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Neurological Rehabilitation

Thiamine supplementation as a treatment approach for post-stroke aphasia: A case report

Friday, October 24, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 5

    Poster Presenter(s)

  • Camille Beaton, DO

    Resident
    University of North Carolina Hospitals PM&R Program
    Chapel Hill, North Carolina

    • Co-Author(s)

  • John M. Baratta, MBA, MD

    Associate Professor
    University of North Carolina School of Medicine
    Chapel Hill, North Carolina

Disclosure(s):
Camille Beaton, DO: No financial relationships to disclose
John M. Baratta, MBA, MD: No financial relationships to disclose
Case Diagnosis: 74-year-old female with left middle cerebral artery (MCA) stroke status post thrombectomy in March 2024

Case Description or Program Description: This patient exhibited a plateauing, moderate post-stroke aphasia following a left MCA territory stroke despite ongoing speech therapy sessions and a donepezil trial. At the patient’s preference, she was treated with thiamine supplementation beginning 8 months after the stroke. She did not have a history of thiamine deficiency or heavy alcohol use. The patient’s aphasia exhibited dramatic improvement within 3 days of thiamine initiation (250 mg daily for one week, then continued at 125 mg daily), with findings simultaneously noted by the patient, her husband, and her speech therapist. Specifically, the patient was noted to have improved word finding and recall associated with initiation of thiamine supplementation. For example, prior to thiamine initiation, the patient required a picture communication board to select meal options, while one week following initiation she was able to communicate selections with 85% accuracy of word use and no cues. Three months after initiation, the patient continues to have notable improvements in speech and language. There have been no side effects noted related to thiamine supplementation.

Setting: Outpatient clinic

Assessment/Results: The patient had notable improvements in speech and language after starting thiamine supplementation. No side effects reported. The patient continues to make substantial improvements.

Discussion (relevance): Thiamine has been associated with improved outcomes for patients with traumatic brain injuries but investigation of thiamine use with stroke has not been investigated. Further, reduced thiamine levels have been found to be a predictor for cognitive impairment after a cerebral infarction. Aphasia is present in 21-38% of acute stroke patients and currently there are no approved medications for post-stroke aphasia.

Conclusions: Thiamine has a low side effect profile, and further research is needed to evaluate its effectiveness in improving language in post-stroke patients in conjunction with speech therapy.