Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies (UMR CNRS 8160), University Hospitals of Lille and Amiens, Lille, and Amiens, France.
Cerebrovasc Dis. 2010;29(5):508-14. doi: 10.1159/000297968. Epub 2010 Mar 19.
The present study aimed to determine the mechanisms and determinants of stroke-related action slowing.
Thirty-six stroke patients not presenting any clinical motor deficit of the preferred hand (mean post-stroke delay 11 months) were compared to matched controls on Finger Tapping test (motor speed), Visual Inspection Time test (visual perceptual speed) and Simple and Choice Reaction Time tests.
Patients were slower on all tests except Choice Reaction Time: Visual Inspection (p = 0.003), Finger Tapping test (p = 0.001), Simple Reaction Time (p = 0.002) tests were impaired including performance measured with the ipsi-lesional hand. This pattern and the uniform lengthening across the entire reaction time distribution both suggest that psychomotor slowing was due to slowing of perceptual and motor processes. The main determinant of action slowing was lesion location: (1) Visual Inspection Time = right inferior parietal lobulus (OR 18, 95% CI 2.9-108); (2) Finger Tapping = left frontal middle gyrus (OR 18, 95% CI 2.9-108) and lenticular nucleus (OR 59, 95% CI 1.9-1,775), and (3) Simple Reaction Time = right lenticular nucleus (OR 110, 95% CI 8-1,490) and posterior fossa (OR 55, 95% CI 3.4-890). Finally poor outcome depended on Tapping Frequency measured with the contra-lesional index (OR 0.1, 95% CI 0.02-0.5; p = 0.0005) and impairment on the Token test (OR 151, 95% CI 2.24-1136; p = 0.02).
This study shows that stroke-related action slowing is mainly due to slowing of perceptual and motor processes. Action slowing was related to lesions of the large network. Finally Tapping Frequency is an independent predictor of outcome. This supports that action slowing is an important consequence of stroke and that it is a promising prognosis index.
本研究旨在确定与中风相关的动作迟缓的机制和决定因素。
将 36 名中风患者（平均发病后 11 个月）与匹配的对照组进行手指敲击测试（运动速度）、视觉检查时间测试（视觉感知速度）和简单和选择反应时间测试比较。
除选择反应时间外，患者在所有测试中均较慢：视觉检查（p = 0.003）、手指敲击测试（p = 0.001）、简单反应时间（p = 0.002）测试受损，包括使用优势手进行的测试。这种模式和整个反应时间分布的均匀延长都表明，精神运动迟缓是由于感知和运动过程的减慢引起的。动作迟缓的主要决定因素是病变部位：（1）视觉检查时间=右侧顶下小叶（OR 18，95%CI 2.9-108）；（2）手指敲击=左侧额中回（OR 18，95%CI 2.9-108）和豆状核（OR 59，95%CI 1.9-1.775）；（3）简单反应时间=右侧豆状核（OR 110，95%CI 8-1.490）和后颅窝（OR 55，95%CI 3.4-890）。最后，不良结局取决于用对侧指数测量的敲击频率（OR 0.1，95%CI 0.02-0.5；p = 0.0005）和代币测试的损害（OR 151，95%CI 2.24-1136；p = 0.02）。
本研究表明，与中风相关的动作迟缓主要是由于感知和运动过程的减慢所致。动作迟缓与大网络的病变有关。最后，敲击频率是结局的独立预测因子。这支持动作迟缓是中风的重要后果，并且是有前途的预后指标。
