Motor recovery after stroke depends on intact sustained attention: A 2-year follow-up study.

Abstract

The functional recovery of 47 right-brain-damaged stroke patients was studied over a 2-year period. The researchers hypothesized that sustained attention capacity should predict the degree of motor and functional recovery over this period because of a proposed privileged role of sustained attention in learning-based recovery of function. As predicted, significant correlations were found between sustained attention capacity at 2 months and functional status (including the Barthel Index) at 2 years. This relationship was shown to exist independently of 2-month functional status. Furthermore, compared with a left-brain-damaged group of cerebrovascular accident (CVA) patients, the right-brain CVA group did not recover functional ability as well over the 2-year period. This increasing difference in functional status over a 2-year period was mirrored by an emerging difference in sustained attention capacity, in favor of the left-brain CVA group.

Between-session and within-session intra-individual variability in attention in aphasia

“…Attention, including fluctuations in attention over time, may therefore have critical implications for the treatment of language deficits in aphasia. There is already evidence that good attention in stroke patients is predictive of overall functional recovery (Mysiw, Beegan, & Gatens, 1989), as well as motor recovery (Robertson, Ridgeway, Greenfield, & Parr, 1997). Additionally, there is evidence that successful language rehabilitation may involve changes in attention-related neural networks, in particular the DMN (Marcotte, Perlbarg, Marrelec, Benali, & Ansaldo, 2013).…”

“…Not only has attention been shown to be predictive of long-term functional recovery after stroke (Mysiw, Beegan, & Gatens, 1989;Robertson, Ridgeway, Greenfield, & Parr, 1997), evidence from the aphasia literature has also suggested that cognitive abilities such as attention may successfully predict language therapy outcomes (Lambon Ralph, Snell, Most models frame attention as a domain-general resource that may be drawn on for a variety of tasks, both linguistic and non-linguistic (e.g. Posner & Petersen, 1990;Mirsky, Anthony, Duncan, Ahearn, & Kellam, 1991;Petersen & Posner, 2012;Cohen, 2014).…”

Reducing Attention Deficits After Stroke Using Attention Process Training

“…9,10 Impaired attention can reduce cognitive productivity when other cognitive functions are intact 11 and is key to learning motor skills. 12 Robertson et al 13 reported that sustained attention 2 months after stroke predicts functional recovery at 2 years. Nys 9 found cognitive impairment 1 week after stroke predicts quality of life 6 months after stroke (Stroke Impact Scale), with visual hemi-inattention contributing significantly.…”

A right hemisphere role in cognitive reserve

“…Specifically, the ability to sustain attention to a tone counting task (a validated measure of sustained attention which is related to right frontal function) at two months post-stroke predicted not only everyday life function 2 years later, but also the functional dexterity of the left hand in a pegboard task (Robertson, et al, 1997).…”