TACTILE EXTINCTION AND FUNCTIONAL STATUS AFTER STROKE - A PRELIMINARYINVESTIGATION

Background and Purpose Research has identified a number of factors ass ociated with poststroke recovery, but the prediction of long-term func tional outcome remains an uncertain endeavor. In previous work, extinc tion to tactile, double-simultaneous stimulation has been shown to hav e short-term predictive utility. The present study was designed to exa mine its long-term prognostic value and to determine the relative impo rtance of tactile extinction, cognitive functioning, and visual neglec t as predictors of poststroke functional status. Methods Successive ad missions to an acute-care facility (n=26) were assessed three times: 1 month, 3.5 months, and 6 months after stroke. Hierarchical multiple r egression, a procedure that maximizes the effect of the variables firs t entered, was used to predict functional status. Cognitive functionin g and visual neglect were forced into the equation on the first step; tactile extinction was entered on the second step. Multivariate analys is of variance was used to compare the functional status of subjects w ith no extinction versus those who demonstrated extinction at the firs t assessment and later improved and those who continued to manifest th e deficit. Results Tactile extinction on the left-hand side of the bod y was the most important predictor of functional outcome. A significan t group-by-time interaction implied that the course of improvement in functional status differed between the groups. Conclusions Tactile ext inction shows promise as a predictor of poststroke functional status, but further work is required to substantiate the present findings.