Gender and stroke lateralization: factors of functional recovery after the first-ever unilateral stroke?

The goal of this prospective study was to evaluate gender differences in rehabilitation outcome in patients after the first-ever unilateral stroke.

A total of eighty right-handed patients were prospectively enrolled, 35 (44%) women, and 45 (56%) men. A degree of neurological deficit was quantified by the National Institutes of Health Stroke Scale. Functional outcome was assessed by the Motor Status Scale, Chedoke Arm and Hand Activity Inventory, Rivermead Mobility Index and Barthel Index.

At the time of hospital admission there was no significant gender difference in clinical stroke severity. At discharge, we registered significantly better motor and functional recovery in men compared to women. Further, we found significantly better rehabilitation outcome in women with stroke in dominant left hemisphere (LH) than in women with stroke in subdominant right hemisphere (RH). Conversely, men with stroke in subdominant RH had significantly better rehabilitation outcome than men with stroke in dominant LH. Using a multivariate analysis we have found that men with stroke in RH had significantly higher probability to reach not only high response in mobility, but also more autonomy in ADL. The frequency of stroke in LH was significantly higher in both genders aged less than 51 years, as well as in women, while the frequency of stroke in RH was significantly higher in men.

This paper places particular emphasis on substantial gender-based differences in functional recovery of patients with their first-ever unilateral stroke.