Neck Surgery Combined with Speech Therapy Shows Promise in Stroke Aphasia Recovery

A groundbreaking clinical trial indicates that combining neck surgery with intensive speech therapy yields significantly greater improvements in communication for individuals recovering from stroke-induced aphasia. The research,published in *The BMJ*,offers a potential new avenue for treating this common and debilitating condition.

Improved Communication After stroke: A New Approach

Stroke is a leading cause of aphasia, a condition affecting communication abilities, including speaking, understanding, reading, and writing. More then 60% of stroke patients experience aphasia up to a year post-stroke, a phase known as chronic post-stroke aphasia. While intensive speech and language therapy (iSLT) is a standard treatment, researchers have been exploring whether combining it with other interventions could enhance its effectiveness.

The recent study investigated the impact of combining iSLT with C7 neurotomy (NC7),a type of neck surgery. Researchers in China recruited 50 patients, aged 40 to 65, who had experienced aphasia and muscle stiffness in their right arm for over a year following a stroke affecting the left side of their brain (the language center). All participants were fluent Chinese speakers prior to their stroke.

Participants were randomly assigned to either the intervention group (surgery plus three weeks of iSLT) or the control group (three weeks of iSLT alone).The primary outcome measured was the change in Boston Naming Test (BNT) score, which assesses the ability to name drawings of everyday objects. Secondary measures included changes in aphasia severity, quality of life, and post-stroke depression.

Did You Know? Aphasia affects approximately 2 million Americans, highlighting the urgent need for effective treatments ^[1].

Significant Improvements Observed

The results demonstrated that the intervention group experienced statistically significant improvements across all measured outcomes compared to the control group.One month after the intervention,the average increase in BNT score was 11.16 points in the surgery plus iSLT group, compared to only 2.72 points in the iSLT-only group.This improvement in language function remained stable at six months, with a difference of 8.26 points between the groups.

Moreover, aphasia severity improved more significantly in the intervention group, and patients reported improvements in their daily activities and a reduction in post-stroke depression. Notably, no severe adverse events related to the surgery were reported within the six-month follow-up period.

While the authors acknowledge that the study’s participants were relatively young, predominantly male, and all native Chinese speakers, limiting the generalizability of the findings, they conclude that NC7 plus iSLT is a superior treatment for chronic post-stroke aphasia compared to iSLT alone. They also suggest that this combined approach can improve patients’ quality of life and reduce post-stroke depression.

Pro Tip: Engaging in regular cognitive exercises and social interaction can further support aphasia recovery alongside medical interventions.

Expert Commentary and Future Directions

Supattana Chatromyen, from the Neurological Institute of Thailand, described the trial as an interesting step forward in an accompanying editorial. While cautioning that further evidence is needed, Chatromyen suggests that these findings offer a glimmer of hope for individuals with chronic stroke who meet specific criteria.

Chatromyen concludes that while intensive SLT remains the cornerstone of aphasia treatment, C7 neurotomy could become a potential adjunctive option for carefully selected individuals in the future. This research should stimulate further scientific investigation and a critical re-evaluation of rehabilitation paradigms and policies for chronic stroke care, fostering a more optimistic and proactive approach to long-term recovery.

Understanding Aphasia

Aphasia is a language disorder that affects the ability to communicate. It can be caused by stroke, head injury, brain tumor, or other neurological conditions. The severity of aphasia can vary, ranging from mild difficulties finding words to a complete loss of the ability to speak, understand, read, or write.

The National Institute on Deafness and Other Communication Disorders (NIDCD) reports that approximately 1 million people in the united States have aphasia ^[2]. While there is no cure for aphasia, speech therapy and other rehabilitation strategies can help individuals improve their communication skills and quality of life.

Disclaimer: This article provides general information and should not be considered medical advice. Consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.

Have you or a loved one experienced aphasia after a stroke? What strategies have you found helpful in managing communication challenges? Share your thoughts and experiences in the comments below!