Motor-intentional Disorders in Right Hemisphere Stroke

Abstract

Objective: Damage to premotor and prefrontal regions results in motor-intentional disorders (MIDs) that disrupt initiation, maintenance, and termination of volitional movements. MIDs more frequently occur in right hemisphere rather than in left hemisphere injury. The aim of this study was to evaluate the prevalence of MIDs in patients with right hemisphere stroke and the factors that have influence on MIDs. Methods: Subjects consisted of 25 consecutive patients with right hemisphere stroke and 12 normal controls. They underwent a series of experiments using force dynamometer along with bedside examination. Results: It was identified that the force control test screened for MIDs with a higher sensitivity than bedside examinations: motor akinesia (38% vs. 11%), motor impersistence (50% vs. 10%), and motor perseveration (47% vs. 25%). The patients were significantly inferior to the controls in terms of force control capabilities in the 4 force control phases (1.6 to 16.3 times). The location and area of lesion and space of force production were not related to the severity of MIDs whereas the presence of neglect was related to the severity of MIDs. Conclusions: Our results suggest force dynamometer is a sensitive method to detect MIDs and the presence of neglect may influence the frequency of MIDs. © 2009 by Lippincott Williams & Wilkins.