Association between executive dysfunction and mild to severe upper extremity deficits in stroke survivors: A resting...

We aimed to observe the association between executive function and mild to severe upper extremity deficits in stroke survivors. Meanwhile, applying functional Near-Infrared Spectroscopy (fNIRS) to investigate the resting-state functional connectivity (FC) patterns of patients with post-stroke executive impairment (PSEI).

122 stroke survivors with mild to severe upper extremity deficits were enrolled. The Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Stroop color-word test assessed cognitive and executive function. The Fugl-Meyer assessment of the upper extremity (FMA-UE) and Action Research Arm Test (ARAT) assessed motor function. They were collected fNIRS data at the resting state.

(1) In patients with mild to moderate upper extremity deficits, PSEI patients exhibited decreased speed/coordination of the upper extremity compared to the NPSEI patients (P < 0.05). The MoCA (r = 0.280, P = 0.047) and FAB (r = 0.358, P = 0.010) were associated with the speed/coordination. PSEI patients showed a decreased FC between the left dorsolateral prefrontal cortex (DLPFC) and the right Pre-Motor and Supplementary Motor Cortex (PreM&SMC), the right primary Somatosensory Cortex (PSMC) (P < 0.05); (2) In patients with severe upper extremity deficits, PSEI patients showed a reduction in FMA and ARAT (P < 0.05). The MoCA was associated with ARAT (r = 0.296, P = 0.016) and FMA-UE (r = 0.317, P = 0.009). The FAB was related to ARAT (r = 0.263, P = 0.033) and FMA-UE (r = 0.295, P = 0.016). PSEI patients did not show a significant change in FC (P ＞ 0.05).

Our study suggests that the association between executive function and upper extremity after stroke is associated with the degree of upper extremity deficits. Additionally, the FC among cortical and subcortical brain regions were different with varying degrees of upper extremity deficits in PSEI patients.