title: The complexity of the relationship between neuropsychological deficits and impairment in everyday tasks after stroke.
abstract: OBJECTIVE
  A large body of research reports that stroke patients are debilitated in terms of daily independence after dismissal from the hospital unit. Patients struggle with the use of daily objects or performing complex actions. Differences between individual deficits of patients are often associated with the site of the brain damage. However, clinical studies suggest that patients exhibit varied constellations of action-associated difficulties and neuropsychological deficits. There is a lack of conclusive evidence indicating how different neuropsychological symptoms link to the impaired ability to perform activities of daily living (ADL).
  
  
  METHODS
  To further address this matter, in this study we compared the behavior of patients with left brain damage (LBD) and right brain damage (RBD) following stroke in two naturalistic task scenarios (tea making and document filing), and compared the committed action errors to the neuropsychological screening results.
  
  
  RESULTS
  We observed mild to severe impairments in both the LBD and RBD groups amounting to 37-55% of failure rate in attainment of action goal. Interestingly, the performance on both tasks was not correlated to each other, suggesting that the tasks involved a different set of higher cognitive functions. Despite similar behavioral manifestations, in the LBD group poor task performance was related to deficits in praxis performance and unilateral tactile and visual extinction. The presence of aphasia did not correlate with task performance, except for a link between low scores in Aachen aphasia test scales and misestimation error in the tea making task. In the RBD group, difficulties with performance were primarily linked to deficit in praxis and unilateral visual extinction.
  
  
  CONCLUSIONS
  Despite similar behavior, the underlying mechanisms of the deficits after stroke might be different (in patients with LBD and RBD) and reveal complex interlinks of cognitive networks involved in the ability to carry on everyday tasks.
authors.affiliation: Department of Sport and Health Sciences Institute of Human Movement Science Technische Universität München München Germany.
authors.forename: Marta M N
authors.initials: MM
authors.lastname: Bieńkiewicz
authors.affiliation: Department of Sport and Health Sciences Institute of Human Movement Science Technische Universität München München Germany ; Graduate School of Systemic Neurosciences Ludwig-Maximilians-Universität München Planegg-Martinsried Germany.
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Brandi
authors.affiliation: Department of Sport and Health Sciences Institute of Human Movement Science Technische Universität München München Germany.
authors.forename: Charmayne
authors.initials: C
authors.lastname: Hughes
authors.affiliation: Department of Sport and Health Sciences Institute of Human Movement Science Technische Universität München München Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Voitl
authors.affiliation: Department of Sport and Health Sciences Institute of Human Movement Science Technische Universität München München Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Hermsdörfer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001037:Aphasia; D003071:Cognition; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis
keywords: Action disorganization syndrome; activities of daily living; apraxia; neuropsychological deficits; stroke