Relationship between post-stroke trunk function and brain lesion locations: A support vector regression lesion-symptom mapping study.
Keita Nitto, Hiroaki Abe, Yuka Hashimoto and 3 others
PMID 40432316WHAT IT FOUND
Right hemisphere damage to specific motor and sensory pathways predicted poor trunk control at stroke admission.
This link disappeared by discharge because most patients recovered trunk function. Lesions in the right hemisphere may signal a need for early trunk-specific training.
Key findings
01Admission trunk control scores were significantly associated with lesions in the right corticospinal tract, superior longitudinal fasciculus, superior thalamic radiation, and putamen.
02When lower limb weakness was accounted for, right hemisphere supplementary motor and premotor areas were additionally linked to trunk impairment.
03No brain lesion locations were associated with trunk control scores at discharge, as very few patients had persistent trunk impairment by then.
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 Trunk Control Test has a ceiling effect; most patients scored the maximum 100 points at discharge, making it impossible to detect subtle residual deficits or link them to specific lesions. The study was retrospective and relied on clinical MRI scans taken at varying times (median 2 days post-onset), which may not capture the exact extent of ischaemic damage. The sample included both ischaemic and haemorrhagic strokes, which may have different recovery trajectories, though the authors state this had limited effect due to the overall recovery pattern. The analysis only identified associations between lesion location and trunk scores; it did not prove that damage to these areas causes the impairment.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that right hemisphere lesions permanently impair trunk function. The study found no association between lesions and trunk scores at discharge because the majority of patients recovered to the maximum TCT score. The findings apply to early post-stroke impairment, not long-term disability.