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Motor-intentional Disorders in Right Hemisphere Stroke

Seo, Sang Won MD*; Jung, Kihyo MS; You, Heecheon PhD; Lee, Byung Hwa MA*; Kim, Gyeong-Moon MD*; Chung, Chin-Sang MD*; Lee, Kwang Ho MD*; Na, Duk L. MD*

Cognitive and Behavioral Neurology: December 2009 - Volume 22 - Issue 4 - p 242-248
doi: 10.1097/WNN.0b013e3181b7f251
Original Studies

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.

*Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul

Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea

Supported by the Korea Research Foundation Grant (KRF-2004-042-H00024) and the Samsung Biomedical Research Institute Grant (SBRI C-A7-209-2).

Reprints: Duk L. Na, MD, Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, Republic of Korea (e-mail: dukna@skku.edu).

Received for publication July 7, 2008

accepted July 5, 2009

© 2009 Lippincott Williams & Wilkins, Inc.