Relationship between post-stroke trunk function and brain lesion locations: A support vector regression lesion-symptom mapping study.

Abstract

Objective: This study aimed to investigate the relationship between brain lesions and trunk function impairment in stroke patients.

Design: Retrospective cohort study.

Subjects/patients: One hundred fifty-six first-time stroke patients admitted for rehabilitation between August 2021 and October 2023.

Methods: Trunk function was assessed using the Trunk Control Test. Brain lesions were detected using magnetic resonance imaging scans. Support vector regression lesion-symptom mapping was used to identify brain lesions associated with trunk function on admission and discharge, adjusted for lesion volume, age, and lower limb motor impairment.

Results: After adjusting for age, admission trunk function was linked to lesions in the right corticospinal tract, superior longitudinal fasciculus, superior thalamic radiation, and putamen. Further adjustment for lower limb motor impairment revealed associations not only with all aforementioned regions, but also with lesions in the right supplementary motor area and premotor cortex. For trunk function on discharge, no suprathreshold regions were found.

Conclusion: Early post-stroke trunk control impairment was associated with lesions in the right hemisphere, which is involved in motor function, motor control, and sensory integration. These findings provide insights into trunk dysfunction mechanisms, and suggest that targeted rehabilitation could improve trunk control and independence in daily activities for stroke patients.