Time-dependent decline of body-specific attention to the paretic limb in chronic stroke patients

Abstract

Objective: To examine whether reduced body-specific attention to a paretic limb is found in chronic stroke patients in a time-dependent manner.

Methods: Twenty-one patients with chronic hemiparesis (10 left and 11 right hemiparesis) after subcortical stroke and 18 age-matched healthy controls were recruited in this study. Standard neuropsychological examinations showed no clear evidence of spatial neglect in any patient. In order to quantitatively measure spatial attention to the paretic hand, a visual detection task for detecting a target appearing on the surface of either a paretic or dummy hand was used. This task can measure the body facilitation effect, which makes faster detection of a target on the body compared with one far from the body.

Results: In stroke patients, there was no difference in the reaction time for a visual target between the paretic and the dummy hands, while the healthy participants showed faster detection for the visual target on the real hand than on the dummy one. The index of the body facilitation effect, subtracting the reaction time for the target-on-paretic hand from that for the target-on-dummy one, was correlated with the duration since onset and with finger function test on the Stroke Impairment Assessment Set.

Conclusions: The reduction of the body facilitation effect in the paretic limb suggests the decline of body-specific attention to the paretic one in patients with chronic hemiparesis. This decline of body-specific attention, leading to neglect for the paretic limb, will be one of the most serious problems for rehabilitation based on use-dependent plasticity.