Effects of bromocriptine in a patient with crossed nonfluent aphasia: a case report.
OBJECTIVE
Because studies have shown some positive effects of the dopaminergic agent bromocriptine for improving verbal production in patients with nonfluent aphasia, we examined its effect in a patient with an atypical form of crossed nonfluent aphasia from a right hemisphere lesion.


METHODS
Open-label single-subject experimental ABAB withdrawal design.


METHODS
A right-handed man who, after a right frontal stroke, developed nonfluent aphasia, emotional aprosodia, and limb apraxia.


METHODS
Escalating doses up to 20mg of bromocriptine in 2 separate phases.


METHODS
We measured verbal fluency (words/min in discourse, Thurstone letter fluency), expression of emotional prosody, and gesture production.


RESULTS
The patient showed substantial improvement in both verbal fluency measures and no significant improvement in gesture or emotional prosody. Verbal fluency improvements continued in withdrawal phases.


CONCLUSIONS
Our results are less likely caused by practice or spontaneous recovery because we observed little improvement in emotional prosody and gesture tasks. Verbal fluency improvements during treatment and withdrawal phases suggest that the effects of bromocriptine may be long-lasting in its influence on the neural networks subserving verbal initiation.
Old Dominion University, Norfolk, VA, USA. sraymer@odu.edu
A M
AM
Raymer
D
D
Bandy
J C
JC
Adair
R L
RL
Schwartz
D J
DJ
Williamson
L J
LJ
Gonzalez Rothi
K M
KM
Heilman
D001037:Aphasia / Q000188:drug therapy* / Q000209:etiology; D001971:Bromocriptine / Q000627:therapeutic use*; D002544:Cerebral Infarction / Q000150:complications; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged
D018491:Dopamine Agonists; D001971:Bromocriptine