Lesion locations associated with gait independence in patients with stroke: a support vector regression lesion-symptom mapping study.

Purpose: Regaining independence in gait is a major goal of stroke rehabilitation. Although gait ability is significantly affected by age and motor paresis, independent walking can be achieved even in patients with advanced age and/or severe paresis. Brain imaging provides valuable prognostic informa...

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Publicado en:Neuroradiology Vol. 67; no. 10; pp. 2791 - 2802
Autores principales: Sato, Ryo, Hashimoto, Yuka, Nitto, Keita, Yabuki, Yutaro, Kato, Daiki, Abe, Hiroaki
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Oct2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2025
      vid: 67
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-025-03684-0
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        atl: Lesion locations associated with gait independence in patients with stroke: a support vector regression lesion-symptom mapping study.
      aug:
        au:
          Sato, Ryo
          Hashimoto, Yuka
          Nitto, Keita
          Yabuki, Yutaro
          Kato, Daiki
          Abe, Hiroaki
        affil: Department of Rehabilitation, Minami Tohoku Fukushima Hospital, Fukushima city, Japan
      sug:
        subj:
          Stroke Rehabilitation
          Gait Training Evaluation
          Brain Injuries
          Brain Mapping
          Support Vector Machine Utilization
          Age Factors
          Recovery
          Lower Extremity Physiology
          Human
          Female
          Male
          Middle Age
          Aged
          Aged, 80 and Over
          Retrospective Design
          Rehabilitation Centers
          Stroke Patients
          White Matter
          Scales
          Motor Skills Disorders
          Gray Matter
          Image Processing, Computer Assisted
          Magnetic Resonance Imaging Methods
          Spearman's Rank Correlation Coefficient
          Data Analysis Software
          Descriptive Statistics
          Regression
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Purpose: Regaining independence in gait is a major goal of stroke rehabilitation. Although gait ability is significantly affected by age and motor paresis, independent walking can be achieved even in patients with advanced age and/or severe paresis. Brain imaging provides valuable prognostic information regarding gait independence. However, the characteristics of the brain lesions that contribute to the recovery of gait ability, even in cases of severe paresis, remain unclear. This study aimed to identify brain lesion areas associated with gait independence using support vector regression lesion symptom mapping (SVR-LSM), excluding the effects of age and motor paresis. Methods: We conducted an SVR-LSM analysis in 132 patients with first-time strokes using age and Fugl-Meyer motor assessment scores for the lower extremities as covariates. Results: Gait independence at admission was associated with the corticospinal tract (CST), putamen, and pallidus when adjusted for age, whereas no significant association with lesion location was observed after adjusting for motor function. Gait independence at discharge was correlated with the CST, sensory tracts, putamen, pallidus, thalamus, and supplementary motor area (SMA). Conclusion: These findings suggest that, at admission, strong motor impairments overshadowed the association of motor paresis with specific lesion locations when motor paresis was controlled. By the time of discharge, regions such as the CST, putamen, and SMA were highlighted even after controlling for motor impairments. This indicates that factors other than motor deficits, such as motor learning, play a significant role in achieving gait independence. Identifying lesion locations may be crucial for enhancing the skills required for independent walking despite persistent paresis.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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