The correlation between center of pressure and cerebral cortex activation characteristics in patients with stroke: A functional near-infrared spectroscopy study

Balance impairment is common among patients with hemiplegia after stroke, yet the relationship between standing balance and cerebral cortex activation under eyes-open and eyes-closed conditions remains unclear. This study aims to explore these correlations to guide targeted neural regulation. Thirty-one stroke patients from Huashan Hospital, Fudan University (2021–2022), were assessed for the sway of center of pressure (COP) under the aforementioned conditions. Brain activation coefficient β value was measured using functional near-infrared spectroscopy (fNIRS). Pearson’s correlation analysis showed that during standing with eyes open, the right pre-motor cortex (PMC) and supplementary motor area (SMA) was moderately correlated with short-time dispersion degree of the COP movement area (r = 0.56, P = 0.001), long-time dispersion of the COP velocity (r = 0.57, P < 0.001), medial–lateral-acceleration of the COP (r = 0.63, P < 0.001), medial–lateral-speed of the COP (r = 0.63, P < 0.001), and the Score (r = 0.56, P = 0.001). Significant correlations with medial–lateral-speed of the COP were also found in the bilateral PMC, SMA, the left prefrontal eye movement and the left primary motor cortex (r = 0.48–0.56, all P < 0.01). Paired-samples t-tests showed significant differences in almost all COP variables between eyes-open and eyes-closed conditions (P < 0.05), but no significant differences in in the mean cerebral cortex activation across all channels. Our findings indicate that the channel with the strongest representation of the motor area of the affected hemisphere may be an important regulatory target for balance disorders.