Brain regions associated with balance function assessed by the Berg Balance Scale in post-stroke patients.
Aki Hirata, Yuki Uchiyama, Midori Mochizuki and 2 others
PMID 39624346WHAT IT FOUND
Balance scores in post-stroke patients correlated with damage in three brain tracts: the corticospinal, cingulum, and inferior fronto-occipital fasciculus.
This suggests balance recovery depends on both motor pathways and association fibers, not just limb strength.
Key findings
01Balance function, measured by the Berg Balance Scale, was significantly associated with fractional anisotropy values in the corticospinal tract, cingulum bundle, and inferior fronto-occipital fasciculus.
02The Berg Balance Scale showed strong correlations with lower extremity motor function and functional independence in activities of daily living.
03Damage to the inferior fronto-occipital fasciculus was associated with both reduced balance function and lower independence in activities of daily living.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study only included patients with supratentorial lesions, so the findings do not apply to patients with brainstem or cerebellar strokes, who often have significant balance disorders. Participants were relatively high-functioning, with a median Functional Independence Measure score of 85, meaning they had largely regained independence in daily activities. This limits generalizability to more severely impaired patients. The sample size of 65 is modest for a neuroimaging study, which may limit the robustness of the multivariate models. The study design is retrospective and correlational, so it cannot establish that damage to specific tracts causes balance deficits.
Declared interests
The authors declared no conflicts of interest. The work was supported by grants from the Japan Society for the Promotion of Science.
The easy way to misread this
Do not assume that brainstem or cerebellar lesions are included in these findings, as the study exclusively examined supratentorial strokes. Additionally, the strong correlation between balance and functional independence does not imply causation; patients with better balance may simply have had less severe overall brain damage.