ABSTRACT
Background Post-stroke aphasia is a common but intractable sequela which still needs new and more effective treatments. Evidence from follow-ups after contralateral seventh cervical nerve transfer surgery indicated that nerve transection leads to immediate language improvements in patients with right post-stroke aphasia.
Objective Through a prospective cohort design, this study aims to prove that C7 neurotomy at the intervertebral foramen (NC7) combined with a 3-week intensive speech and language therapy (iSLT) can improve the language function in post-stroke aphasia patients.
Methods In this study, patients aged over 18 years old and had been diagnosed with post-stroke aphasia for 1 year or longer were included. Primary outcomes were the change in the ability to retrieve personally relevant words in Boston Naming Test (BNT) with follow-up assessment after three-weeks’ iSLT post-operatively. As well as several secondary outcome measures including the Western Aphasia Battery (WAB), daily communication abilities (measured by the Communication Activities of Daily Living Third Edition [CADL-3]) and Fugl-Meyer of upper limb part (UEFM).
Results The average increase of BNT score was 11.2 points from baseline to 3 weeks post-operatively (P=0.001, 95%CI: 8.1-14.1). The WAB and CADL-3 assessment showed 9.4, 10.4 points increasing in average (P<0.005, 95%CI: 4.6 to 14.1; P<0.001, 95%CI:6.7 to 14.1) from baseline to 4-week follow-up, respectively. The mean difference from baseline to 3 weeks post-operatively in UEFM score decreased 0.8 points (95% CI: -3.2 to 1.6; p<0.405).
Conclusions NC7 plus iSLT significantly improved the language function in patients with post-stroke aphasia, and did not significantly affect the motor function of the right limb. The mechanism of this surgery needs to be further explored.
Competing Interest Statement
The authors have declared no competing interest.
Clinical Trial
ChiCTR2200060147
Funding Statement
This study was funded by the National key R&D program of China (2022YFC3602700), National Natural Science Foundation of China (82021002, 81830063 and 82072539), Shanghai Municipal Science and Technology Major Project (2018SHZDZX05), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-007, Shanghai Municipal Clinical Medical Center Project(2022ZZ01007), Youth Talent Project of Shanghai Municipal Health Commission (2022YQ009).
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Institutional review board of Shanghai Jing'an District Central Hospital (Affiliated to Hua Shan hospital of Fudan University) gave ethical approval for this work.
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Footnotes
Interests of conflict: The authors have no conflict of interest concerning the materials or methods used in this study or the findings specified in this article.
Funding Resources: This study was funded by the National key R&D program of China (2022YFC3602700), National Natural Science Foundation of China (82021002, 81830063 to Xu and 82072539 to Feng), Shanghai Municipal Science and Technology Major Project (2018SHZDZX05), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-007 to Xu), Shanghai Municipal Clinical Medical Center Project(2022ZZ01007), Youth Talent Project of Shanghai Municipal Health Commission (2022YQ009 to Feng).
Ethic committee approval: The study was approved by the institutional review board of Shanghai Jing’an District Central Hospital (Affiliated to Hua Shan hospital of Fudan University) and registered on www.chictr.org.cn (number: ChiCTR2200060147). Signed consent in this study were acquired from all the patients participated in.
Data Availability
All data produced in the present study are available upon reasonable request to the authors.