Augmenting Language Therapy for Aphasia: Levodopa
Augmenting Language Therapy for Aphasia: A Randomized Double-Blind Placebo-Controlled Trial of Levodopa in Combination With Speech-Language Therapy
The purpose of this study is to evaluate the effectiveness of the medication levodopa, in
combination with speech-language treatment, on the language outcome of study subjects with
nonfluent aphasia (i.e. difficulty with the comprehension and expression of spoken and
written language) following a stroke.
Stroke is the third leading cause of death and the most common cause of disability in the
United States. According to the American Stroke Association, the prevalence of stroke in the
U.S. is approximately 4.8 million with approximately 700,000 additional strokes occurring
annually. Approximately 150,000 to 250,000 stroke survivors becoming severely and
permanently disabled each year.
A common neurological deficit among stroke survivors, and thus a substantial contributor to
post-stroke disability, is aphasia. The loss of, or difficulty with language is extremely
debilitating and has enormous social and economic impact on quality of life. Presently, the
only treatment available for persons with aphasia is speech-language rehabilitation.
With rehabilitation only, however, many patients achieve a less than satisfactory
improvement in speech-language function, and thus are left with significant disability.
To enhance motor and language recovery in patients with neurological impairments, interest
in the use of novel biological therapies, including pharmacological agents, has recently
emerged. There is preliminary evidence that increased levels of dopamine, in combination
with language treatment, may improve the deficits of aphasia following stroke. Most studies
have investigated the adjunctive effects of the dopamine agonist bromocriptine, with mixed
results. However, new evidence is suggesting that levodopa, a precursor to dopamine, may be
more effective in promoting language learning.
This study proposes to evaluate the effectiveness of levodopa in study subjects with Broca's
aphasia after stroke, delivered concurrent with speech-language rehabilitation.
The language changes in subjects who receive speech and language therapy combined with
levodopa will be compared to that of subjects who receive the same speech-language
rehabilitation but with a placebo (i.e. a pill that does not contain the study drug,
levodopa). The two study groups will be compared to determine the degree to which
improvements in language performance occur and the degree to which they are maintained over
The protocol is double-blind: neither subjects nor researchers will know whether a subject
took levodopa or placebo until the study's conclusion.
Nonfluent Aphasia, Stroke
Levodopa, Ischemic Stroke, Aphasia, Speech Rehabilitation
Rehabilitation Institute of Chicago
Rehabilitation Institute of Chicago, U.S. Department of Education