Hemispheric specialization for motor sequencing: abnormalities in levels of programming.

Left and right hemisphere stroke patients and control subjects performed sequences of hand postures which varied in complexity (repetitive and heterogeneous) and length (one to five). Performance in the hand ipsilateral to the stroke was compared to a control group using the same hand. Neither stroke group had problems preprogramming sequences prior to movement. The only deficit seen for the right hemisphere group was a greater difference in movement time (MT) between heterogeneous and repetitive sequences relative to controls, regardless of sequence length. This suggested right hemisphere damage results in subtle timing but not error deficits on more complex movements, perhaps due to increased external spatial demands. The left hemisphere group was slower to execute single postures, and had difficulty scheduling motor programs for repetitive and heterogeneous movements such that inter-response times (IRTs) were more affected by sequence length than for controls. Left hemisphere patients also made more errors on heterogeneous sequences as they increased in length, and the difference in MTs between repetitive and heterogeneous sequences increased more with increasing length relative to their control group. These results suggested the left hemisphere plays a role in controlling single postures, in scheduling motor programs during repetitive and heterogeneous movements, and in processes related to sequential ordering.