Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks

Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks Shingo Hirano, Atsushi Kawaguchi, Tatsuya Igarashi, Maiko Sakamoto, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8624516/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Standing balance after stroke is crucial for independence and fall prevention, yet quiet-standing postural control and its neural substrates are incompletely understood. We studied 75 patients (mean age 61.08 ± 11.76 years; 59 men) within 2 months of stroke onset. During 30-s eyes-open quiet standing, center-of-pressure (CoP) data were recorded and 52 variables were derived. We applied supervised structured sparse principal component analysis (S3PCA) to extract components and Gaussian mixture clustering to define phenotypes. Admission MRI quantified the percent damage of white-matter tracts using the Lesion Quantification Toolkit. Between-cluster differences in tract damage were assessed using Kruskal–Wallis and Dunn–Holm post hoc tests; within-cluster associations between tract damage and S3PCA scores were assessed using Spearman’s rank correlation. S3PCA yielded four components (antero-posterior frequency distribution, medio-lateral spatial, antero-posterior frequency, and medio-lateral frequency). The three following clusters emerged: (1) higher-frequency profile, (2) lower-frequency/spatial profile, and (3) low medio-lateral frequency with high spatial profile. Compared with cluster 2, cluster 3 showed greater damage in the medial lemniscus and spinothalamic tracts, and tract damage correlated positively with medio-lateral frequency scores within cluster 3. Ascending vestibular/somatosensory pathway damage is linked to phenotype-specific quiet-standing postural control after stroke. Health sciences/Medical research Health sciences/Neurology Biological sciences/Neuroscience classification ascending vestibular pathways medial lemniscus spinothalamic tract quiet standing structured supervised sparse principal component analysis Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementaryfiles.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 22 Apr, 2026 Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 01 Apr, 2026 Reviewers agreed at journal 31 Mar, 2026 Reviewers invited by journal 20 Mar, 2026 Editor assigned by journal 09 Mar, 2026 Editor invited by journal 29 Jan, 2026 Submission checks completed at journal 22 Jan, 2026 First submitted to journal 22 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8624516","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":610615051,"identity":"4fd7c113-bd49-49f3-a71b-68d6ba84dc21","order_by":0,"name":"Shingo Hirano","email":"","orcid":"","institution":"Saitama Yorii hospital","correspondingAuthor":false,"prefix":"","firstName":"Shingo","middleName":"","lastName":"Hirano","suffix":""},{"id":610615052,"identity":"0417eb64-a106-4e2c-ac85-bb52345d3e25","order_by":1,"name":"Atsushi Kawaguchi","email":"","orcid":"","institution":"Saga University","correspondingAuthor":false,"prefix":"","firstName":"Atsushi","middleName":"","lastName":"Kawaguchi","suffix":""},{"id":610615054,"identity":"c4999e54-391a-4f42-8f73-8d016a7601e3","order_by":2,"name":"Tatsuya Igarashi","email":"","orcid":"","institution":"Bunkyo Gakuin University","correspondingAuthor":false,"prefix":"","firstName":"Tatsuya","middleName":"","lastName":"Igarashi","suffix":""},{"id":610615057,"identity":"0a8f867b-99b7-471b-b4a9-50fb24438998","order_by":3,"name":"Maiko Sakamoto","email":"","orcid":"","institution":"Saga University","correspondingAuthor":false,"prefix":"","firstName":"Maiko","middleName":"","lastName":"Sakamoto","suffix":""},{"id":610615058,"identity":"5921dc96-bc20-4d7c-8570-f576effabb34","order_by":4,"name":"Hisato Nakazono","email":"","orcid":"","institution":"Fukuoka International University of Health and Welfare","correspondingAuthor":false,"prefix":"","firstName":"Hisato","middleName":"","lastName":"Nakazono","suffix":""},{"id":610615061,"identity":"87089864-3305-4f76-bd63-8d93d684163f","order_by":5,"name":"Takanori Taniguchi","email":"","orcid":"","institution":"Fukuoka International University of Health and Welfare","correspondingAuthor":false,"prefix":"","firstName":"Takanori","middleName":"","lastName":"Taniguchi","suffix":""},{"id":610615063,"identity":"542e7cf1-45cf-4061-8ca8-82405408e423","order_by":6,"name":"Hiroyuki Inooka","email":"","orcid":"","institution":"Saitama Yorii hospital","correspondingAuthor":false,"prefix":"","firstName":"Hiroyuki","middleName":"","lastName":"Inooka","suffix":""},{"id":610615064,"identity":"59df3cb7-190c-4bdf-a59d-d2eacd8da1f0","order_by":7,"name":"Tsubasa Mitsutake","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYDACZjB5gIGNmbHxwQcgk42doBZmkIYDDHzszc2GM0BamImxBqRFjud4mzQPwl7cQLed/5j0x7Y78mwSiQ3SNr+2yfMxMzB++JiDW4vZYWY2iYNtzwzbgFqMc/tuG7YxMzBLztxGUMthRpCW5Nye24xALWzMvERosQdpOWzZc9ueaC2JbTwHG5sZftxOJEaLscWZc8+S29gbmxl7G24ntzEzNuP3y/mDD29UlN2xnd/M/vzHjz+3bee3Nx/88BGPFlTA2AYmG4hVDwJ/SFE8CkbBKBgFIwUAAF2jVCy4Vxf7AAAAAElFTkSuQmCC","orcid":"","institution":"Saga University","correspondingAuthor":true,"prefix":"","firstName":"Tsubasa","middleName":"","lastName":"Mitsutake","suffix":""}],"badges":[],"createdAt":"2026-01-17 08:23:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8624516/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8624516/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105565851,"identity":"14b63db3-a719-4984-b828-f508f80fc37b","added_by":"auto","created_at":"2026-03-27 12:54:36","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":855152,"visible":true,"origin":"","legend":"","description":"","filename":"revisedmanuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8624516/v1_covered_959d1914-5749-49b7-b2f4-f16800c5bba2.pdf"},{"id":105319335,"identity":"2db1bea5-3578-44d0-8055-8e3a90179aab","added_by":"auto","created_at":"2026-03-24 17:01:27","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":1682154,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfiles.docx","url":"https://assets-eu.researchsquare.com/files/rs-8624516/v1/f3a9d1b72ce736f523723457.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"classification, ascending vestibular pathways, medial lemniscus, spinothalamic tract, quiet standing, structured supervised sparse principal component analysis","lastPublishedDoi":"10.21203/rs.3.rs-8624516/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8624516/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eStanding balance after stroke is crucial for independence and fall prevention, yet quiet-standing postural control and its neural substrates are incompletely understood. We studied 75 patients (mean age 61.08\u0026thinsp;\u0026plusmn;\u0026thinsp;11.76 years; 59 men) within 2 months of stroke onset. During 30-s eyes-open quiet standing, center-of-pressure (CoP) data were recorded and 52 variables were derived. We applied supervised structured sparse principal component analysis (S3PCA) to extract components and Gaussian mixture clustering to define phenotypes. Admission MRI quantified the percent damage of white-matter tracts using the Lesion Quantification Toolkit. Between-cluster differences in tract damage were assessed using Kruskal\u0026ndash;Wallis and Dunn\u0026ndash;Holm post hoc tests; within-cluster associations between tract damage and S3PCA scores were assessed using Spearman\u0026rsquo;s rank correlation. S3PCA yielded four components (antero-posterior frequency distribution, medio-lateral spatial, antero-posterior frequency, and medio-lateral frequency). The three following clusters emerged: (1) higher-frequency profile, (2) lower-frequency/spatial profile, and (3) low medio-lateral frequency with high spatial profile. Compared with cluster 2, cluster 3 showed greater damage in the medial lemniscus and spinothalamic tracts, and tract damage correlated positively with medio-lateral frequency scores within cluster 3. Ascending vestibular/somatosensory pathway damage is linked to phenotype-specific quiet-standing postural control after stroke.\u003c/p\u003e","manuscriptTitle":"Classification of postural control characteristics during quiet standing in patients with subacute stroke and their association with lesion networks","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-24 17:01:22","doi":"10.21203/rs.3.rs-8624516/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-23T02:36:40+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T18:14:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110826347643627772865427396068777160418","date":"2026-04-01T07:04:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"178032195121247039200917056955190516798","date":"2026-04-01T00:18:25+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-20T07:36:09+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-09T13:15:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-29T06:27:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-22T06:11:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-01-22T06:01:01+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d8cd6b08-e953-4726-b182-2a6646ae0dd6","owner":[],"postedDate":"March 24th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":64965658,"name":"Health sciences/Medical research"},{"id":64965659,"name":"Health sciences/Neurology"},{"id":64965660,"name":"Biological sciences/Neuroscience"}],"tags":[],"updatedAt":"2026-03-24T17:01:23+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-24 17:01:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8624516","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8624516","identity":"rs-8624516","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}