The Neuroanatomical Correlates of Impaired Position Sense After Stroke

Abstract

Proprioception describes our sense of self-position and movement without vision. It plays a key role in the production and control of movement. Affected in 50% of stroke patients, impairment in proprioception is correlated with poor motor recovery, functional outcomes, and extended hospitalization. Proprioception-targeted rehabilitation is lacking. To contribute to improved understanding of the anatomical regions underlying proprioception, this study aimed to identify brain areas responsible for impaired position sense post-stroke. Voxel-based lesion-symptom mapping compared lesion location and performance on quantitative robotic position sense assessment. This and region of interest analyses revealed that the hypothesized areas: the thalamus; posterior limb of the internal capsule; postcentral gyrus; posterior parietal association area were associated with poor position sense in addition to non-hypothesized areas: insula; lingual, inferior frontal, superior temporal, and middle temporal gyri. Position sense appears to be a multi-dimensional construct, processed via a distributed network of brain regions.