The interaction between neuropsychological and motor deficits in patients after stroke

Abstract

Stroke survivors typically experience varying degrees of motor and neuropsychological deficits. Although these deficits are frequently treated as separate entities in the cognitive and physical rehabilitation settings, there is considerable interaction between them. Cognitive-motor interference, for example, refers to the simultaneous performance of cognitive and motor functions that results in diminished execution of one or both of the tasks. Studies have demonstrated that when performing dual tasks, poststroke patients will typically favor the cognitive function over the motor task. Furthermore, only certain cognitive functions will interfere with motor abilities, while the intensity of the motor task may magnify the detriment in dual-task performance. Moreover, mood disorders, particularly depression, have also been shown to interact substantially with physical functioning. Consequently, poststroke patientswith depression experience greater reductions in their activities of daily living and worse rates of recovery. Recent neuroimaging studies suggest an association between white matter hyperintensities and both motor and neuropsychological poststroke deficits. The relationship between spasticity and cognition deficits needs to be further explored with regard to the deleterious consequences of poststroke spasticity on quality of life and overall motor function. These insights, among others, contribute to a growing, if embryonic, body of knowledge about poststroke motor/cognitive interaction that will ultimately inform developments in treatment and rehabilitation. © 2013 American Academy of Neurology.