Neuronal substrates of motor impairment after subcortical ischemic stroke: a functional neuroimaging meta-analysis

Functional neuroimaging studies have been conducted to investigate the neural correlates of motor-related activity after subcortical ischemic stroke (SIS). However, the specific neural substrates underlying these motor-related changes remain inadequately understood. This meta-analytic study quantitatively synthesized data from 12 functional neuroimaging studies to examine alterations in neural activity related to motor function after SIS. The analysis included 135 patients with SIS and 148 healthy controls, with ages ranging from 27 to 83 years (33% female). Compared with healthy controls, patients with SIS exhibited: (1) hyperactivity in the bilateral precentral gyri (M1), postcentral gyri, supplementary motor areas, and superior parietal lobule, and the right supramarginal gyrus; (2) hypoactivity in the left middle frontal gyrus and the right lobule IV/V of the cerebellum. Meta-regression analysis further revealed that: (1) hyperactivity in the left precentral gyrus and postcentral gyrus in patients with SIS relative to healthy controls was inversely correlated with the time after SIS; (2) hyperactivity in the left superior parietal lobule was positively associated with motor assessment scores. These findings suggest that altered neural activity within the motor-related areas may serve as biomarkers of motor impairment in SIS. Additionally, changes in the precentral gyrus and superior parietal lobule may reflect neural plasticity or recovery processes following SIS-related damage. These results provide valuable insights that could inform the development of predictive models and therapeutic strategies aimed at improving rehabilitation outcomes for individuals recovering from SIS.