High modularity, more flexible of brain networks in patients with mild to moderate motor impairments after stroke

Stroke is recognized as a network communication disorder. Advances in neuroimaging technologies have enhanced our comprehension of dynamic cerebral alterations. However, different levels of motor function impairment after stroke may have different patterns of brain reorganization. Abnormal and adaptive patterns of brain activity in mild-to-moderate motor function impairments after stroke remain still underexplored. We aim to identify dynamic patterns of network remodeling in stroke patients with mild-to-moderate impairment of motor function. fMRI data were obtained from 30 stroke patients and 31 healthy controls to establish a spatiotemporal multilayer modularity model. Then, graph-theoretic measures, including modularity, flexibility, cohesion, and disjointedness, were calculated to quantify dynamic reconfiguration. Our findings reveal that the post-stroke brain exhibited higher modular organization, as well as heightened disjointedness, compared to HCs. Moreover, analyzing from the network level, we found increased disjointedness and flexibility in the Default mode network (DMN), indicating that brain regions tend to switch more frequently and independently between communities and the dynamic changes were mainly driven by DMN. Notably, modified functional dynamics positively correlated with motor performance in patients with mild-to-moderate motor impairment. Collectively, our research uncovered patterns of dynamic community reconstruction in multilayer networks following stroke. Our findings may offer new insights into the complex reorganization of neural function in post-stroke brain.