The impact of recovery of visuo-spatial neglect on motor recovery of the upper paretic limb after stroke.
The impact of recovery of visuo-spatial neglect on motor recovery of the upper paretic limb after stroke.
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DOI：
10.1371/journal.pone.0100584
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Kwakkel G
中科院分区：
文献类型：
--
作者：
Nijboer TC;Kollen BJ;Kwakkel G
本研究的目的是调查卒中后52周内偏瘫上肢的协同性和力量的改善与视觉空间忽视严重程度之间的纵向关系。采用密集重复测量设计，每个受试者18次测量，用Fugl Meyer运动评分和手臂运动指数测量VSN严重程度与运动损伤之间的纵向联系。对101名首次发生半球卒中的缺血性中风患者进行前瞻性队列研究，采用字母删除测试对忽视进行评估。所有的时间依赖性措施都是每周一次，从中风后14天内开始。从第10周到第20周，每两周测量一次。采用随机系数分析和趋势分析探讨运动功能改善时间与忽视严重程度之间的纵向关系。在101名中风患者中，有51人在中风发作时表现出忽视。偏瘫患者上肢的协同性和力量改善较少，与更严重的忽视有关。这种关联在中风后的前10周最为明显。忽视对上肢运动恢复的抑制作用似乎主要发生在中风后前10周的自发神经恢复期间。这一发现表明，大规模白质束尤其是知觉-注意网络的损伤抑制了大脑中其他网络的恢复，这表明了一种共同的潜在机制。
The aim of the current study was to investigate the longitudinal relationship between improvements of synergism and strength of the upper paretic limb and severity of visuo-spatial neglect during the first 52 weeks post-stroke. The longitudinal association between severity of VSN and motor impairment using Fugl Meyer motor score and Motricity Index of the arm was measured in an intensive repeated measurement design including 18 measurement sessions for each subject. Neglect was assessed using the letter cancellation test applied in a prospective cohort of 101 ischemic, first-ever, hemispheric stroke patients. All time-dependent measures were taken weekly, starting within 14 days post-stroke. From week 10 to 20 biweekly measurements are obtained. The longitudinal relationship of (bi)weekly time on improvement of motor functions and severity of neglect was investigated using random coefficient analysis and trend analyses. Fifty-one of the 101 stroke patients showed neglect at stroke onset. Less improvement of synergism and strength of the upper paretic limb was associated with more severe neglect. This association was most pronounced in the first 10 weeks post-stroke. The seemingly suppressive effect of neglect on upper-limb motor recovery appears to take place mainly during spontaneous neurological recovery of first 10 weeks post-stroke. This finding suggests that damage to large-scale white matter tracts of especially the perceptual-attention networks suppress recovery of other networks at distance in the brain suggesting a common underlying mechanism.
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影响因子：
3.6
作者：
Nijboer, Tanja C. W.;Kollen, Boudewijn J.;Kwakkel, Gert
通讯作者：
Kwakkel, Gert
DOI：
10.1111/j.1532-5415.1993.tb06947.x
发表时间：
1993-04-01
影响因子：
6.3
作者：
KALRA, L;CROME, P
通讯作者：
CROME, P
影响因子：
4.2
作者：
Krakauer JW;Carmichael ST;Corbett D;Wittenberg GF
通讯作者：
Wittenberg GF
影响因子：
4.8
作者：
FOLSTEIN, MF;FOLSTEIN, SE;MCHUGH, PR
通讯作者：
MCHUGH, PR
影响因子：
9.9
作者：
Buxbaum, LJ;Ferraro, MK;Coslett, HB
通讯作者：
Coslett, HB