Relationship between cortical or subcortical lesions and long-term functional capacity in stroke patients

Abstract

Strokes occur in the cortical or subcortical regions of the brain, compromise cortical functions and sensory-motor performance, and have a negative impact on long-term functional capacity. The aim of this study was to evaluate the relationship between strokes in the cortical or subcortical regions and autonomy, functional independence, and use of locomotor aids. We evaluated 62 patients with ischemic strokes confirmed by CT-scan. The cortical and subcortical regions were defined by an experienced neuroradiologist. Patients were divided into two groups: those with cortical strokes (group 1: n = 47) and those with subcortical strokes (group 2: n = 15). Patients were then assessed for autonomy and independence 90 days after stroke using the Barthel Index and modified Rankin Scale. Locomotor aid included the use of wheelchairs, crutches, and walking sticks for community outings. The associations of cortical or subcortical strokes with autonomy, independence, and use of locomotor aids were analyzed by simple logistic regression corrected for confounding variables (age, severity of stroke and treatment received) and were considered significant when P < 0.05. Lower autonomy was observed in group 1 than in group 2. Specifically, 6.4% of patients in group 1 scored higher than 95 on the Barthel Index, compared to 46.7% in group 2 ( P = 0.04). A significant difference in the use of locomotor aids was observed between the groups (wheelchair: 29.8% of group 1 vs. 6.7% of group 2, P = 0.03; walking sticks or crutches: 44, 7% of group 1 vs. 33.3% of group 2, P = 0.03; Table 1). Patients with ischemic strokes in cortical regions demonstrate less autonomy and have a greater chance of using locomotor aids than patients with strokes in subcortical regions do.