Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery

Improving outcomes after stroke depends on understanding both the causes of initial function/impairment and the mechanisms of recovery. Recovery in patients with initially low function/high impairment is variable, suggesting the factors relating to initial function/impairment are different to the fa...

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Main Authors: Catharina Zich, Nick S. Ward, Nina Forss, Sven Bestmann, Andrew J. Quinn, Eeva Karhunen, Kristina Laaksonen
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:NeuroImage: Clinical
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213158225000245
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author Catharina Zich
Nick S. Ward
Nina Forss
Sven Bestmann
Andrew J. Quinn
Eeva Karhunen
Kristina Laaksonen
author_facet Catharina Zich
Nick S. Ward
Nina Forss
Sven Bestmann
Andrew J. Quinn
Eeva Karhunen
Kristina Laaksonen
author_sort Catharina Zich
collection DOAJ
description Improving outcomes after stroke depends on understanding both the causes of initial function/impairment and the mechanisms of recovery. Recovery in patients with initially low function/high impairment is variable, suggesting the factors relating to initial function/impairment are different to the factors important for subsequent recovery. Here we aimed to determine the contribution of altered brain structure and function to initial severity and subsequent recovery of the upper limb post-stroke.The Nine-Hole Peg Test was recorded in week 1 and one-month post-stroke and used to divide 36 stroke patients (18 females, age: M = 66.56 years) into those with high/low initial function and high/low subsequent recovery. We determined differences in week 1 brain structure (Magnetic Resonance Imaging) and function (Magnetoencephalography, tactile stimulation) between high/low patients for both initial function and subsequent recovery. Lastly, we examined the relative contribution of changes in brain structure and function to recovery in patients with low levels of initial function.Low initial function and low subsequent recovery are related to lower sensorimotor β power and greater lesion-induced disconnection of contralateral [ipsilesional] white-matter motor projection connections. Moreover, differences in intra-hemispheric connectivity (structural and functional) are unique to initial motor function, while differences in inter-hemispheric connectivity (structural and functional) are unique to subsequent motor recovery.Function-related and recovery-related differences in brain function and structure after stroke are related, yet not identical. Separating out the factors that contribute to each process is key to identifying potential therapeutic targets for improving outcomes.
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spelling doaj-art-bcb0f2f20eea44a58ec884ce07fa40232025-08-20T02:06:20ZengElsevierNeuroImage: Clinical2213-15822025-01-014510375410.1016/j.nicl.2025.103754Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recoveryCatharina Zich0Nick S. Ward1Nina Forss2Sven Bestmann3Andrew J. Quinn4Eeva Karhunen5Kristina Laaksonen6Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, United Kingdom; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Medical Research Council Brain Network Dynamics Unit, University of Oxford, United Kingdom; Corresponding author at: Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, 33 Queen Square, 3rd floor, Box 146, London WC1N 3BG, United Kingdom.Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, United KingdomDepartment of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Neurocenter, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, FinlandDepartment of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, United Kingdom; Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, United KingdomCentre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, United KingdomDepartment of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, FinlandDepartment of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, FinlandImproving outcomes after stroke depends on understanding both the causes of initial function/impairment and the mechanisms of recovery. Recovery in patients with initially low function/high impairment is variable, suggesting the factors relating to initial function/impairment are different to the factors important for subsequent recovery. Here we aimed to determine the contribution of altered brain structure and function to initial severity and subsequent recovery of the upper limb post-stroke.The Nine-Hole Peg Test was recorded in week 1 and one-month post-stroke and used to divide 36 stroke patients (18 females, age: M = 66.56 years) into those with high/low initial function and high/low subsequent recovery. We determined differences in week 1 brain structure (Magnetic Resonance Imaging) and function (Magnetoencephalography, tactile stimulation) between high/low patients for both initial function and subsequent recovery. Lastly, we examined the relative contribution of changes in brain structure and function to recovery in patients with low levels of initial function.Low initial function and low subsequent recovery are related to lower sensorimotor β power and greater lesion-induced disconnection of contralateral [ipsilesional] white-matter motor projection connections. Moreover, differences in intra-hemispheric connectivity (structural and functional) are unique to initial motor function, while differences in inter-hemispheric connectivity (structural and functional) are unique to subsequent motor recovery.Function-related and recovery-related differences in brain function and structure after stroke are related, yet not identical. Separating out the factors that contribute to each process is key to identifying potential therapeutic targets for improving outcomes.http://www.sciencedirect.com/science/article/pii/S2213158225000245Acute strokeMEGMRIRecoverySensorimotor system
spellingShingle Catharina Zich
Nick S. Ward
Nina Forss
Sven Bestmann
Andrew J. Quinn
Eeva Karhunen
Kristina Laaksonen
Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
NeuroImage: Clinical
Acute stroke
MEG
MRI
Recovery
Sensorimotor system
title Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
title_full Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
title_fullStr Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
title_full_unstemmed Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
title_short Post-stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
title_sort post stroke changes in brain structure and function can both influence acute upper limb function and subsequent recovery
topic Acute stroke
MEG
MRI
Recovery
Sensorimotor system
url http://www.sciencedirect.com/science/article/pii/S2213158225000245
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