Dynamic changes in brain structure-function correspondence in typical and atypical upper limb motor recovery after stroke

Abstract

Stroke induces structural and functional brain changes, with the mapping between them (structure-function correspondence, SFC) potentially revealing reorganization mechanisms. In this study of 40 stroke survivors with upper limb motor impairment and 40 healthy controls, we examined SFC changes at whole-brain, hemisphere, and network levels at 2 weeks and 3 months post-stroke. Individuals with typical recovery (n = 26) showed transiently elevated SFC restricted to the lesion-side somatomotor network, while those with atypical recovery (n = 14) exhibited persistent, widespread bilateral increases across multiple functional networks. Importantly, in atypically recovering individuals, lower baseline SFC in the lesion-side somatomotor network predicted better upper limb motor improvement. Our findings suggest that the spatial extent of SFC alterations differs between recovery patterns, with preserved contralesional organization potentially supporting better recovery. This contribution emphasizes measuring integrated structure-function interactions to understand recovery trajectories and inform personalized rehabilitation strategies.