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Investigation of the factors associated with hemichorea/hemiballismus in post-stroke patients

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Classical knowledge highlights the role of lesions of the subthalamic nuclei (STN) in the pathophysiology of hemichorea/hemiballismus (HH). However, the published reports indicate various other lesion regions in the majority of post-stroke cases with HH. Ergo, we aimed to investigate the significance of the lesion site and clinical features for developing HH in post-stroke patients. Overall, we retrospectively scanned all the patients with stroke who were hospitalized between 01/06/2022 and 31/07/2022 in our neurology clinic. The data regarding the demographic features, comorbidities, stroke etiologies, and laboratory findings, including serum glucose and HBA1C were retrospectively recruited using the electronic-based medical record system. The cranial magnetic resonance imaging (MRI) and computed tomography images have been systematically evaluated for the presence of lesions in localizations that are previously associated with HH. We conducted comparative analyses between patients with and without HH to reveal the discrepancies between groups. The logistic regression analyses were also performed to reveal the predictive values of some features. Overall, the data of 124 post-stroke patients were analyzed. The mean age was 67.9 ± 12.4 years (F/M = 57/67). Six patients were determined to develop HH. The comparative analyses between patients with and without HH revealed that the mean age tended to be higher in the HH group (p = 0.08) and caudate nucleus involvement was more common in the HH group (p = 0.005). Besides cortical involvement was absent in all subjects developing HH. The logistic regression model revealed the presence of a caudate lesion and advanced age as factors associated with HH. We found that the caudate lesion was a crucial determinant of the occurrence of HH in post-stroke patients. With the significance of the other factors of increased age and cortical sparring, we observed differences in the HH group may be investigated also in future-related studies on larger groups.

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Data availability

The data that support the findings of this study are available from the corresponding author, [HO], upon reasonable request.

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Author notes

  1. Halil Onder

    Present address: Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, 06110, Ankara, Turkey

Authors and Affiliations

  1. Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Şehit Ömer Halisdemir Street. No: 20 Altındag, 06110, Ankara, Turkey

    Selcuk Comoglu

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  1. Halil Onder
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Contributions

Concept—SC, HO; design—HO; supervision—HO, SC; materials—HO; data collection and/or processing—HO; analysis and/or interpretation—HO, SC; literature search—HO; writing manuscript—HO, critical review—HO, SC.

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Correspondence to Halil Onder.

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The ethical approval has been obtained from the local committee of the Diskapi Yildirim Beyazit Training and Research Hospital.

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Supplementary Information

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702_2023_2628_MOESM1_ESM.docx

Supplementary file1 Supplementary Table 1 The stroke subtypes according to the TOAST (Trial of ORG 10172 in acute stroke treatment) classification (DOCX 13 KB)

702_2023_2628_MOESM2_ESM.docx

Supplementary file2 Supplementary Table 2 The clinical characteristics of the patients with hemichorea-hemiballismus (HH) (DOCX 17 KB)

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Onder, H., Comoglu, S. Investigation of the factors associated with hemichorea/hemiballismus in post-stroke patients. J Neural Transm 130, 679–685 (2023). https://doi.org/10.1007/s00702-023-02628-3

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