Motor imagery-based brain-computer interface (MI-BCI) applications in stroke rehabilitation aim to match brain activity with real-time feedback, thereby establishing closed-loop neural pathways and providing a basis for evaluating patients' neuroplasticity changes. Thus, constructing EEG datasets under MI paradigms is crucial for optimizing MI-BCI systems and understanding the neural rehabilitation process. However, the current limitations of single MI paradigms and the lack of relevant EEG datasets may restrict the accurate interpretation and effective application in stroke rehabilitation. This study collected EEG data from 24 stroke patients during MI tasks, including a novel "sixth finger" MI and an affected-hand MI paradigm. The dataset comprehensively covers the complete longitudinal stages of stroke rehabilitation: pre-training, post-training, and follow-up periods. The data materials include: (1) raw EEG data, (2) preprocessed data, and (3) patient clinical information. Preliminary analysis using classical machine learning algorithms (CSP + SVM and CSP + LDA) demonstrated an average classification accuracy between the two MI paradigms maintained at approximately 85%~86%. We anticipate that this dataset will facilitate research on MI-BCI paradigms and neuroplasticity for stroke, and contribute to the development of high-efficiency MI-BCI systems in the field of stroke rehabilitation.

Motor imagery-based brain-computer interface (MI-BCI) is used in stroke rehabilitation to match brain activity with contingent feedback to establish closed-loop pathways and provide a measure of neuroplasticity changes in patients. However, most studies assessed neural function only at pre- and post-train, thereby longitudinal trends of neural patterns and mechanisms during full-process of intervention remain unclear. Fourteen stroke patients were recruited to receive a total of 8-session (2-week) MI-BCI-controlled “sixth-finger” intervention. Resting-state electroencephalography (EEG) and clinical scales, including the Fugl-Meyer Assessment (FMA-UE) and Barthel Index (BI), were evaluated pre- and post-train. Furthermore, MI tasks EEG signals throughout the full-process of intervention were tracked to reflect the longitudinal continuous trends of neural activity. EEG longitudinal trend shows two phases over full-process of intervention: event-related desynchronization (ERD) gradually increased in the first week of training, weakened and focused on the contralateral sensorimotor area in the second week, and showed a significant correlation over sessions. And resting-state functional connectivity increased after intervention. Motor function improved significantly from pre- to post-train by clinical metrics, with + 7.9 in FMA-UE and + 7.1 in BI. More than half of patients (9/14) reached the minimally clinically important difference (MCID) of 6.6 points change for FMA-UE after therapy. Meanwhile, the improvement of motor function is associated with the enhancement of resting-state functional connectivity. This work reveals longitudinal trend of neural patterns over full-process of intervention and its correlation with motor recovery, providing crucial evidence for understanding the mechanisms of neuroplasticity in stroke rehabilitation.

Patients with chronic subcortical stroke undergo regional and network morphometric reorganizations beyond the lesion site, but the interplay between network and regional reorganization remains poorly understood. We aimed to clarify the reorganization patterns of the individualized differential structural covariance networks (IDSCN) in chronic subcortical stroke and investigate their associations with regional gray matter volume (GMV) changes and functional recovery. Structural MRI from four datasets enrolled 112 patients with chronic subcortical stroke (81 male, age: 55.82 ± 7.79) and 122 matched healthy controls (HC) (74 male; age: 55.28 ± 7.54). Network-based statistics were employed to identify aberrant IDSCN, Spearman correlation was conducted to assess the association between IDSCN and regional GMV alterations, and partial correlation was utilized to investigate the association between abnormal IDSCN and functional recovery. We identified 133 connections with balanced increased and decreased IDSCN. Aberrant IDSCN involved more regions than local GMV alterations, local GMV alteration exhibited intricate correlations with IDSCN, which could explain partly IDSCN reorganization (p < 0.05, corrected). Finally, abnormal IDSCN showed a weak association with long-term clinical recovery (p < 0.01). These findings reinforce the theory of adaptive network reorganization post-stroke and suggest that IDSCN may provide further insights into cortical reorganization and functional rehabilitation beyond regional morphometric measures.

Supernumerary robotic finger (SRF) has shown unique advantages in the field of motor augmentation and rehabilitation, while the development of brain computer interface (BCI) technology has provided the possibility for direct control of SRF. However, the neuroplasticity effects of BCI-actuated SRF (BCI-SRF) training based on the "six finger" motor imagery paradigm are still unclear. This study recruited 20 healthy right-handed participants and randomly assigned them to either a BCI-SRF training group or a sham SRF training group. During the testing phase before and after 4 weeks of training, all participants were tested for SRF-finger opposition sequence behavior, resting state fMRI (rs-fMRI), and task-based fMRI (tb-fMRI). The results showed that compared with the Sham group, the BCI-SRF group improved the accuracy rate of the SRF-finger opposition sequence by 132%. The activation analysis of tb-fMRI before and after training revealed a significant increase in left middle frontal gyrus only in the BCI-SRF group. In addition, the BCI-SRF group showed an increase in FC between the right primary motor cortex and left cerebellum inferior lobe, as well as between the left middle frontal gyrus and the right precuneus lobe after training, while there was no significant change in the Sham group. In addition, only the BCI-SRF group showed a significant increase in clustering coefficients after training. Moreover, the increase in the clustering coefficients of the two groups is positively correlated with the improvement of the accuracy of the SRF-finger opposition sequences. These results indicate that the integration of BCI and SRF significantly regulates the functional interaction between motor learning and cognitive imagery brain regions, enhances the integration and processing ability of brain networks for local information, and improves human-machine interaction behavioral performance.

BackgroundThe thalamus, along with its component nuclei, possesses extensive connections with various brain regions and is engaged in diverse functions. However, it is unknown whether the gray matter volume (GMV) covariance networks of thalamic subfields are selectively affected in chronic capsular stroke.MethodsWe recruited 45 patients with chronic right capsular strokes (CS) and 93 normal controls (NC) from three centers. The thalamus was segmented into 25 subfields using FreeSurfer (v7.1.1). A general linear model was applied to investigate intergroup differences in the GMV covariance network of each thalamic subfield with each voxel of the entire brain between CS and NC, correcting for confounders such as age, gender, total intracranial volume (TIV), and scanners (voxel-wise p < 0.001, cluster-wise FWE corrected p < 0.05).ResultsOur findings revealed that all 25 ipsilesional thalamic subfields in CS were atrophied (p < 0.05, FDR correction). Among these, 16 ipsilesional thalamic subfields (including AV, LD, LP, VLa, VLp, VPL, VM, CeM, CL, MDm, LGN, PuM, PuI, CM, Pf, and Pt) exhibited significantly subfield-specific increased GMV covariance connectivity with the anterior orbital gyrus, superior occipital gyrus, calcarine, anterior cingulate cortex, precentral gyrus, and other regions. Additionally, although none of the contralesional thalamic subfields demonstrated regional GMV changes, 3/25 showed subfield-specific increased GMV covariance connectivity with the ipsilesional anterior orbital gyrus and subcortex.ConclusionThe GMV covariance networks of thalamic subfields are selectively involved in patients with chronic capsular stroke, which affect not only the ipsilesional thalamic subfields but also the contralesional ones.

BACKGROUND:Accurately assessing the duration of nonacute intracranial large vessel occlusion (ILVO) is critical, because occlusion exceeding 3 months significantly reduces endovascular treatment efficacy. This study explores high-resolution vessel wall imaging to differentiate subacute (3 days-1 month), short-duration chronic (1-3 months), and long-duration chronic (>3 months) ILVOs. METHODS:A retrospective analysis was conducted on consecutive patients with nonacute ILVOs with well-documented clinical courses (June 2018-March 2022). High-resolution vessel wall imaging pre- and postcontrast features, including traditional and histogram characteristics, were evaluated. Logistic regression identified key determinants for distinguishing occlusion durations. Endovascular treatment outcomes were assessed in a subset of patients. RESULTS:Among 218 ILVOs (77 subacute, 69 short-duration chronic, 72 long-duration chronic), multivariate analysis identified signal intensity (odds ratio [OR], 3.71; P<0.001), enhancement index (OR, 1.79; P<0.001), precontrast skewness (OR, 4.41; P=0.04), and postcontrast coefficient of variation (OR, 9.34; P<0.001) as significant for differentiating subacute and long-duration chronic ILVOs. Short- versus long-duration chronic ILVOs were distinguished by signal intensity (OR, 4.02; P<0.001), enhancement index (OR, 2.02; P<0.001), lumen diameter (OR, 1.70; P=0.002), and precontrast skewness (OR, 4.91; P=0.047). Short-duration ILVOs showed higher recanalization success (91.7% versus 61.9%, P=0.02) and required fewer stents (45.8% versus 90.5%, P=0.02) compared with long-duration ILVOs. CONCLUSIONS:High-resolution vessel wall imaging features effectively differentiate ILVO durations, providing structural insights into occluded vessels. These findings can guide endovascular recanalization strategies, emphasizing the importance of occlusion duration in treatment planning.

Potential changes in patterns of dynamic functional network connections at the cerebellar-cerebral level in pontine infarction (PI) patients remain unclear. The study aimed to investigate the abnormal patterns of dynamic functional connectivity (dFC) between the cerebellar subregions within networks and regions of the cerebral cortex in patients with PI. Forty-six chronic left pontine infarction (LPI), 32 chronic right pontine infarction (RPI), and 50 healthy controls (HCs) were recruited to undergo resting-state fMRI scans. Cerebellar-cerebral dFC was characterized using the sliding window method and seed-based connectivity analyses. Correlations between altered dFC values and clinical variables (The Rey Auditory Verbal Learning Test and Flanker task) in PI patients and healthy controls were investigated. Compared with HCs, the PI groups showed significantly aberrant cerebellar-cerebral dFC between cerebellar subregions within networks and supratentorial cerebral cortex, including executive, default-mode, and motor networks. Furthermore, Correlation analysis showed a decoupling between abnormal dFC and cognitive functions in PI patients. These findings indicate that PI patients are accompanied by damage to cerebellar subregions within networks and cerebellar-cerebral pathways, which may provide a potential target for treatment or an indication of therapeutic efficacy.

BackgroundThrough its extensive connection with the cortex, the thalamus constitutes the hub of cortico-subcortical circuits and participants in multi-dimensional functions. However, the differential involvements of thalamic functional connectivity in chronic capsular and pontine stroke are still unknown.MethodsThe research recruited 66 left-lesion chronic stroke patients, including 46 capsular strokes (CS) and 20 pontine stroke (PS) patients, and 67 normal controls (NC). The thalamic subfields functional connectivities were compared between groups using a two-way repeated analysis of variance (ANOVA), corrected for confounders including age, gender, education and scanners. Spearman partial correlation was used to explore the potential association between altered thalamic FC and clinical variables.ResultsThe ipsilesional thalamus of CS patients had abnormally decreased FC with widespread cognitive-related areas while increased FC with visual- and somatic-motor areas. In contrast, the ipsilesional thalamus of PS patients mainly demonstrated increased FC in these sensorimotor areas. Even in the contralesional thalamus, we observed similar (with the ipsilesional) but less extensive functional dysconnectivity patterns in both the CS and PS patients (P < 0.05, corrected using family-wise error [FWE] at the voxel level). Finally, we found significant group x subfields interactions on thalamic functional connectivity, where capsular vs. pontine stroke demonstrate varied functional dysconnectivity with specific thalamic subfields. Finally, a weak correlation was found between FC of both ipsilesional/contralesional thalamic subfields and motor, working and verbal memory.ConclusionsThe thalamic functional dysconnectivity after chronic stroke are lesion-location and subfields dependent. Moreover, functional dysconnectivity were shown in both the ipsilesional and contralesional thalamus with similar patterns.

Brain computer interface (BCI) technology can decode motion intentions to manipulate supernumerary robotic finger (SRF), facilitating direct human-machine control and enhancing limb motion capabilities. However, the longitudinal neuroplasticity mechanism of BCI-controlled SRF training using the sixth finger motor imagery paradigm remains unclear. In this study, we observed concurrent changes in behavior and brain activity following 4 weeks of BCI-controlled SRF training (BCI_SRF) or sham SRF training (Sham). The results demonstrated a 132% improvement in SRF-finger opposition accuracy with BCI_SRF training compared to Sham training. Resting-state fMRI analysis revealed a significant enhancement in functional connectivity between M1_ R and Cerebellum_8_L due to BCI-SRF training. These findings suggest that active brain involvement enhances the cortical-subcortical interaction of the sensorimotor network, thereby improving human-computer interaction performance. Our research provides valuable insights for enhancing human-computer interaction and exhibits significant potential in hand rehabilitation post-stroke.

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Background: Subcortical stroke may significantly alter the cerebral cortical structure and affect attention function, but the details of this process remain unclear. The study aimed to investigate the neural substrates underlying attention impairment in patients with subcortical stroke. Materials and Methods: In this prospective observational study, two distinct datasets were acquired to identify imaging biomarkers underlying attention deficit. The first dataset consisted of 86 patients with subcortical stroke, providing a cross-sectional perspective, whereas the second comprised 108 patients with stroke, offering longitudinal insights. All statistical analyses were subjected to false discovery rate correction upon P < 0.05. Results: In the chronic-stage data, the stroke group exhibited significantly poorer attention function compared with that of the control group. The cortical structure analysis showed that patients with stroke exhibited decreased cortical thickness of the precentral gyrus and surface area of the cuneus, along with an increase in various frontal, occipital, and parietal cortices regions. The declined attention function positively correlated with the superior frontal gyrus cortical thickness and supramarginal gyrus surface area. In the longitudinal dataset, patients with stroke showed gradually increasing cortical thickness and surface area within regions of obvious structural reorganization. Furthermore, deficient attention positively correlated with supramarginal gyrus surface area both at the subacute and chronic stages post-stroke. Conclusions: Subcortical stroke can elicit dynamic reorganization of cortical areas associated with attention impairment. Moreover, the altered surface area of the supramarginal gyrus is a potential neuroimaging biomarker for attention deficits.

ObjectiveThe purpose of the study was to investigate the abnormality both of static spontaneous brain activity and dynamic temporal variances following a pontine infarction. MethodsForty-six patients with chronic left pontine infarction (LPI), thirty-two patients with chronic right pontine infarction (RPI), and fifty healthy controls (HCs) were recruited for the study. The static amplitude of low-frequency fluctuations (sALFF), static regional homogeneity (sReHo), dynamic ALFF (dALFF), and dynamic ReHo (dReHo) were employed to detect the alterations in brain activity induced by an infarction. The Rey Auditory Verbal Learning Test and Flanker task were used to evaluate the verbal memory and visual attention function, respectively. Receiver operating characteristic curve analysis was used to reveal the potential capacity of these metrics to distinguish the patients from HCs. ResultsThere were significant variations of these static and dynamic metrics in patients with chronic pontine infarction. The altered regions involved the supratentorial regions, including cortex and subcortical. Moreover, the altered metrics were significantly correlated with verbal memory and visual attention. In addition, these static and dynamic metrics also showed potential in distinguishing stroke patients with behavior deficits from HCs. ConclusionThe pontine infarction-induced cerebral activation changes are observed in both motor and cognitive systems, indicating the functional damage and reorganization across the global cerebral level in these patients with subtentorial infarction, and there is a reciprocal effect between motor and cognitive impairment and repair.

IntroductionThe objective of this study was to characterize the alteration patterns of dynamic spatiotemporal activity in chronic subcortical stroke patients with varying motor outcomes, while investigating the imaging indicators relevant to the assessment of potential cognitive deficits in these patients.MethodsA total of 136 patients and 88 normal controls were included in the analysis of static and dynamic intrinsic brain activity, determined by amplitude of low-frequency fluctuations.ResultsThe findings unveiled that subcortical stroke patients exhibited significantly aberrant temporal dynamics of intrinsic brain activity, involving regions within multiple brain networks. These spatiotemporal patterns were found to be contingent upon the side of the lesion. In addition, these aberrant metrics demonstrated potential in discerning cognitive deficits in stroke patients with memory impairment, with the dynamic indices exerting more influence than the static ones. The observe findings may indicate that subcortical stroke can trigger imbalances in the segregation and integration of spatiotemporal patterns across the entire brain with multi-domain networks, especially in patients with poor motor outcomes.ConclusionIt suggests that the temporal dynamics indices of intrinsic brain activity could serve as potential imaging indicators for assessing cognitive impairment in patients with chronic subcortical stroke, which may be associated with the motor outcomes.

Subcortical ischemic stroke can lead to persistent structural changes in the cerebral cortex. The evolution of cortical structural changes after subcortical stroke is largely unknown, as are their relations with motor recovery, lesion location, and early impairment of specific subsets of fibers in the corticospinal tract (CST). In this observational study, cortical structural changes were compared between 181 chronic patients with subcortical stroke involving the motor pathway and 113 healthy controls. The impacts of acute lesion location and early impairments of specific CSTs on cortical structural changes were investigated in the patients by combining voxel-based correlation analysis with an association study that compared CST damage and cortical structural changes. Longitudinal patterns of cortical structural change were explored in a group of 81 patients with subcortical stroke using a linear mixed-effects model. In the cross-sectional analyses, patients with partial recovery showed more significant reductions in cortical thickness, surface area, or gray matter volume in the sensorimotor cortex, cingulate gyrus, and gyrus rectus than did patients with complete recovery; however, patients with complete recovery demonstrated more significant increases in the cortical structural measures in frontal, temporal, and occipital regions than did patients with partial recovery. Voxel-based correlation analysis in these patients showed that acute stroke lesions involving the CST fibers originating from the primary motor cortex were associated with cortical thickness reductions in the ipsilesional motor cortex in the chronic stage. Acute stroke lesions in the putamen were correlated with increased surface area in the temporal pole in the chronic stage. The early impairment of the CST fibers originating from the primary sensory area was associated with increased cortical thickness in the occipital cortex. In the longitudinal analyses, patients with partial recovery showed gradually reduced cortical thickness, surface area, and gray matter volume in brain regions with significant structural damage in the chronic stage. Patients with complete recovery demonstrated gradually increasing cortical thickness, surface area, and gray-matter volume in the frontal, temporal, and occipital regions. The directions of slow structural changes in the frontal, occipital, and cingulate cortices were completely different between patients with partial and complete recovery. Complex cortical structural changes and their dynamic evolution patterns were different, even contrasting, in patients with partial and complete recovery, and were associated with lesion location and with impairment of specific CST fiber subsets.

Subcortical stroke may cause widespread structural changes to the cerebral cortex in multiple domains; however, the details of this process remain unclear. In this prospective observational study, we acquired two datasets to investigate the effect of lesion location on cortical structure. One was cross-sectional, comprising 269 patients with chronic stroke, either capsular stroke (CS) or pontine stroke (PS), and the other was longitudinal, comprising 119 patients with CS or PS. In the chronic-stage data, both CS and PS exhibited reduced cortical thickness in the precentral gyrus and increased cortical thickness and area in the frontal, temporal, occipital and insular cortices. Cortical thicknesses were correlated with motor outcomes in the precentral and lingual gyri, and early impairment of the corticospinal tract was associated with cortical thickness in the middle frontal gyrus. In the longitudinal dataset, CS showed gradually decreasing cortical thickness in the precentral gyrus, and both CS and PS showed gradually increasing cortical thickness and area in regions with significant structural reorganization. Subcortical stroke can therefore cause complex cortical structural changes in multi-domain regions involved in motor, primary and higher cognitive areas and have different evolution patterns depending on the subcortical level of the lesion affecting the motor pathways.

Recent neuroimaging studies have shown the possibility of cognitive impairment after pontine stroke. In this study, we aimed to use voxel-mirrored homotopic connectivity (VMHC) to investigate changes in the cognitive function in chronic pontine stroke. Functional MRI (fMRI) and behavioral assessments of cognitive function were obtained from 56 patients with chronic pontine ischemic stroke [28 patients with left-sided pontine stroke (LP) and 28 patients with right-sided pontine stroke (RP)] and 35 matched healthy controls (HC). The one-way ANOVA test was performed for the three groups after the VMHC analysis. Results showed that there were significant decreases in the bilateral lingual gyrus (Lingual_L and Lingual_R) and the left precuneus (Precuneus_L) in patients with chronic pontine ischemic stroke compared to HCs. However, in a post-hoc multiple comparison test, this difference remained only between the HC and RP groups. Moreover, we explored the relationship between the decreased z -values in VMHC and the behavior-task scores using a Pearson's correlation test and found that both scores of short-term memory and long-term memory in the Rey Auditory Verbal Learning Test were positively correlated with z -values of the left lingual gyrus (Lingual_L), the right lingual gyrus (Lingual_R), and the left precuneus (Precuneus_L) in VMHC. Besides that, the z -values of Precuneus_L in VMHC were also negatively correlated with the reaction time for correct responses in the Flanker task and the spatial memory task. In conclusion, first, the lingual gyrus played an important role in verbal memory. Second, the precuneus influenced the working memory, both auditory-verbal memory and visual memory. Third, the right-sided stroke played a greater role in the results of this study. This study provides a basis for further elucidation of the characteristics and mechanisms of cognitive impairment after pontine stroke.

Background and Purpose: Motor deficit is the most common disability after stroke, and early prediction of motor outcome is critical for early interventions. Here, we constructed a fine map of the corticospinal tract (CST) for early prediction of motor outcome and for understanding the secondary brain changes after subcortical stroke. Methods: Diffusion spectrum imaging data from 50 healthy adults were used to reconstruct fine maps of CST with different origins, including primary motor area (M1), primary sensory area (S1), premotor cortex, and supplementary motor area (SMA). Their diffusion properties correlated with motor functions in healthy adults. The impacts of the impairments of different CST on motor outcomes and on structural and functional changes of brain were investigated in 136 patients with subcortical stroke by combining CST damage-symptom association study and voxel-based lesion-symptom mapping. Results: In healthy adults, the isotropy of M1 fiber correlated with walking endurance and that of SMA fiber with motor dexterity. In chronic stroke patients, the integrity of M1 and SMA fibers showed the most significant correlation with motor deficits. The percentage of early damage of M1 and SMA fibers correlated with that of chronic motor deficits. Voxel-based lesion-symptom mapping revealed that acute stroke lesions in the bilateral M1 and right SMA fibers were associated with chronic motor deficits. The early damage of M1 fiber negatively correlated with the integrity of M1-M1 fiber, and the early damage of SMA fiber negatively correlated with gray matter volume of the contralateral cerebellum in the chronic stage. Conclusions: The CST that originated from the M1 and SMA are closely associated with motor outcomes and brain structural changes, and the fine maps of CST from these 2 cortical areas are useful in assessing and predicting long-term motor outcome in patients with subcortical stroke.

Background: Bell palsy (BP) is a simple peripheral facial paralysis. A variety of acupuncture treatments have been reported effective for the recovery of BP. However, the relative effectiveness of these acupuncture treatments is still unclear. Therefore, we plan to summarize the evidence and determine the most effective acupuncture treatment for BP. Methods: We will search the following database, including The Cochrane Library, PubMed, Web of Science, EMBASE, China BioMedical Literature (CBM),China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang database, from their inceptions to April 30, 2020, in order to collect randomized controlled trials (RCTs) on acupuncture in the treatment of BP. We will use Stata16.0 and WinBUGS software for statistical analysis and draw surface under the cumulative ranking curve (SUCRA) graph for each outcome indicator to predict the order of curative effect of treatment measures. Results: This study will compare and rank the effectiveness of different acupuncture methods in the treatment of BP, and the outcome indicators will include House-Brackmann Grading Scale, sequelae, Facial Disability Index score, Sunnybrook facial grading system, Portmann score, and adverse events. Conclusion: Our study will provide supports for clinical practice.

Background and Purpose: Early studies have indicated that the cortico-rubro-spinal tracts play important roles in motor dysfunction after stroke. However, the differential involvement of the rubral branches in capsular and pontine stroke, and their associations with the motor impairment are still unknown. Methods: The present study recruited 144 chronic stroke patients and 91 normal controls (NC) from three hospitals, including 102 cases with capsular stroke (CS) and 42 cases with pontine stroke (PS). The rubral branches, including bilateral corticorubral tracts (CRT), dentatorubral tracts (DRT), and rubrospinal tracts (RST), and the cortico-spinal tract (CST) were reconstructed based on the dataset of the Human Connectome Project. Group differences in diffusion scalars of each rubral branch were compared, and the associations between the diffusion measures of rubral branches and the Fugl-Meyer assessment (FMA) scores were tested. Results: The bilateral CRT of the CS cases showed significantly lower factional anisotropy (FA) than in the NC. The bilateral DRT of the PS cases had lower FA than in the NC. Both CS and PS cases had significantly lower FA of the bilateral RST than the NC. Besides, the stroke patients demonstrated significantly lower FA in bilateral CSTs than the NC. Partial correlation analysis identified significantly positive correlations between the FA of the ipsilesional and CRT and the FMA scores in the CS group, and significantly positive correlations between the FA of the RST bilaterally and the FMA scores in the CS and PS groups. Furthermore, the association between RST integrity and FMA scores still survived after controlling for the effect of the CST. Finally, multiple regression modelling found that rubral tract FA explained 39.2% of the variance in FMA scores for CS patients, and 48.8% of the variance in FMA scores for PS patients. Conclusions: The bilateral rubral branches were differentially involved in the chronic capsular and pontine stroke, and the impairment severity of each rubral branch was dependent on lesion locations. The integrity of the rubral branches is related to motor impairment in both the chronic capsular and pontine stroke.

Objective To explore the influence of the location of the infarction lesion on the resting-state functional connectivity (rsFC) of the motor execution network. Methods A total of 144 patients with infarction of the motor pathway were involved in the study, including 97 patients with capsule stroke (CS) and 47 patients with pontine stroke (PS).50 age-matched healthy subjects were enrolled.After acquiring the structural images and the resting-state functional MRI data of all the subjects by 3.0-Tesla MR scanner, the functional connectivity was calculated in different regions of interest and the differences of the rsFC within the motor execution network among patients with different infarction location were compared. Results Left CS patients exhibited increased rsFC in L_PMd (MNI x, y, z: -22, -13, 57) -R_M1 (MNI x, y, z: 38, -22, 56) (F=3.951, P=0.022), the increased rsFC than healthy controls (P=0.031); Left CS patients exhibited increased rsFC in R_PMv (MNI x, y, z: 53, 0, 25)-L_SPL (MNI x, y, z: -22, -64, 54) than healthy controls (F=4.017, P=0.021), left CS patients exhibited decreased rsFC in R_PCG (MNI x, y, z: 37, -34, 53) -R_PMv (MNI x, y, z: 53, 0, 25) than healthy controls(F=-3.788, P=0.025). Right CS patients exhibited increased rsFC than healthy controls in R_PMd(MNI x, y, z: 28, -10, 54)-L_M1(MNI x, y, z: -38, -22, 56) (F=4.438, P=0.014), right CS patients exhibited increased rsFC than healthy controls in R_PMv(MNI x, y, z: 53, 0, 25)-R_PCG(MNI x, y, z: 37, -34, 53)(F=4.830, P=0.010), right CS patients exhibited decreased rsFC in L_M1(MNI x, y, z: -38, -22, 56)-L_SMA(MNI x, y, z: -5, -4, 57) than healthy controls (F=-5.102, P=0.007). And the left PS patients showed increased rsFC than healthy controls in R_DN -L_SMA (F=4.939, P=0.009), left PS patients exhibited increased rsFC than healthy controls in L_DN-R_SMA (F=3.431, P=0.036), left PS patients exhibited reduced rsFC than healthy controls in R_AICb -R_PMd (F=-4.114, P=0.019). Right PS patients showed increased rsFC compared with healthy controls in L_DN-R_M1(F=3.075, P=0.049), and increased rsFC compared with healthy controls in L_AICb-R_SCb (F=3.725, P=0.027). Conclusion The infarction location poses influence on the FC alteration of the motor network after stroke. Key words: Cerebral infarction; Motor execution network; Functional connectivity; Resting-state fMRI