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Semin Speech Lang 2004; 25(4): 309-321
DOI: 10.1055/s-2004-837244
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Neuropharmacology of Verbal Perseveration

Patrick McNamara1 , Martin L. Albert2
  • 1Department of Neurology, Boston University School of Medicine; VA New England Healthcare System, Boston, Massachusetts
  • 2Harold Goodglass Aphasia Research Center and Language in the Aging Brain Laboratory, Department of Neurology, Boston University School of Medicine and VA New England Healthcare System, Boston, Massachusetts
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Publication History

Publication Date:
15 December 2004 (online)

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ABSTRACT

In this article we will review available evidence concerning the effects of forebrain catecholaminergic and cholinergic activity on verbal perseveration. The anatomy and physiology of these two major neuropharmacological systems make it likely that they influence speech and language functioning directly as well as the cognitive systems that have an indirect impact on speech and language functions. Both catecholaminergic and cholinergic agents have been shown to influence executive cognitive functions (ECFs) such as “resistance to interference” and “attentional switching” as well as mnemonic encoding and retrieval processes. The ECF effects are most likely mediated by prefrontal cortex; mnemonic processes are mediated by both prefrontal and temporal lobes. Although no full-scale clinical trials on the effects of pharmacological agents on verbal perseveration have been conducted as yet, existing preclinical trials suggest that both presynaptic and postsynaptic dopaminergic agents can reduce perseverative responding by increasing inhibitory control processes. Cholinesterase inhibitors and other cholinergic agents can reduce perseverative responding by reducing verbal intrusions.

KEYWORDS

Perseveration - catecholamines - dopamine - norepinephrine - acetylcholine - executive function - prefrontal cortex - inhibition

REFERENCES

  • 1 Albert M, Sandson J. Perseveration in aphasia.  Cortex. 1986;  22 103-115
    PubMedGoogle Scholar
  • 2 Yamdori A. Verbal perseveration in aphasia.  Neuropsychologia. 1981;  18 591-594
    PubMedGoogle Scholar
  • 3 Santo-Pietro M J, Rigrodsky S. The effects of temporal and semantic conditions on the occurrence of the error response of perseveration in adult aphasics.  J Speech Hear Res. 1982;  25 184-192
    PubMedGoogle Scholar
  • 4 Emery P, Helm-Estabrooks N. The role of perseveration in aphasic confrontation naming performance.  Proceedings of Clinical Aphasiology. 1989;  18 64-83
    PubMedGoogle Scholar
  • 5 Bayles K A, Tomoeda C K, Kaszniak A W, Stern L Z, Eagans K K. Verbal perseveration of dementia patients.  Brain Lang. 1985;  25 102-116
    CrossrefPubMedGoogle Scholar
  • 6 Barr W B, Bilder R M, Goldberg E, Kaplan E, Mukherjee S. The neuropsychology of schizophrenic speech.  J Commun Disord. 1989;  22 327-349
    CrossrefPubMedGoogle Scholar
  • 7 DeLisi L E. Speech disorder in schizophrenia: review of the literature and exploration of its relation to the uniquely human capacity of language.  Schizophr Bull. 2001;  27 481-496
    PubMedGoogle Scholar
  • 8 Bayles K A, Trosset M W, Tomoeda C K, Montgomery E B, Wilson J. Generative naming in Parkinson disease patients.  J Clin Neuropsychol. 1993;  15 547-562
    PubMedGoogle Scholar
  • 9 Benke T, Hohenstein C, Poewe W, Butterworth B. Repetitive speech phenomena in Parkinson's disease.  J Neurol Neurosurg Psychiatry. 2000;  69 319-325
    CrossrefPubMedGoogle Scholar
  • 10 Butters M, Goldstein G, Allen D, Shemansky W. Neuropsychological similarities and differences among Huntington's disease, multiple sclerosis, and cortical dementia.  Arch Clin Neuropsychol. 1998;  13 721-735
    CrossrefPubMedGoogle Scholar
  • 11 Ridley R M. The psychology of perseverative and stereotyped behavior.  Prog Neurobiol. 1994;  44 221-231
    CrossrefPubMedGoogle Scholar
  • 12 Hotz G, Helm-Estabrooks N. Perseveration. Part II. A study of perseveration in closed-head injury.  Brain Inj. 1995;  9 160-171
    PubMedGoogle Scholar
  • 13 Lombardi W, Andreason P, Sirocco K et al.. Wisconsin Card Sorting Test performance following head injury: Dorsolateral fronto-striatal circuit activity predicts perseveration.  J Clin Exp Neuropsychol. 1999;  21 2-16
    PubMedGoogle Scholar
  • 14 Sayles D G. Cortical excitability, perseveration and stuttering.  J Speech Hear Res. 1971;  14 462-475
    PubMedGoogle Scholar
  • 15 Aman M G. Review of serotonergic agents and perseverative behavior in patients with developmental disabilities.  Ment Retard Dev Disabil Res Rev. 1999;  5 279-289
    CrossrefPubMedGoogle Scholar
  • 16 Branford D, Bhaumik S, Naik B. Selective serotonin re-uptake inhibitors for the treatment of perseverative and maladaptive behaviours of people with intellectual disability.  J Intellect Disabil Res. 1998;  42 301-306
    CrossrefPubMedGoogle Scholar
  • 17 Davis R, Nolen-Hoeksema S. Cognitive inflexibility among ruminators and nonruminators.  Cognit Ther Res. 2000;  24 699-711
    PubMedGoogle Scholar
  • 18 Fibiger H C. The organization and some projections of cholinergic neurons of the mammalian forebrain.  Brain Res. 1982;  257 327-388
    PubMedGoogle Scholar
  • 19 Semba K, Fibiger H C. Organization of central cholinergic systems.  Prog Brain Res. 1989;  79 37-63
    PubMedGoogle Scholar
  • 20 Mesulam M-M. Central cholinergic pathways: neuroanatomy and some behavioral implications. In: Anoli M, Reader TA, Dykes RW, Gloor P Neurotransmitters and Cortical Functions. New York; Plenum 1988: 237-260
    Google Scholar
  • 21 Everitt B J, Robbins T W. Central cholinergic systems and cognition.  Annu Rev Psychol. 1997;  48 649-684
    CrossrefPubMedGoogle Scholar
  • 22 Auld D S, Kornecook T J, Bastianetto S, Quirion R. Alzheimer's disease and the basal forebrain cholinergic system: relations to beta-amyloid peptides, cognition, and treatment strategies.  Prog Neurobiol. 2002;  68 209-245
    CrossrefPubMedGoogle Scholar
  • 23 Bowen D M, Smith C B, White P, Davison A N. Neurotransmitter-related enzymes and indices of hypoxia in senile dementia and other abiotrophies.  Brain. 1976;  99 459-496
    PubMedGoogle Scholar
  • 24 Perry E K, Tomlinson B E, Blessed G et al.. Correlation of cholinergic abnormalities with senile plaques and mental test scores in senile dementia.  BMJ. 1978;  2 1457-1459
    CrossrefPubMedGoogle Scholar
  • 25 Foote S, Morrison J. Extrathalamic modulation of cortical function.  Annu Rev Neurosci. 1987;  10 67-95
    CrossrefPubMedGoogle Scholar
  • 26 Amaducci L, Sorbi S, Albanese A, Gainotti G. Choline acetyltranserferase (ChAT) activity differs in right and left human temporal lobes.  Neurology. 1981;  31 799-805
    PubMedGoogle Scholar
  • 27 Glick S, Ross D, Hough L. Lateral asymmetry of neurotransmitters in human brain.  Brain Res. 1982;  234 53-63
    CrossrefPubMedGoogle Scholar
  • 28 Hutsler J J, Gazzaniga M S. Acetylcholinesterase staining in human auditory and language cortices: regional variation of structural features.  Cereb Cortex. 1996;  6 260-270
    PubMedGoogle Scholar
  • 29 Goldman-Rakic P. Circuitry of primate prefrontal cortex and regulation of behavior by representational memory. In: Mountcastle V, Plum F Higher Cortical Function, Handbook of Physiology. Bethesda, MD; American Physiological Society 1987: 373-417
    Google Scholar
  • 30 Le Moal M, Simon H. Mesocorticolimbic dopaminergic network: functional and regulatory roles.  Physiol Rev. 1991;  71 155-234
    PubMedGoogle Scholar
  • 31 Lewis D A. The catecholaminergic innervation of primate prefrontal cortex.  J Neural Transm Suppl. 1992;  36 179-200
    PubMedGoogle Scholar
  • 32 Tzschentke T M. Pharmacology and behavioral pharmacology of the mesocortical dopamine system.  Prog Neurobiol. 2001;  63 241-320
    CrossrefPubMedGoogle Scholar
  • 33 Nieoullon A. Dopamine and the regulation of cognition and attention.  Prog Neurobiol. 2002;  67 53-83
    CrossrefPubMedGoogle Scholar
  • 34 Oke A, Keller R, Mefford I, Adams R. Lateralization of norepinephrine in human thalamus.  Science. 1978;  200 1411-1413
    PubMedGoogle Scholar
  • 35 Berridge C W, Espana R A, Stalnaker T A. Stress and coping: asymmetry of dopamine efferents within the prefrontal cortex. In: Hugdahl K, Davidson RJ The Asymmetrical Brain. Cambridge, MA; The MIT Press 2003: 69-104
    Google Scholar
  • 36 Pizzagalli D, Shackman A J, Davidson R J. The functional neuroimaging of human emotion: asymmetric contributions of cortical and subcortical circuitry. In: Hugdahl K, Davidson RJ The Asymmetrical Brain. Cambridge, MA; The MIT Press 2003: 511-532
    Google Scholar
  • 37 Coull J T. Neural correlates of attention and arousal: insights from electrophysiology, functional neuroimaging and psychopharmacology.  Prog Neurobiol. 1998;  55 343-361
    CrossrefPubMedGoogle Scholar
  • 38 Arnsten A FT. Catecholamine modulation of prefrontal cortical cognitive function.  Trends Cogn Sci. 1998;  2 436-447
    CrossrefPubMedGoogle Scholar
  • 39 Arnsten A FT, Goldman-Rakic P S. Alpha adrenergic mechanisms in prefrontal cortex associated with cognitive decline in aged non-human primates.  Science. 1985;  230 1273-1276
    PubMedGoogle Scholar
  • 40 Sara S J, Herve-Minville A. Inhibitory influence of frontal cortex on locus coeruleus.  Proc Natl Acad Sci USA. 1995;  92 6032-6036
    PubMedGoogle Scholar
  • 41 Berridge C W, Arnsten A, Foote S. Noradrenergic modulation of cognitive function.  Psychol Med. 1993;  23 557-564 , (editorial)
    PubMedGoogle Scholar
  • 42 D’Esposito M, Albert M L. Pharmacology of memory. In: Memoire et Vieillissement Paris; Maloine Editeur 1991: 247-252
    Google Scholar
  • 43 Levin ED, Decker MW, Butcher LL Neurotransmitter Interactions and Cognitive Function. Boston; Birkhauser 1992
    Google Scholar
  • 44 Terry A V, Jackson W J, Buccafusco J J. Effects of concomitant cholinergic and adrenergic stimulation on learning and memory performance by young and aged monkeys.  Cereb Cortex. 1993;  3 304-312
    PubMedGoogle Scholar
  • 45 Friedman J I, Temporini H, Davis K L. Pharmacologic strategies for augmenting cognitive performance in schizophrenia.  Biol Psychiatry. 1999;  45 1-16
    CrossrefPubMedGoogle Scholar
  • 46 Sandson J, Albert M. Perseveration in behavioral neurology.  Neurology. 1987;  37 1736-1741
    PubMedGoogle Scholar
  • 47 Morton J B, Munakata Y. Active versus latent representations: a neural network model of perseveration, dissociation and decalage.  Dev Psychobiol. 2002;  40 255-265
    CrossrefPubMedGoogle Scholar
  • 48 Cohen L, Dehaene S. Competition between past and present: assessment and interpretation of verbal perseverations.  Brain. 1998;  121 1641-1659
    CrossrefPubMedGoogle Scholar
  • 49 Gotts S J, della Rocchetta A I, Cipolotti L. Mechanisms underlying perseveration in aphasia: evidence from a single case study.  Neuropsychologia. 2002;  40 1930-1947
    CrossrefPubMedGoogle Scholar
  • 50 Brozoski T, Brown R, Rosvold H, Goldman P. Cognitive deficit caused by regional depletion of dopamine in prefrontal cortex of rhesus monkey.  Science. 1979;  205 929-931
    PubMedGoogle Scholar
  • 51 Watanabe M, Kodama T, Hikosaka K. Increase in extracellular dopamine in the primate prefrontal cortex during a working memory task.  J Neurophysiol. 1997;  78 2795-2798
    PubMedGoogle Scholar
  • 52 Gotham A, Brown R, Marsden C. “Frontal” cognitive functions in patients with Parkinson's disease “on” and “off” levodopa.  Brain. 1988;  111 299-321
    CrossrefPubMedGoogle Scholar
  • 53 Cools A, Berger H, Buytenhuijs E, Horstink M, Van Spaendonck K. Manifestations of switching disorders in animals and man with dopamine deficits in A10 and/or A9 circuitries. In: Wolters E, Scheltens P Mental Dysfunction in Parkinson's Disease. Dordrecht, The Netherlands; ICG 1995: 49-68
    Google Scholar
  • 54 Lange K W, Paul G M, Naumann M, Gesell W. Dopaminergic effects on cognitive performance in patients with Parkinson's disease.  J Neural Transm Suppl. 1995;  46 423-432
    PubMedGoogle Scholar
  • 55 Taylor A, Saint-Cyr J. The neuropsychology of Parkinson's disease.  Brain Cogn. 1995;  28 281-296
    PubMedGoogle Scholar
  • 56 Downes J, Sharp H, Costall B, Sagar H, Howe J. Alternating fluency in Parkinson's disease: an evaluation of the attentional control theory of cognitive impairment.  Brain. 1993;  116 887-902
    PubMedGoogle Scholar
  • 57 Lange K W, Robbins T W, Marsden C D et al.. L-dopa withdrawal in Parkinson's disease selectively impairs cognitive performance in tests sensitive to frontal lobe dysfunction.  Psychopharmacology (Berl). 1992;  107 394-404
    PubMedGoogle Scholar
  • 58 Callaway E, Halliday R, Naylor H. Cholinergic activity and constraints on information processing.  Biol Psychiatry. 1992;  33 1-22
    PubMedGoogle Scholar
  • 59 Meador K J. An overview of neurotransmitters in cognitive function. In: Pharmacology of Cognition. Half-day course presented at the 49th Annual Meeting of the American Academy of Neurology Boston, MA; April 15-22, 1997
    Google Scholar
  • 60 Rusted J M, Warburton D M. Cognitive models and cholinergic drugs.  Neuropsychobiology. 1989;  21 31-36
    PubMedGoogle Scholar
  • 61 Arnsten A FT, Steere J C, Hunt R D. The contribution of alpha-2 noradrenergic mechanisms to prefrontal cortical cognitive function.  Arch Gen Psychiatry. 1996;  53 448-455
    CrossrefPubMedGoogle Scholar
  • 62 Stern Y, Mayeux R, Cote L. Reaction time and vigilance in Parkinson's disease. Possible role of altered norepinephrine metabolism.  Arch Neurol. 1984;  41 1086-1089
    PubMedGoogle Scholar
  • 63 Mayeux R, Stern Y, Sano M, Cote L, Williams J BW. Clinical and biochemical correlates of bradyphrenia in Parkinson's disease.  Neurology. 1987;  37 1130-1134
    PubMedGoogle Scholar
  • 64 Riekkinen M, Kejonen K, Jakala P, Soininen H, Riekkinen Jr P. Reduction of noradrenaline impairs attention and dopamine depletion slows responses in Parkinson's disease.  Eur J Neurosci. 1998;  10 1429-1435
    CrossrefPubMedGoogle Scholar
  • 65 Kuiper M A, Wolters E C. CSF biochemistry in Parkinson's disease patients with mental dysfunction. In: Wolters E, Scheltens P Mental Dysfunction in Parkinson's Disease. Dordrecht, The Netherlands; ICG 1995: 163-176
    Google Scholar
  • 66 McGurk S R. The effects of clozapine on cognitive functioning in schizophrenia.  J Clin Psychiatry. 1999;  6(Suppl 12) 24-30
    PubMedGoogle Scholar
  • 67 Green M, Marshall B, Wirshing W et al.. Does risperidone improve verbal working memory in treatment resistant schizophrenia?.  Am J Psychiatry. 1997;  154 799-804
    PubMedGoogle Scholar
  • 68 McGurk S, Green M, Wirshing W et al.. The effects of risperidone vs. haloperidol in treatment-resistant schizophrenia: The trail-making test.  CNS Spectr. 1997;  2 60-64
    PubMedGoogle Scholar
  • 69 Buchanan R W, Holstein C, Breier A. The comparative efficacy and long term effect of clozapine treatment on neuropsychological test performance.  Biol Psychiatry. 1994;  36 717-725
    CrossrefPubMedGoogle Scholar
  • 70 Hoff A, Faustman W, Wieneke M et al.. The effect of clozapine on symptom reduction, neurocognitive function and clinical management in treatment refractory state hospital schizophrenic inpatients.  Neuropsychopharmacology. 1996;  15 361-369
    CrossrefPubMedGoogle Scholar
  • 71 Murphy B, Arnsten A FT, Goldman-Rakic P S, Roth R H. Increased dopamine turnover in the prefrontal cortex impairs spatial working memory performance in rats and monkeys.  Proc Natl Acad Sci USA. 1996;  93 1325-1329
    CrossrefPubMedGoogle Scholar
  • 72 Kulisevsky J, Avial A, Barbanoj M et al.. Acute effects of levodopa on neuropsychological performance in stable and fluctuating Parkinson's disease patients at different levodopa plasma levels.  Brain. 1996;  119 2121-2132
    PubMedGoogle Scholar
  • 73 Whitehouse P J, Price D L, Clark A W, Coyle J T, DeLong J T. Alzheimer's disease: evidence for a selective loss of cholinergic neurons in the nucleus basalis.  Ann Neurol. 1981;  10 122-126
    CrossrefPubMedGoogle Scholar
  • 74 Bartus R T, Dean R L, Flicker C. Cholinergic psychopharmacology: an integration of human and animal research on memory. In: Meltzer HY Psychopharmacology: The Third Generation of Progress. New York; Raven Press 1987: 219-232
    Google Scholar
  • 75 Davis K L, Thal L J, Gamzu E R et al.. A double-blind, placebo-controlled multicenter study of tacrine for Alzheimer's disease.  N Engl J Med. 1992;  327 1253-1259
    CrossrefPubMedGoogle Scholar
  • 76 Farlow M R, Evans R M. Pharmacologic treatment of cognition in Alzheimer's dementia.  Neurology. 1998;  51(Suppl 1) S36-S44
    PubMedGoogle Scholar
  • 77 DeKosky S T. Treatment of cognitive impairments in Alzheimer's disease. In: Pharmacology of Cognition. Education program syllabus presented at the 51st Annual Meeting of the American Academy of Neurology Toronto, Ontario, Canada; April 17-24, 1999: 2PC.005-1-2PC:005-13
    Google Scholar
  • 78 Farlow M, Gracon S I, Hershey L A et al.. A controlled trial of tacrine in Alzheimer's disease.  JAMA. 1992;  268 2523-2529
    CrossrefPubMedGoogle Scholar
  • 79 Knapp M, Knopman D, Solomon P et al.. A 30-week randomized controlled trial of high dose tacrine in patients with Alzheimer's disease.  JAMA. 1994;  271 985-991
    CrossrefPubMedGoogle Scholar
  • 80 Rogers S L, Farlow M R, Doody R S, Mohs R, Friedhoff L T. A 24-week double-blind, placebo-controlled trial of donepezil in patients with Alzheimer's disease. Donepezil Study Group.  Neurology. 1998;  50 136-145
    CrossrefPubMedGoogle Scholar
  • 81 Rosler M, Anand R, Cicin-Sain A et al.. Efficacy and safety of rivastigmine in patients with Alzheimer's disease: international randomized controlled trial.  BMJ. 1999;  318 633-640
    PubMedGoogle Scholar
  • 82 Drachman D A, Leavitt J. Human memory and the cholinergic system.  Arch Neurol. 1974;  30 113-121
    CrossrefPubMedGoogle Scholar
  • 83 Thal L J, Fuld P A, Masur O M et al.. Oral physostigmine and lecithin improve memory in Alzheimer disease.  Ann Neurol. 1983;  13 491-496
    CrossrefPubMedGoogle Scholar
  • 84 Fuld P, Katzman R, Davies P. Intrusions as a sign of Alzheimer dementia: chemical and pathological verification. Ann Neurol 1982 11: 155-159
    Google Scholar
  • 85 Tanaka Y, Minernatsu K, Hirano T et al.. Effects of COP-choline on dynamic changes in LCBF and cognitive function in demented subjects-An H2150-PET study [In Japanese with English abstract].  Clin Neuro1. 1994;  34 877-881
    PubMedGoogle Scholar
  • 86 Tanaka Y, Miyazaki M, Albert M L. Effect of increased cholinergic activity on naming in aphasia.  Lancet. 1997;  350 116-117
    PubMedGoogle Scholar
  • 87 Willmes K, Huber W, Poeck K et al.. Die Wirkung von Piracetam bei der logopadischen Intensivthepapie von chronish aphasischen Patienten. In: VonHelmchen Sonderd ruck ans Wirlumgen und WirksarnIeit von Nootropika. Berlin; Springer-Verlag 1988: 177-187
    Google Scholar
  • 88 Aarsland O, Larsen J P, Reinvang I et al.. Effects of cholinergic blockade on language in healthy young women: implications for the cholinergic hypothesis in dementia of the Alzheimer's type.  Brain. 1994;  117 1377-1384
    PubMedGoogle Scholar
  • 89 Dubois B, Bernard P, Lhermitte F et al.. Cholinergic deficiency and frontal dysfunction in Parkinson's disease.  Ann Neuro1. 1990;  28 117-121
    CrossrefPubMedGoogle Scholar
  • 90 Imamura T, Takanashi M, Hattori N et al.. Bromocriptine treatment for perseveration in demented patients.  Alzheimer Dis Assoc Disord. 1998;  12 109-113
    PubMedGoogle Scholar
  • 91 Buckingham H W, Christman S S. Phonemic carryover perseveration: word blends.  Semin Speech Lang. 2004;  25 XXX
    PubMedGoogle Scholar
  • 92 Leanderson R, Meyerson B, Persson A. Effect of L-Dopa on speech in Parkinsonism: an EMG study of labial articulatory function.  J Neurol Neurosurg Psychiatry. 1971;  34 679-681
    PubMedGoogle Scholar
  • 93 Nakano K, Zubick H, Tyler H. Speech defects of parkinsonian patients: effects of levodopa therapy on speech intelligibility.  Neurology. 1973;  23 865-870
    CrossrefPubMedGoogle Scholar
  • 94 Quaglieri C, Celesia G. Effect of thalamotomy and levodopa therapy on the speech of Parkinson patients.  Eur J Neurol. 1977;  15 34-39
    CrossrefPubMedGoogle Scholar
  • 95 Wolfe V, Garvin J, Bacon M, Waldrop W. Speech changes in Parkinson's disease during treatment with L-dopa.  J Commun Disord. 1975;  8 271-279
    CrossrefPubMedGoogle Scholar
  • 96 Critchley E. Speech disorders of Parkinsonism: a review.  J Neurol Neurosurg Psychiatry. 1981;  44 751-758
    PubMedGoogle Scholar
  • 97 Cahill L, Murdoch B, Theodoros D et al.. Effect of oral levodopa treatment on articulatory function in Parkinson's disease.  Motor Control. 1998;  2 161-172
    PubMedGoogle Scholar
  • 98 Goberman A M, Coelho C. Acoustic analysis of Parkinsonian speech. I: Speech characteristics and L-Dopa therapy.  NeuroRehabilitation. 2002;  17 237-246
    CrossrefPubMedGoogle Scholar
  • 99 Poluha P, Teulings H, Brookshire R. Handwriting and speech changes across the levadopa cycle in Parkinson's disease.  Acta Psychol (Amst). 1998;  100 71-84
    PubMedGoogle Scholar
  • 100 Louis E D, Winfield L, Fahn S, Ford B. Speech dysfluency exacerbated by levodopa in Parkinson's disease.  Mov Disord. 1991;  16 562-565
    PubMedGoogle Scholar
  • 101 Benson D F. Presentation 10. In: Benton AL Behavioral Changes in Cerebrovascular Disease. New York; Harper and Row 1970: 77
    Google Scholar
  • 102 McNeil M R, Small S L, Masterson R J, Fossett T. Behavioral and pharmacological treatment of lexical-semantic deficits in case of primary progressive aphasia.  Am J Speech Lang Pathol. 1995;  4 76-87
    PubMedGoogle Scholar
  • 103 Walker-Batson D. Pharmacotherapy in the treatment of aphasia. In: Goldstein LB Restorative Neurology: Advances in Pharmacotherapy for Recovery After Stroke. Armonk, NY; Futura Publishing 1998: 257-270
    Google Scholar
  • 104 Albert M L, Bachman D, Morgan A, Helm-Estabrooks N. Pharmacotherapy for aphasia.  Neurology. 1988;  38 877-879
    PubMedGoogle Scholar
  • 105 Gupta S R, Mlcoch A G. Bromocriptine treatment of nonfluent aphasia.  Arch Phys Med Rehabil. 1992;  73 373-376
    CrossrefPubMedGoogle Scholar
  • 106 Sabe L, Salvarezza F, Garcia Cuerva A, Leiguarda R, Starkstein S. A randomized double-blind placebo controlled study of bromocriptine in non-fluent aphasia.  Neurology. 1995;  45 2272-2274
    PubMedGoogle Scholar
  • 107 Bragoni M, Altieri M, Di Piero V et al.. Bromocriptine and speech therapy in non-fluent chronic aphasia after stroke.  Neurol Sci. 2000;  21 19-22
    CrossrefPubMedGoogle Scholar
  • 108 Gupta S R, Mlcoch A J, Scolaro C, Moritz T. Bromocriptine treatment of nonfluent aphasia.  Neurology. 1995;  45 2170-2173
    PubMedGoogle Scholar

Patrick McNamaraPh.D. 

Department of Neurology (127), VA New England Healthcare System

150 S. Huntington Avenue

Boston, MA 02130

Email: mcnamar@bu.edu

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