Background Post-stroke aphasia (PSA) is an impairment of the generation or comprehension of language due to acute cerebrovascular lesions. Subacute phase span the 7th day to 24 weeks post-onset while > 6 months is termed chronic phase. Language recovery does not arise immediately in chronic PSA, unlike the acute phase. The majority of the treatment modalities in these two PSA phases are still in the infancy stage, facing dilemmas and considered experimental requiring constant updates. Hence, we aimed to upgrade the existing literature regarding available PSA management options, advances, and drawbacks pertaining to subacute and chronic phases. Main text In this review, we analyzed the management options for subacute and chronic vascular aphasia. MEDLINE, through PubMed, ScienceDirect, and Google Scholar were explored for English studies by utilizing the terms “stroke aphasia” Plus “vascular aphasia”; 160,753 articles were retrieved. The latest studies, published from 2016 to July 2020, were selected. Article headings and abstracts were analyzed for relevance and filtered; eventually, 92 articles were included in this review. Various management options were extracted as follows: noninvasive brain stimulation (NIBS), technology-based therapies, speech-language therapy (SLT), pharmacotherapy, music-based therapies, and psychosocial interventions. Conclusion The PSA therapy evolves towards more intense SLT therapy, yet the optimal dosage of the emerging high-intensity therapies is controversial. As spinal and cerebellar NIBS, Telespeech, and E-mental health mark PSA's future, distinct pharmacological options remain a dilemma. Across the continuum of care, PSA–depression comorbidity and inadequate PSA post-discharge education to patient’s families are the significant therapeutic challenges. Future therapeutic mechanisms, optimal dose/timing, and tolerability/safety exploration are obliged.

中文翻译：

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亚急性和慢性血管性失语症的管理：更新综述

背景 中风后失语症 (PSA) 是由于急性脑血管病变导致的语言生成或理解障碍。亚急性期跨越发病后第 7 天至 24 周，而 > 6 个月被称为慢性期。与急性期不同，慢性 PSA 不会立即出现语言恢复。这两个 PSA 阶段中的大多数治疗方式仍处于起步阶段，面临困境并被认为是需要不断更新的实验性方法。因此，我们旨在升级现有的关于亚急性和慢性期相关 PSA 管理选项、进展和缺点的文献。正文 在这篇综述中，我们分析了亚急性和慢性血管性失语症的治疗方案。MEDLINE，通过 PubMed、ScienceDirect、通过使用术语“卒中失语症”加“血管性失语症”，在 Google Scholar 上进行了英语研究；检索到 160,753 篇文章。选取了 2016 年至 2020 年 7 月发表的最新研究。分析文章标题和摘要的相关性并进行过滤；最终，本综述收录了 92 篇文章。提取的各种管理选项如下：无创脑刺激 (NIBS)、基于技术的疗法、言语语言疗法 (SLT)、药物疗法、基于音乐的疗法和社会心理干预。结论 PSA 疗法向更强烈的 SLT 疗法发展，但新兴的高强度疗法的最佳剂量存在争议。由于脊髓和小脑 NIBS、Telespeech 和电子心理健康标志着 PSA 的未来，不同的药理学选择仍然是一个两难选择。在整个护理过程中，PSA-抑郁症合并症和对患者家属的 PSA 出院后教育不足是重大的治疗挑战。未来的治疗机制、最佳剂量/时间和耐受性/安全性探索是必须的。