Reorganization of Dynamic Network in Stroke Patients and Its Potential for Predicting Motor Recovery

Objective: The investigation of brain functional network dynamics offers a promising approach to understanding network reorganization poststroke. This study aims to explore the dynamic network configurations associated with motor recovery in stroke patients and assess their predictive potential using multilayer network analysis. Methods: Resting-state functional magnetic resonance imaging data were collected from patients with subacute stroke within 2 weeks of onset and from matched healthy controls (HCs). Group-independent component analysis and a sliding window approach were utilized to construct dynamic functional networks. A multilayer network model was applied to quantify the switching rates of individual nodes, subnetworks, and the global network across the dynamic network. Correlation analyses assessed the relationship between switching rates and motor function recovery, while linear regression models evaluated the predictive potential of global network switching rate on motor recovery outcomes. Results: Stroke patients exhibited a significant increase in the switching rates of specific brain regions, including the medial frontal gyrus, precentral gyrus, inferior parietal lobule, anterior cingulate, superior frontal gyrus, and postcentral gyrus, compared to HCs. Additionally, elevated switching rates were observed in the frontoparietal network, default mode network, cerebellar network, and in the global network. These increased switching rates were positively correlated with baseline Fugl-Meyer assessment (FMA) scores and changes in FMA scores at 90 days poststroke. Importantly, the global network's switching rate emerged as a significant predictor of motor recovery in stroke patients. Conclusions: The reorganization of dynamic network configurations in stroke patients reveals crucial insights into the mechanisms of motor recovery. These findings suggest that metrics of dynamic network reorganization, particularly global network switching rate, may offer a robust predictor of motor recovery.