Piracetam improves activated blood flow and facilitates rehabilitation of poststroke aphasic patients

Background and Purpose-In a prospective, double-blind, placebo-controlled s tudy, it was investigated whether piracetam improves language recovery in p oststroke aphasia assessed by neuropsychological tests and activation PET m easurement of cerebral blood flow. Methods-Twenty-four stroke patients with aphasia were randomly allocated to 2 groups: 12 patients received 2400 mg piracetam twice daily, 12 placebo. Before and at the end of the 6-week treatment period in which both groups r eceived intensive speech therapy, the patients were examined neuropsycholog ically and studied with (H2O)-O-15 PET at rest and during activation with a word-repetition task. Blood flow was analyzed in 14 language-activated bra in regions defined on reconstructed surface views from MRI coregistered to the PET images, Results-Before treatment, both groups were comparable with respect to perfo rmance in language tasks and to type and severity of aphasia. In the pirace tam group, increase of activation effect was significantly higher (P<0.05) in the left transverse temporal gyrus, left triangular part of inferior fro ntal gyrus, and left posterior superior temporal gyrus after the treatment period compared with the initial measures. The placebo group showed an incr ease of activation effect only in the left vocalization area. In the test b attery, the piracetam group improved in 6 language functions, the placebo g roup only in 3 subtests. Conclusions-Piracetam as an adjuvant to speech therapy improves recovery of various language functions, and this effect is accompanied by a significan t increase of fisk-related flow activation in eloquent areas of the left he misphere.