Clinical and Neuropsychological Characteristics of Patients with Stroke of the Basal Ganglia

Ko, Myoung Hwan; Kim, Yun Hee; Seo, Jeong Hwan

Abstract

The experimental evidences suggest that the roles of basal ganglia are cognition and emotion through the corticostriatothalamocortical relationship. The patients with lesions in the caudate nucleus have high incidences of cognitive and behavioral abnormalities accompanied with the motor paralysis. In these patients, the accurate assessment of neuropsychologic dysfunctions and the prompt application of cognitive rehabilitation programs are important for the functional restoration. We evaluated the patients with stroke of basal ganglia for the clinical and neuropsychological characteristics in relation to the involved substructures of basal ganglia. Fourteen patients were evaluated for the clinical neurologic examinations, functional assessment by functional independence measure(FIM), speech assessment, and various neuropsychological tests for the assessment of attention and memory functions. The results were analysed a ccording to their lesion sites. Of the nine patients with stroke at the right basal ganglia, five patients had neglect of the contralateral hemispace and one had dysarthria. On the other hand, of the five patients with stroke at the left basal ganglia, none had hemispatial neglect and three had aphasia or dysarthria. Of the six patients with caudate lesions, three had aphasia or dysarthria, whereas of the eight patients without caudate lesion, one had dysarthria. The scores of Wechsler memory test were significantly lower in the patients with caudate lesions(P<0.05). Among the FIM subscales, the scores of communication and social cognition were significantly lower in the patients with caudate lesions(P<0.05). The Motor Score was significantly lower in the patients with putamen lesions(P<0.05). Among the FIM subscales, the scores of self care and locomotion were significantly lower in the patients with putamen lesions(P<0.05).