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The right hemisphere is important for driving-related cognitive function after stroke

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Abstract

Considering quality of life (QOL) after stroke, car driving is one of the most important abilities for returning to the community. In this study, directed attention and sustained attention, which are thought to be crucial for driving, were examined. Identification of specific brain structure abnormalities associated with post-stroke cognitive dysfunction related to driving ability would help in determining fitness for car driving after stroke. Magnetic resonance imaging was performed in 57 post-stroke patients (51 men; mean age, 63 ± 11 years) who were assessed for attention deficit using a standardized test (the Clinical Assessment for Attention, CAT), which includes a Continuous Performance Test (CPT)-simple version (CPT-SRT), the Behavioral Inattention Test (BIT), and a driving simulator (handle task for dividing attention, and simple and selective reaction times for sustained attention). A statistical non-parametric map (SnPM) that displayed the association between lesion location and cognitive function for car driving was created. From the SnPM analysis, the overlay plots were localized to the right hemisphere during handling the hit task for bilateral sides (left hemisphere damage related to right-side neglect and right hemisphere damage related to left-side neglect) and during simple and selective reaction times (false recognition was related to damage of both hemispheres). A stepwise multiple linear regression analysis confirmed the importance of both hemispheres, especially the right hemisphere, for cognitive function and car driving ability. The present study demonstrated that the right hemisphere has a crucial role for maintaining directed attention and sustained attention, which maintain car driving ability, improving QOL for stroke survivors.

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Acknowledgments

The authors would like to thank the MRI Team at Hibino Hospital for the special efforts.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Koji Shimonaga, Seiji Hama, Akiko Yanagawa, Toshinori Matsushige & Kaoru Kurisu

  2. Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

    Koji Shimonaga, Toshinori Matsushige & Tatsuya Mizoue

  3. Department of Rehabilitation, Hibino Hospital, Hiroshima, Japan

    Seiji Hama & Akiko Yanagawa

  4. Graduate School of Engineering, Hiroshima University, Hiroshima, Japan

    Toshio Tsuji, Kazumasa Yoshimura, Shinya Nishino & Zu Soh

  5. Department of Neurology, Shimane University, Matsue, Shimane, Japan

    Keiichi Onoda

  6. Department of Psychiatry and Neuroscience, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan

    Hidehisa Yamashita

  7. Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Hiroshima, Japan

    Shigeto Yamawaki

Authors
  1. Koji Shimonaga
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  2. Seiji Hama
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  3. Toshio Tsuji
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  4. Kazumasa Yoshimura
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  5. Shinya Nishino
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  6. Akiko Yanagawa
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  7. Zu Soh
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  8. Toshinori Matsushige
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  9. Tatsuya Mizoue
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  10. Keiichi Onoda
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  11. Hidehisa Yamashita
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  12. Shigeto Yamawaki
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  13. Kaoru Kurisu
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Corresponding author

Correspondence to Seiji Hama.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review boards and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written, informed consent was obtained from all individual participants included in the study.

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Shimonaga, K., Hama, S., Tsuji, T. et al. The right hemisphere is important for driving-related cognitive function after stroke. Neurosurg Rev 44, 977–985 (2021). https://doi.org/10.1007/s10143-020-01272-9

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  • DOI: https://doi.org/10.1007/s10143-020-01272-9

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