Restoration of motor function in stroke patients: peculiarities relating to damage of the right or left hemisphere

Negative symptoms in stroke patients and length of hospital stay

The purpose of this study was to assess whether the presence and severity of psychiatric symptoms in stroke patients correlate with their length of stay (LOS) in a rehabilitation unit, with special emphasis on the role of negative symptoms (NS). Twenty-three stroke patients, consecutively recruited from the inpatient rehabilitation unit, were evaluated on admission with the Mini-Mental State Examination (MMSE), the Positive and Negative Symptom Scale (PANSS), the Hamilton Depression Rating Scale (HDRS), the Scale for Assessment of Negative Symptoms (SANS), and the Functional Independent Measure (FIM). NS scores significantly correlated with LOS, with SANS total score being the most informative, and the attentional impairment subscale the least. The group of patients with pronounced NS stayed in the hospital twice as long as patients with the score on the NS subscale of PANSS below 16. These two groups did not differ in their cognitive performance or in the positive symptom subscale of PANSS scores. Total FIM score on admission was lower and HDRS scores higher in patients with pronounced NS. However, these differences, unlike those of LOS, have not reached statistical significance. The presence and severity of NS in stroke patients are associated with a longer hospital stay. Identification and treatment of NS might lead to a faster discharge from rehabilitation unit.

Self-report of indifference and anxiety among persons with right hemisphere stroke

A sample of persons with a single ischemic cerebral stroke was used to elucidate and quantify the indifference associated with right hemisphere stroke. Seven persons with right hemisphere stroke were compared with 10 persons with left hemisphere stroke on two aspects of indifference (social indifference and lack of anxiety). Persons with right hemisphere stroke reported themselves as being substantially less anxious (p = .025) and somewhat more socially indifferent (p = .081) than did those with left hemisphere stroke. Lack of appropriate anxiety may contribute to the clinical descriptions of indifference, failure to make expected recovery, and difficulty in relationships with others.

Striatal dopamine after cortical injury

After right or left unilateral sensorimotor cortex ablation or a sham operation, dopamine concentrations were assayed in the right and left striatum of rats. In the sham-operated animals, a greater amount of dopamine was found in the left striatum compared with the right. Right or left sensorimotor cortex injury reduced dopamine in both striata. Right hemisphere lesions produced a greater loss of dopamine in the right striatum compared with the effect of a left lesion on dopamine in the left striatum. The results support the hypothesis of an asymmetric response to cortical injury.