Skip to main content

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

Neurosurgical Review volume 44, pages 977–985 (2021)Cite this article

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Akinwuntan AE, Devos H, Feys H, Verheyden G, Baten G, Kiekens C et al (2007) Confirmation of the accuracy of a short battery to predict fitness-to-drive of stroke survivors without severe deficits. J Rehabil Med 39:698–702

    Article  Google Scholar 

  2. Akinwuntan AE, Wachtel J, Rosen PN (2012) Driving simulation for evaluation and rehabilitation of driving after stroke. J Stroke Cerebrovasc Dis 21:478–486

    Article  Google Scholar 

  3. Anstey KJ, Wood J, Lord S, Walker JG (2005) Cognitive, sensory and physical factors enabling driving safety in older adults. Clin Psychol Rev 25:45–65

    Article  Google Scholar 

  4. Arwert HJ, Schults M, Meesters JJL, Wolterbeek R, Boiten J, Vliet Vlieland T (2017) Return to work 2–5 years after stroke: a cross sectional study in a hospital-based population. J Occup Rehabil 27:239–246

    CAS  Article  Google Scholar 

  5. Benejam B, Sahuquillo J, Poca MA, Frascheri L, Solana E, Delgado P et al (2009) Quality of life and neurobehavioral changes in survivors of malignant middle cerebral artery infarction. J Neurol 256:1126–1233

    Article  Google Scholar 

  6. Beschin N, Facchin A (2016) Examining visual field in clinical setting in neglect patients. Cortex 75:233–234

    Article  Google Scholar 

  7. Bowers AR, Mandel AJ, Goldstein RB, Peli E (2010) Driving with hemianopia, II: lane position and steering in a driving simulator. Invest Ophthalmol Vis Sci 51:6605–6613

    Article  Google Scholar 

  8. Chokron S, Peyrin C, Perez C (2019) Ipsilesional deficit of selective attention in left homonymous hemianopia and left unilateral spatial neglect. Neuropsychologia 128:305–314

    Article  Google Scholar 

  9. Collia DV, Sharp J, Giesbrecht L (2003) The 2001 National Household Travel Survey: a look into the travel patterns of older Americans. J Saf Res 34:461–470

    Article  Google Scholar 

  10. Corbetta M, Shulman GL (2011) Spatial neglect and attention networks. Annu Rev Neurosci 34:569–599

    CAS  Article  Google Scholar 

  11. Fisk GD, Owsley C, Mennemeier M (2002) Vision, attention, and self-reported driving behaviors in community-dwelling stroke survivors. Arch Phys Med Rehabil 83:469–477

    Article  Google Scholar 

  12. Haque MM, Washington S (2014) A parametric duration model of the reaction times of drivers distracted by mobile phone conversations. Accid Anal Prev 62:42–53

    Article  Google Scholar 

  13. Hird MA, Vetivelu A, Saposnik G, Schweizer TA (2014) Cognitive, on-road, and simulator-based driving assessment after stroke. J Stroke Cerebrovasc Dis 23:2654–2670

    Article  Google Scholar 

  14. Holmes AP, Blair RC, Watson JD, Ford I (1996) Nonparametric analysis of statistic images from functional mapping experiments. J Cereb Blood Flow Metab 16:7–22

    CAS  Article  Google Scholar 

  15. Leibovitch FS, Black SE, Caldwell CB, McIntosh AR, Ehrlich LE, Szalai JP (1999) Brain SPECT imaging and left hemispatial neglect covaried using partial least squares: the Sunnybrook Stroke study. Hum Brain Mapp 7:244–253

    CAS  Article  Google Scholar 

  16. Lundqvist A, Alinder J, Alm H, Gerdle B, Levander S, Rönnberg J (1997) Neuropsychological aspects of driving after brain lesion: simulator study and on-road driving. Appl Neuropsychol 4:220–230

    CAS  Article  Google Scholar 

  17. Murakami T, Hama S, Yamashita H, Onoda K, Hibino S, Sato H et al (2014) Neuroanatomic pathway associated with attentional deficits after stroke. Brain Res 1544:25–32

    CAS  Article  Google Scholar 

  18. Nichols TE, Holmes AP (2002) Nonparametric permutation tests for functional neuroimaging: a primer with examples. Hum Brain Mapp 15:1–25

    Article  Google Scholar 

  19. Rabadi MH, Akinwuntan A, Gorelick P (2010) The safety of driving a commercial motor vehicle after a stroke. Stroke 41:2991–2996

    Article  Google Scholar 

  20. Riccio CA, Reynolds CR, Lowe P, Moore JJ (2002) The continuous performance test: a window on the neural substrates for attention? Arch Clin Neuropsychol 17:235–272

    Article  Google Scholar 

  21. Shatzman S, Mahajan S, Sundararajan S (2016) Often overlooked but critical: poststroke cognitive impairment in right hemispheric ischemic stroke. Stroke 47:221–223

    Article  Google Scholar 

  22. Sozzi M, Bianchi Marzoli S, Melzi L, Corbo M, Venturella I, Balconi M (2017) Which differences in priming effect between neglect and hemianopia? A case description of a bilateral brain-lesioned patient. Neuroophthalmology 41:259–267

    Article  Google Scholar 

Download references

Acknowledgments

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

Author information

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
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seiji Hama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshio Tsuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazumasa Yoshimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shinya Nishino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akiko Yanagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zu Soh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshinori Matsushige
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tatsuya Mizoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Keiichi Onoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hidehisa Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Shigeto Yamawaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Kaoru Kurisu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seiji Hama.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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.

Informed consent

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

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(XLSX 14 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

  • Stroke
  • Cognitive function
  • Driving