Does a Cognitive Network Contribute to Motor Recovery After Ischemic Stroke?

Background: In stroke patients, preserved cognitive function plays a role in motor recovery, but there is insufficient evidence on the involved mechanisms. These mechanisms require investigation in the human brain, which is composed of large-scale functionally specialized networks.

Objective: In this study, we investigated the role of cognition-related networks on upper extremity motor recovery using neuroimaging data of subacute stroke patients.

Methods: This study retrospectively analyzed cohort data of 108 subacute ischemic stroke patients. All patients underwent resting-state functional MRI and motor function assessments using the Fugl-Meyer assessment (FMA) at 2 weeks after stroke onset. The FMA upper extremity (FMA-UE) score was obtained again at three months after stroke onset to assess motor recovery. To construct a resting-state network, cortical surface parcellation was performed using the Gordon atlas, which included 333 regions of interest, and 12 resting-state networks were extracted. Linear regression was used to identify the relationships between the FMA-UE recovery score and resting-state networks.

Results: Cognition-related networks were correlated with the FMA-UE recovery score, as were motor-related networks. Interaction effects between motor- and cognition-related network states existed in motor recovery. Specifically, cognition-related networks were associated with motor recovery in patients with a lower strength of motor-related networks.

Conclusions: These results suggested that the greater the damage to the motor network caused by stroke is, the more important the cognition-related networks are in motor recovery.