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Mean Motor Disconnectivity Predicts Hand Function Impairment After Stroke: Beyond Motor Cortex Output.

Kate Pirog Revill1, Elizabeth Rizor2, Marc W Haut3

  • 1Department of Psychology, Emory University, Atlanta, GA (K.P.R.).

Stroke
|January 7, 2026
PubMed
Summary
This summary is machine-generated.

A new measure, mean motor disconnectivity (MMD), better predicts hand function after stroke. MMD explains additional variability beyond existing measures like motor evoked potential status.

Keywords:
connectomemotor cortexputamenthalamusupper extremity

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Area of Science:

  • Neuroscience
  • Neurology
  • Medical Imaging

Background:

  • Persistent hand dysfunction is a common stroke deficit, linked to primary motor cortex (M1) and corticospinal tract (CST) damage.
  • Current assessment methods like CST lesion load and motor evoked potential (MEP) status show significant inter-individual variability.
  • The need for improved measures to predict hand function recovery after stroke is critical.

Purpose of the Study:

  • To investigate if mean motor disconnectivity (MMD), a novel measure, explains additional variance in hand function among subacute stroke patients.
  • To compare the predictive power of MMD against established measures of stroke-related motor pathway damage.

Main Methods:

  • Thirty-two subacute ischemic stroke patients with upper extremity weakness were studied.
  • Skilled hand function was assessed using the Jebsen-Taylor test.
  • Mean motor disconnectivity (MMD) was calculated from structural MRI-based lesion masks within a 20-region motor network; MEP status and CST lesion load were also measured.

Main Results:

  • Motor evoked potential (MEP) status, CST lesion load, and MMD were significantly correlated with preserved hand function.
  • Lesion volume alone was not a significant predictor.
  • Including MMD in a multivariable model significantly improved its fit compared to a model with MEP status alone.

Conclusions:

  • Mean motor disconnectivity (MMD) explains additional variability in skilled hand function post-stroke, beyond MEP status.
  • Disconnectivity measures capture stroke impact on motor areas more comprehensively than traditional metrics.
  • MMD shows promise as a more sensitive biomarker for predicting motor recovery after stroke.