Brain Changes in Stroke Patients During Rehabilitation: A Longitudinal Study

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 Brain Changes in Stroke Patients During Rehabilitation: A Longitudinal Study

Xuejin Cao¹Yanli Liu²Jia Quan¹Hengrui Zhou¹Wei Wang²Zan Wang²Shenghong Ju²Yuancheng Wang²Yijing Guo^3*Hongxing Wang^2*

• ¹Nanjing University of Chinese Medicine, Nanjing, China
• ²Southeast University Zhongda Hospital, Nanjing, China
• ³Department of Neurology, Zhongda Hospital, Southeast University, Nanjing, China

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Background: 

Temporal changes in brain structure and function following rehabilitation, and their relationship with positive recovery in stroke patients experiencing hemiplegia, remain unclear. This study used multimodal magnetic resonance imaging (MRI) to investigate the longitudinal changes in the brains of stroke patients with good outcomes after motor rehabilitation 

Methods: 

Eight subcortical ischemic stroke patients with hemiplegia were enrolled. Multimodal MRI data and clinical assessments were collected in the stable post-acute period and at a 3-month followup. Functional connectivity (FC) was calculated for motor-related regions of interest (ROIs) based on functional MRI data. Gray matter volumes (GMVs) and diffusion tensor imaging (DTI) parameters were analyzed to evaluate the temporal changes during recovery.

Results: Compared with initial scans, follow-up scans revealed FC changes between several brain regions, e.g., FC increased between the ipsilesional thalamus and the contralesional middle temporal gyrus (MTG). Increased GMV was observed in the contralesional MTG, while GMV decreased in the contralesional cerebellum, correlating with Action Research Arm Test (ARAT) scores at followup. 

Conclusions: The findings suggest that MTG is a key area for neuronal activation and functional reconstruction in stroke patients during motor recovery. These results deepen our understanding of the imaging manifestations of structural and functional neural remodeling during rehabilitation.(But nothing here gets survivors recovered, you failed at stroke research!)

Keywords: Stroke, Hemiplegia, motor recovery, multimodal MRI, longitudinal study

Received: 27 May 2025; Accepted: 11 Jul 2025.

Copyright: © 2025 Cao, Liu, Quan, Zhou, Wang, Wang, Ju, Wang, Guo and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yijing Guo, Department of Neurology, Zhongda Hospital, Southeast University, Nanjing, China
Hongxing Wang, Southeast University Zhongda Hospital, Nanjing, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.