouraging effects of the stimulation with improved lexical access and fluency for all @entity1 . The effects were specific, independent of the motor recovery or of the @entity158 reported by the @entity1 , and they were linked to the stimulation parameters. CONCLUSIONS: Due to the small number of existing cases in the literature, the strength of the evidence is still low. Two main hypotheses of neurobiological mechanisms have been explored: either using continuous stimulation to modify cortical perilesional inhibition or using intermittent stimulation during the speech and language therapy sessions to explore synaptic plasticity and long-term potentiation or @entity308 . To establish the role of epidural stimulation and the relevant stimulation protocols and parameters, large randomized controlled trials are mandatory. We suggest avenues of investigation.

Epidural Cortical Stimulation as a Treatment for XXXX : A Systematic Review of the Literature and Underlying Neurophysiological Mechanisms.

@entity1 :: ('9606', 'Species') :: ['patients', 'people'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity2026 :: ('MESH:D001037', 'Disease') :: ['aphasia', 'poststroke aphasia'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity2026 :: (MESH:D001037,Disease) :: ['Poststroke Aphasia']
