New approach to post-stroke aphasia emerges

Researchers report that in patients with chronic aphasia after stroke, right neurotomy of the seventh cervical nerve (C7) at the intervertebral foramen plus intensive speech and language therapy (SLT) improves language function better than intensive SLT alone.

The findings were reported on June 25, 2025 in the BMJ/British Medical Journal.

As background to the study, the authors noted that, “Chronic aphasia after stroke is challenging to treat. Intensive speech and language therapy (SLT) has been a main treatment for patients with chronic aphasia, but improvements in efficacy are needed.”

The researchers in China identified 50 patients aged 40 to 65 years with aphasia and muscle stiffness (spasticity) in their right arm for more than a year after a single stroke affecting the left side of the brain, which is responsible for language.

They randomized the subjects 1:1 to receive either C7 neurotomy plus three weeks of intensive SLT (intervention group, n=25) or three weeks of intensive SLT only (control group, n=25).

The primary endpoint was the change in Boston Naming Test (BNT) score (ability to name drawings of everyday objects) at day 3, one month and six months into the trial.
At one-month, mean increase in BNT score was 11.16 points in the neurotomy plus SLT group and 2.72 points in the control group, a statistically significant difference (P<0.001). The difference remained stable at six months (8.26 points), and it remained statistically significant (P<0.001).

The severity of aphasia improved significantly more in the intervention group than the control group (P<0.001). And patient-reported activity of daily life and post-stroke depression improved compared with controls.

The authors concluded, “C7 neurotomy plus three weeks of intensive SLT was associated with a greater improvement in language function compared with three weeks of intensive SLT alone over a period of six months. No severe adverse events or long-term troublesome symptoms or functional loss were reported.”