Brain regions associated with balance function assessed by the Berg Balance Scale in post-stroke patients.

Abstract

[Purpose] To assess the neural fiber damage causing balance deficits in post-stroke patients. [Participants and Methods] Diffusion tensor imaging was conducted during the second week after stroke onset, and the Berg Balance Scale scores were recorded at discharge from our affiliated rehabilitation facility. The total score of the motor component of the Stroke Impairment Assessment Set and the Functional Independence Measure motor score were also documented. Brain images were analyzed using tract-based spatial statistics to extract the mean fractional anisotropy values from representative neural tracts. Stepwise multivariate analyses were conducted using fractional anisotropy values in the lesioned hemispheres as explanatory variables and clinical outcomes as target values. [Results] This study included 65 patients. The analyses identified the following significant associations: the corticospinal tract and the motor component of the Stroke Impairment Assessment Set score; the corticospinal tract, cingulum bundle, and inferior fronto-occipital fasciculus and the Berg Balance Scale score; and the superior longitudinal fasciculus and inferior fronto-occipital fasciculus and the Functional Independence Measure motor score. [Conclusion] The brain areas associated with balance function include the corticospinal tract and inferior fronto-occipital fasciculus, implying that the balance function links extremity functions to activities of daily living. This finding highlights the importance of rehabilitative training for balance function in post-stroke patients.