title: Directional and spatial motor intentional disorders in patients with right versus left hemisphere strokes.
abstract: OBJECTIVE
  Motor intentional disorders (MIDs) are characterized by dysfunction in the preparation, initiation, maintenance, and termination of goal-oriented actions. In this study, we investigated (1) whether patients with right hemisphere strokes (RHS) and left hemisphere strokes (LHS) differ in the frequency of delayed action initiation (hypokinesia) and motor impersistence; (2) whether there is a directional or hemispatial component of hypokinesia or motor impersistence; (3) whether there is an association between the presence of hemispatial neglect and tests for MID; and (4) the location of injury associated with MID.
  
  
  METHODS
  Thirty-two patients with acute unilateral stroke (21 with RHS and 11 with LHS) and 12 age-matched healthy controls participated in the study. To determine the presence and severity of directional and spatial hypokinesia and impersistence we used a new apparatus, the Directional Movement Tester (DMT). While being tested with the DMT, the participants held a static bar located either in the right or left hemispace using either their right or left hand and upon stimulus onset pushed the bar either leftward or rightward and maintained a given force for 10 sec.
  
  
  CONCLUSIONS
  The frequency of hypokinesia and impersistence was higher in the RHS group than in the LHS group, but there were no hypokinetic directional or spatial asymmetries. The RHS group did demonstrate left contralesional directional impersistence, but there were no spatial asymmetries of impersistence. Signs of hemispatial neglect were not associated with these measures of MID. Participants with frontal or subcortical lesions were significantly more likely to demonstrate hypokinesia and impersistence than those with posterior lesions.
authors.affiliation: Department of Neurology, Pusan National University Hospital, Seoul, Republic of Korea.
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Kim
authors.forename: Baekhee
authors.initials: B
authors.lastname: Lee
authors.forename: Min-Kyung
authors.initials: MK
authors.lastname: Jo
authors.forename: Kihyo
authors.initials: K
authors.lastname: Jung
authors.forename: Heecheon
authors.initials: H
authors.lastname: You
authors.forename: Byung Hwa
authors.initials: BH
authors.lastname: Lee
authors.forename: Han-Jin
authors.initials: HJ
authors.lastname: Cho
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Sung
authors.forename: Dae Soo
authors.initials: DS
authors.lastname: Jung
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Heilman
authors.forename: Duk L
authors.initials: DL
authors.lastname: Na
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D033182:Intention; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D010468:Perceptual Disorders / Q000175:diagnosis / Q000209:etiology*; D010775:Photic Stimulation; D011597:Psychomotor Performance; D011930:Reaction Time; D013028:Space Perception / Q000502:physiology*; D020521:Stroke / Q000150:complications* / Q000473:pathology