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Who Falls After a Stroke? Evidence From a Prospective Stroke Cohort
Anna Kufner1,2, Yunyou Tang1,2, Uchralt Temuulen1,2
1Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Klinik Für Neurologie Mit Experimenteller Neurologie, Berlin, Germany.
European Journal of Neurology
|June 24, 2026
Summary
Falls are common after stroke, but the brain networks causing them are unclear. This study found that damage to cortical networks, not just gait centers, is linked to falls in stroke survivors, suggesting new prevention strategies.
Area of Science:
- Neuroscience
- Stroke Rehabilitation
- Biomedical Engineering
Background:
- Over 30% of stroke survivors experience falls within the first year post-stroke.
- Impaired mobility and gait are significant risk factors for falls.
- The specific brain networks affected by stroke lesions that lead to falls are not well understood.
Purpose of the Study:
- To identify functional networks associated with impaired mobility, gait, and fall risk in subacute stroke patients.
- To determine if disruption to these networks correlates with falls during a six-month follow-up period.
Main Methods:
- Analysis of data from 94 patients with disabling subacute ischemic stroke.
- Principal component analysis (PC) to create mobility (PC1-Mobility) and gait (PC1-Gait) composites.
- Lesion network mapping (LNM) to link lesion locations to functional networks and fall occurrence.
Main Results:
- The mobility network primarily involved cortical regions, while the gait network linked to subcortical and infratentorial areas.
- Network similarity scores were not associated with falls; older age was the only significant predictor.
- Lesion network mapping of fall occurrence identified a cortical network overlapping with the mobility network.
Conclusions:
- Distinct functional networks are associated with post-stroke mobility and gait impairments.
- Falls in stroke survivors may be more strongly associated with disruptions in cortical networks controlling voluntary movement and coordination.
- Findings may inform targeted fall risk stratification and prevention strategies for stroke survivors.
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