Study of the dynamics of changes in functional brain networks in the early recovery period of ischemic stroke according to MRI data

Aim of the study was to evaluate the dynamics of changes in functional brain networks (default mode network, DMN, and sensorimotor network, SMN) during the early recovery period following ischemic stroke, taking into account the volume of ischemic lesions according to MRI data. Material and methods. A dynamic MRI study of the brain was performed on a 3.0 T scanner in 137 patients at 1–3 days, 7–10 days, and 3–4 months after the onset of acute cerebrovascular accident, using a routine protocol (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE) supplemented with resting-state functional MRI. Additional assessment included the Montreal Cognitive Assessment (MoCA) and the modified Rankin scale. The study cohort comprised 36 patients diagnosed with acute ischemic supratentorial stroke who underwent at least two MRI examinations. Results and discussion. A trend (p > 0.05) towards increased functional connectivity between DMN and SMN regions was observed from the first to the third examination. The MoCA results (p < 0.05 for 2nd and 3rd study compared to 1st) showed improvement in cognitive functions over time, consistent with the clinical course. The most significant finding of the correlation analysis was a direct correlation between DMN and SMN connectivity at the first observation (R = 0.57; p = 0.006). Lesion volume was found to influence functional connectivity, with a significant effect of larger lesion size on DMN recovery dynamics (R = 0.83; p = 0.04). Conclusions. A parallel increase in intra-network connectivity of the DMN and SMN was demonstrated, indicating systemic functional reorganization of the brain following acute stroke. During the early recovery period, resting-state functional MRI revealed progressive restoration of DMN and SMN connectivity, accompanied by cognitive improvement as assessed by MoCA. Further research is required to clarify the mechanisms of DMN and SMN recovery, as well as the role of lesion volume and localization in functional network reorganization.

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