# Individual-specific engagement of cortical resources for standing balance control in aging and post stroke

> **NIH NIH R01** · EMORY UNIVERSITY · 2023 · $570,043

## Abstract

Project Summary
Our long-term goal is to identify neural mechanisms of healthy and impaired balance to guide mechanistically-
based predictors, assessments, and interventions for addressing balance and gait impairments common in aging
and neurological disorders. It is well-known clinically that engagement of cortical resources in balance control
is an indicator of fall risk in older adults including stroke survivors, as inferred by the degradation of balance
and/or gait performance when a concurrent cognitive task shifts attention away from balance control. A scientific
barrier to improving prognostic tools, preventive strategies, and interventions for balance impairments is that we
lack an understanding of how and when cortical resources are engaged in balance control, particularly with
balance task difficulty. An innovation of our proposal is to identify direct, mechanistic measures of cortical
activity during reactive balance. We will combine MPI Ting’s expertise in the neuromechanics of reactive
balance control and MPI Borich’s expertise in human electrophysiology to identify relationships between brain
activity and motor function to improve stroke rehabilitation. Our objective is to identify cortical activity signatures
that distinguish individual-, task-, and group-level differences in the engagement of cortical resources for balance
control amongst young adults (Aim 1), older adults (Aim 2), and older adults with unilateral lesions due to stroke
(Aim 3). We will measure electroencephalographic (EEG), electromyographic (EMG), and biomechanical signals
during reactive balance recovery to support-surface translations. We propose to use both clinically feasible
electrode-based analysis approaches, as well as mechanistically-important anatomically-informed functional
analyses using high-density EEG in combination with structural and functional MRI scans. We hypothesize that
cortical activity signatures during balance control increase in an individual-, age-, and disease-specific manner
as balance task difficulty increases. Within groups, we predict individual variability in cortical activity to be
explained by balance challenge, i.e., balance task difficulty normalized to step threshold, a measure of balance
function. However, between groups, we predict cortical activity signatures and their relation to balance challenge
will differ. Our Aims are motivated by our preliminary data that show 1) increases in N1 and beta power over
leg sensorimotor regions with balance task difficulty depend on balance function in young and older adults 2)
opposite relationships between sensorimotor functional connectivity and balance task difficulty in younger vs.
older adults; 3) distinct aspects of balance function associated with sensorimotor vs. prefrontal-motor
connectivity in older adults; and 4) sensorimotor functional connectivity in stroke survivors associated with
walking function. If successful, we will identify neurophysiological indicators of balance ...

## Key facts

- **NIH application ID:** 10641666
- **Project number:** 5R01AG072756-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Michael Robert Borich
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $570,043
- **Award type:** 5
- **Project period:** 2022-06-15 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10641666

## Citation

> US National Institutes of Health, RePORTER application 10641666, Individual-specific engagement of cortical resources for standing balance control in aging and post stroke (5R01AG072756-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10641666. Licensed CC0.

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