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

Abstract

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.