Distinct Constructs Underlie Patient-Reported and Performance-Rated Outcomes after Stroke.

Area of Science:

• Neurology
• Neurorehabilitation
• Clinical Outcomes Research

Background:

• Patient-reported outcome measures (PROMs) are crucial in neurological research but their relationship with performance-based measures is not fully understood.
• Sociodemographic factors and brain injury location, particularly in self-awareness regions, may influence PROMs.

Purpose of the Study:

• To investigate the relationship between PROMs and performance-based measures in stroke survivors with arm motor impairments.
• To determine the influence of sociodemographic factors and neuroanatomy on these distinct outcome classes.

Main Methods:

• Longitudinal assessment of 54 stroke survivors using both patient-reported and performance-rated measures across 4 timepoints.
• Factor analysis to define outcome structures, linear regression for sociodemographic associations, and voxel-lesion-symptom/network mapping for neuroanatomic correlations.

Main Results:

• Performance-based and patient-reported measures formed distinct factors throughout recovery.
• Higher education and income adequacy correlated with PROMs, not performance measures.
• Parietal lobe injury was linked to worse PROMs, while corticospinal tract injury related to worse performance outcomes. Salience network connectivity also impacted PROMs.

Conclusions:

• Significant differences exist between performance-rated and patient-reported outcomes post-stroke, each associated with unique factors and brain injury patterns.
• Integrating sociodemographic and neuroanatomic data into neurorehabilitation may enhance patient outcomes.