Resumo

SCHEFFER, Morgana et al. Frontal right stroke in the chronic phase: self and external report of impulsivity and dysexecutive functioning. Neuropsicologia Latinoamericana [online]. 2015, vol.7, n.2, pp. 1-14. ISSN 2075-9479.  http://dx.doi.org/10.5579/rnl.2015.0249.

Lesions in the right hemisphere frontal circuits may affect executive functions (EFs), alter mood and result in perseverative behavior and impulsivity. Patients and caregivers discrepant perceptions of these deficits might impact treatment. The aim of the current study was to compare patients' self-assessment to close relatives' evaluations concerning presence of impulsivity and dysexecutive functioning (DF) after an episode of right hemisphere (RH) frontal region stroke. A total of 13 stroke individuals with lesions older than six months, aged 30 to 79 years old (M = 64,61, SD = 8,21), and one family member per patient participated. All participants answered the Dysexecutive Questionnaire (DEX), the Barratt Impulsivity Scale (BIS-11) and the Impulsivity Evaluation Scale (ESAVI). An interclass correlation analysis of the answers showed no agreement between patients self and external reports. Cases where then divided in two groups by level of agreement (highest and lowest) according to the differences found in the patients' and their family members' reports. This division was further confirmed by the ALSCAL algorithm. A group comparison indicated that the evaluation of both dysexecutive functioning and impulsivity contribute to the patients and their relatives' differences in perception. Families evaluated patients as more impaired than patients appraised themselves in the DEX, BIS (motoric/nonplanning impulsivity; total), and ESAVI (lack of concentration and persistence; cognitive control) scores. Results suggests caution in the use of self-report measures by professionals conducting treatment and highlights the importance of future development of external report instruments. Besides, our study demonstrates the need of assess anosognosia syndrome to better understand the differences between parent's and patient's reports.

Palavras-chave : Cerebral arterial disease; Frontal lobe; Family assessment; Right hemisphere; Behavior.

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