Donepezil in the treatwent of early post-stroke aphasia： a randorrdzed controlled trial

Objective To investigate the effectiveness of donepezil in the treatment of early post-stroke aphasia （PSA）. Methods PSA patients within one month after onset were randomly assigned into either a donepezil group or a control group. On the basis of conventional medication, the donepezil group was given hydrochloride donepezil 5 mg/d. The patients were followed-up after 4 week. The efficacy was evaluated by the Aphasia Battery of Chinese （ABC）, the National Institute of Health Stroke Scale （NIHSS）, the Stroke Aphasic Depression Questionnaire （SADQ）, Chinese version, and the Treatment Emergrnt Symptom Scale （TESS） before and after treatment. Results A total of 48 PSA patients were enrolled in the study. Both the donepezil group and the control group had 24 patients and they all completed the study. There were no sigaificant differences in age, years of education, NIHSS score, SADQ score, stroke duration, as well as the proportions of male, hypertension, diabetes, hyperllpidemia, heart disease, previous stroke or history of transient ischemic attack, smoking, alcohol consumption, type of stroke, and lesion site （all P 〈 0. 01）. There were significant differences in each language score before and after treatment both in the donepezil group and in the control group （all P 〈 0. 01）. The difference values of listening comprehension （47. 8 ± 24. 7 vs. 22. 0 ± 15. 4; t =4. 342, P = 0. 000） and reading comprehension （20. 5 ± 14. 0 vs. 8. 1 ± 10. 5; t = 3.483, P 〈 0. 01） scores before and after treatment in the donepezil group were significantly higher than those in the control group, while there were no significant differences in the information quantity of speech, fluency, series language, repetition, naming, and reading scores （all P 〉 0. 05）. As compared with the control group, there were significant differences in the difference values of the SADQ scores before and after treatment in the donepezil group （6. 2 ±6. 0 vs. 2. 5 ±3.0; t =2. 717, P= 0. 009）. No serious adverse reactions were observed in both groups. Conelusion On the basis of conventional stroke treatment, using hydrochloride donepezll in the early PSA patients has promotion effect on the improvement of listening comprehension and reading comprehension of language function. Key words: Aphasia;  Stroke;  Cholinesterase Inhibitors;  Donepezil;  Treatment Outcome