Article

Proportional recovery of upper-extremity motor function
and aphasia after stroke may suggest common mechanisms for spontaneous
neurobiological recovery.
This study aimed to investigate if the proportional
recovery rule also applies to visuospatial neglect (VSN) in right-hemispheric
first-ever ischemic stroke patients and explored the possible common underlying
mechanisms. METHODS: Patients with upper-limb paresis and VSN were included.
Recovery defined as the change in Letter Cancellation Test (LCT) score at ~8 days
and 6 months poststroke. Potential recovery defined as LCTmax-LCTinitial = 20 -
LCTinitial. Hierarchical clustering separated fitters and nonfitters of the
prediction rule. A cutoff value on LCTmax-LCTinitial was determined. The change
in LCT and Fugl-Meyer Assessment Upper Extremity was expressed as a percentage of
the total possible score to investigate the communality of proportional recovery.
RESULTS: Out of 90 patients, 80 displayed proportional recovery of VSN (ie,
"fitters," 0.97; 95% CI = 0.82-1.12). All patients who did not follow the
prediction rule for VSN (ie, "nonfitters") had >/=15 missing O's at baseline and
failed to show proportional recovery of the upper limb. CONCLUSIONS: This study
shows that the proportional recovery rule also applies to patients with VSN
poststroke. Patients who fail to show proportional recovery of VSN are the same
patients who fail to show proportional recovery of the upper limb. These findings
support the idea of common intrahemispheric mechanisms underlying spontaneous
neurobiological recovery in the first months poststroke. Future studies should
investigate the prognostic clinical and neurobiological markers of these
subgroups.

Langue : ANGLAIS