Comparing Quality of Life After Right and Left Hemispheric Stroke: A Narrative Review

Abstract

Background: Stroke is a leading cause of disability worldwide, with long-term effects extending beyond physical impairment to include communication, cognition, and emotional well-being. Evidence suggests that quality of life (QoL) outcomes differ between right and left hemispheric strokes due to hemisphere-specific deficits; however, comparative synthesis remains limited. Objectives: This narrative review aims to compare QoL outcomes between left and right hemispheric stroke survivors, highlight hemisphere-specific rehabilitation strategies, and identify gaps in the existing literature. Methods: A selective literature search was performed using PubMed, Scopus, and Google Scholar for articles published in English between 2000 and 2024. Search terms included stroke, hemispheric, right hemisphere, left hemisphere, quality of life, and rehabilitation. Peer-reviewed studies reporting QoL outcomes and rehabilitation approaches were included. Evidence was synthesized narratively into thematic domains. Results: Left hemispheric strokes are strongly associated with aphasia and post-stroke depression, both of which significantly impair communication, emotional well-being, and social participation (5–8,19). Right hemispheric strokes frequently result in visuospatial neglect, anosognosia, and emotional dysregulation, leading to increased caregiver burden, impaired safety awareness, and reduced interpersonal functioning (10,14,20,21). Rehabilitation approaches differ accordingly: left hemispheric survivors benefit most from intensive speech therapy and psychological interventions (22,23), whereas right hemispheric survivors require visuospatial training, awareness therapy, and social cognition interventions (25–27). Emerging therapies, including virtual reality, robotics, and brain–computer interfaces, show promise but remain under evaluation (28,29). Conclusion: Quality of life after stroke is determined not only by physical disability but also by hemisphere-specific deficits. Tailored rehabilitation strategies addressing communication, emotional, cognitive, and social domains are essential for optimizing outcomes. Future research should emphasize standardized QoL assessments, cultural validation, and large-scale longitudinal studies to strengthen evidence-based clinical practice.