There is considerable evidence that after a stroke, ipsilesional deficits increase as contralesional impairment increases. However, it is unclear whether this relationship differs based on the side of stroke. Here, we tested the hypothesis that the ipsilesional hand motor capacity co-varies with contralesional hand impairment only in individuals with left hemisphere damage. Forty-two premorbidly right-handed chronic stroke survivors (left hemisphere damage, LHD = 21) with mildto-moderate paresis (Upper Extremity Fugl-Meyer-UEFM range: 19-59) performed distal items of the Wolf Motor Function Test (dWMFT). We used univariate co-efficient of determination ( " ) and multiple linear regression to assess the relationship between motor capacity of ipsilesional and contralesional hands. Contralesional UEFM, and dWMFT were found to be significant predictors of ipsilesional hand motor capacity (p < 0.0001 for both). Importantly, the relationship between contralesional and ipsilesional hands was significantly modified by side of stroke (model adjusted " = 0.26 and 0.42, respectively, p < 0.01). For individuals with LHD, contralesional impairment explained 42% and contralesional hand motor capacity explained 65% of the variance in ipsilesional hand motor capacity. However, this relationship was not statistically significant for individuals with right hemisphere damage (RHD, unadjusted " < 1% for UEFM and 9% for dWMFT, p > 0.05). In chronic stroke survivors with mild-to-moderate impairment, our findings demonstrate that the relationship between contralesional and ipsilesional motor deficits depends on the side of stroke. Specifically, deficits co-vary between the limbs of stroke survivors with left hemisphere damage but not right hemisphere damage.
KeywordsIpsilesional deficits, stroke, hemispheric differences Interlimb Relationship is Hemisphere-Specific Interlimb Relationship is Hemisphere-Specific
Analysis of the interaction effectBy preserving the continuity of the UEFM and utilizing continuous standardized z-scores, our statistical approach allowed a direct comparison of our regression parameters (i.e., ), thus reflecting effect sizes of each of the candidate predictors-contralesional impairment, side of lesion and their interaction. While contralesional impairment alone bore the largest effect on ipsilesional motor capacity ( 0 ), the second largest effect was through the interaction between contralesional UEFM and the side of lesion ( V ), and not the side of lesion alone ( " ). In fact, unlike previous findings, we did not observe a significant effect of the side of lesion on ipsilesional motor capacity 17,18 , nor on contralesional UEFM or dWMFT. 13 One reason for this might be that the effect of the side of lesion observed in those previous studies may have arisen from its interaction with contralesional impairment. However, because an interaction effect was not explicitly tested and because contralesional impairment was either collapsed across the groups 2,3,15 or catagorical 7,8 , variance in the ipsilesional capa...