title: L-dopa does not add to the success of high-intensity language training in aphasia.
abstract: OBJECTIVE
  L-dopa has been shown to improve outcome of moderate-intensity language training after stroke in acute aphasia. Given the critical role of training intensity we probed the effect of l-dopa in combination with high-intensity language training in chronic post-stroke aphasia.
  
  
  METHODS
  In this prospective, randomized, placebo-controlled, double-blind study, aphasia patients (>1 year post stroke) were administered 100/25 mg of l-dopa/carbidopa or placebo daily prior to four hours of language training for two weeks. Conditions were crossed-over after a wash-out period of 4 weeks.
  
  
  RESULTS
  An a-priori planned interim analysis (n = 10) showed that naming performance and verbal communication improved significantly and persistently for at least 6 months in every patient, but l-dopa had no incremental effect to intensive training.
  
  
  CONCLUSIONS
  High-intensity language training in chronic aphasia may take learning to a ceiling that precludes additive benefits from l-dopa. Effects of l-dopa on post-stroke recovery during less intense treatment in chronic aphasia remain to be evaluated.
authors.affiliation: Department of Neurology, University of Muenster, Muenster, Germany.
authors.forename: Caterina
authors.initials: C
authors.lastname: Breitenstein
authors.affiliation: Department of Neurology, University of Muenster, Muenster, Germany.
authors.forename: Catharina
authors.initials: C
authors.lastname: Korsukewitz
authors.affiliation: Fresenius University of Applied Sciences, Hamburg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Baumgärtner
authors.affiliation: Department of Neurology, University Hospital Charite, Berlin, Germany.
authors.forename: Agnes
authors.initials: A
authors.lastname: Flöel
authors.affiliation: Department of Psychology, University of Muenster, Muenster, Germany.
authors.forename: Pienie
authors.initials: P
authors.lastname: Zwitserlood
authors.affiliation: Department of Biomagnetism, University of Muenster, Muenster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Dobel
authors.affiliation: St. Mauritius Hospital and University of Duesseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Knecht
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000209:etiology / Q000628:therapy*; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007807:Language Tests; D007808:Language Therapy / Q000379:methods*; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D018697:Nootropic Agents; D007980:Levodopa
keywords: Stroke; aphasia; intensive training; l-dopa; rehabilitation