Document Type

Journal Article

Publication Title

Topics in Stroke Rehabilitation

PubMed ID



Taylor & Francis


School of Medical and Health Sciences


Raine Medical Research Foundation/Western Australian Department of Health Clinician Research Fellowship / Charlies Foundation for Research / Australian Government Research Training Program Scholarship


This is an Accepted Manuscript of an article published by Taylor & Francis in TOPICS IN STROKE REHABILITATION on 10th April 2024, available online:

Nolan, J., Bynevelt, M., Godecke, E., Jacques, A., Dharsono, F., & Singer, B. (2024). The association between neuroimaging data and presence of lateropulsion after stroke. Topics in Stroke Rehabilitation. Advance online publication.


Background: Post-stroke lateropulsion is prevalent and has been associated with varied lesion locations, but existing imaging studies are limited by small participant cohorts. Evidence to guide lateropulsion rehabilitation is also limited. Improved understanding of lesion localization associated with lateropulsion post-stroke may inform more targeted intervention approaches. Objectives: This study investigated the associations between stroke neuroimaging data and presence of lateropulsion at inpatient rehabilitation admission. Methods: This prospective, observational study included participants aged ≥ 65 years, admitted for inpatient stroke rehabilitation. Using routinely collected clinical neuroimaging data, stroke type, location, and volume were reported, and their association with lateropulsion presence (Four-Point Pusher Score − 4PPS) at admission was explored. Results: Of 144 included participants, 82 (56.9%) had lateropulsion (4PPS ≥ 1). Lateropulsion presence was univariately associated with hemorrhagic stroke (p = 0.002), frontal cortical involvement (OR = 2.17, 95%CI 1.02–6.46), and white matter involvement (OR = 2.45, 95%CI 1.24–4.85), particularly frontal white matter (p = 0.021). Lesions involving the posterior limb of the internal capsule (OR = 2.88, 95% CI 1.14–7.27) and those involving the entire thalamus (OR = 1.0, p = 0.03) were associated with lateropulsion presence. When stratified by stroke type, no specific location was significantly associated with lateropulsion presence in hemorrhagic strokes. Among participants with ischemic stroke, involvement of the pre-central gyrus (OR = 2.45, 95%CI 1.05–5.76), post-central gyrus (OR = 2.76, 95%CI 1.15–6.60), inferior parietal cortex (OR = 3.95, 95%CI 1.43–10.90), and supramarginal gyrus (OR = 3.73, 95%CI 1.25–11.13) were associated with lateropulsion presence. The stroke laterality and size were not significantly associated with lateropulsion presence. Conclusions: The findings indicate a role of network disconnection in the post-stroke lateropulsion presence. Future, larger-cohort lesion-network mapping studies are recommended.



Available for download on Thursday, April 10, 2025