TY - JOUR
T1 - Functional connectivity between homotopic perisylvian regions correlates with functional status after stroke
AU - Tohyama, Takamichi
AU - Fukunaga, Masaki
AU - Otaka, Yohei
N1 - Publisher Copyright:
© 2026 THE AUTHORS. Open access at https://www.minervamedica.it. This is an open access article distributed under the terms of the Creative Commons CC BY-NC-ND license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license. Full details on the CC BY-NC-ND 4.0 are available at https://creativecommons.org/licenses/by-nc-nd/4.0/
PY - 2026/6
Y1 - 2026/6
N2 - BACKGROUND: Goal setting in stroke rehabilitation requires assessing patients' functional status, which involves both recovery and compensatory processes following stroke, underscoring the importance of identifying valid biomarkers. Functional connectivity measures derived from functional magnetic resonance imaging (fMRI) signals, which reflect underlying biological states, may offer value for characterizing functional status. AIM: We tested whether functional connectivity correlates with functional status and discriminates post-stroke functional independence. DESIGN: Observational study. SETTING: Inpatient rehabilitation ward at Fujita Health University Hospital, Japan. POPULATION: Fifty-eight patients with stroke. METHODS: Resting-state fMRI data were used to compute group-sparse inverse covariance matrices, which were negated to estimate partial correlations representing direct functional connectivity. Correlations between connectivity measures and functional independence measure (FIM) scores were examined. Principal component analysis (PCA) was applied to extract dominant connectivity features from connections associated with functional status. Connectivity-based discriminative performance was evaluated using receiver operating characteristic analysis. RESULTS: Connectome mapping revealed significant positive correlations between total FIM scores and interhemispheric connectivity in homotopic perisylvian regions, including the insulae, superior temporal sulci and temporoparietal junctions. PCA extracted a major connectivity component whose strength demonstrated within-sample discrimination of functional independence. Lesions were predominantly located in subcortical regions. CONCLUSIONS: The results support a significant association between homotopic functional connectivity within perisylvian, multifunctional regions located at the intersection of lobes and post-stroke daily functioning. Intrinsic interhemispheric functional connectivity, assessed using fMRI, may offer valuable insights into post-stroke functional status. CLINICAL REHABILITATION IMPACT: These findings highlight a promising direction for developing connectivity-based rehabilitation strategies for stroke-related disability.
AB - BACKGROUND: Goal setting in stroke rehabilitation requires assessing patients' functional status, which involves both recovery and compensatory processes following stroke, underscoring the importance of identifying valid biomarkers. Functional connectivity measures derived from functional magnetic resonance imaging (fMRI) signals, which reflect underlying biological states, may offer value for characterizing functional status. AIM: We tested whether functional connectivity correlates with functional status and discriminates post-stroke functional independence. DESIGN: Observational study. SETTING: Inpatient rehabilitation ward at Fujita Health University Hospital, Japan. POPULATION: Fifty-eight patients with stroke. METHODS: Resting-state fMRI data were used to compute group-sparse inverse covariance matrices, which were negated to estimate partial correlations representing direct functional connectivity. Correlations between connectivity measures and functional independence measure (FIM) scores were examined. Principal component analysis (PCA) was applied to extract dominant connectivity features from connections associated with functional status. Connectivity-based discriminative performance was evaluated using receiver operating characteristic analysis. RESULTS: Connectome mapping revealed significant positive correlations between total FIM scores and interhemispheric connectivity in homotopic perisylvian regions, including the insulae, superior temporal sulci and temporoparietal junctions. PCA extracted a major connectivity component whose strength demonstrated within-sample discrimination of functional independence. Lesions were predominantly located in subcortical regions. CONCLUSIONS: The results support a significant association between homotopic functional connectivity within perisylvian, multifunctional regions located at the intersection of lobes and post-stroke daily functioning. Intrinsic interhemispheric functional connectivity, assessed using fMRI, may offer valuable insights into post-stroke functional status. CLINICAL REHABILITATION IMPACT: These findings highlight a promising direction for developing connectivity-based rehabilitation strategies for stroke-related disability.
KW - Activities of daily living
KW - Cerebrovascular disorders
KW - Functional status
KW - Neuroimaging
UR - https://www.scopus.com/pages/publications/105044042429
UR - https://www.scopus.com/pages/publications/105044042429#tab=citedBy
U2 - 10.23736/S1973-9087.26.09367-6
DO - 10.23736/S1973-9087.26.09367-6
M3 - Article
C2 - 42394539
AN - SCOPUS:105044042429
SN - 1973-9087
VL - 62
SP - 245
EP - 253
JO - European Journal of Physical and Rehabilitation Medicine
JF - European Journal of Physical and Rehabilitation Medicine
IS - 3
ER -