Disruptions of resting-state functional connectivity in post-stroke motor dysfunctions: a meta-analysis

This study aims to unravel the consistent abnormalities in functional connectivity (FC) with the primary motor cortex (M1) for post-stroke motor dysfunctions and the dynamic shifts of FC across distinct phases (acute/subacute/chronic) following stroke onset. Eleven studies with 269 stroke patients and 257 healthy controls (HCs) were included after screening articles in PubMed, Web of Science, and Embase. Voxel-wise meta-analysis and subgroup analysis on three phases after stroke onset were applied using the anisotropic effect size-signed differential mapping toolbox. Additionally, a M1-seeded FC analysis from an independent dataset with 29 stroke patients and 40 HCs was applied to validate the results of the meta-analyses. The abnormal connectivity with M1 in patients with post-stroke motor dysfunctions extended beyond motor-related regions to non-motor domains. A consistent interhemispheric connectivity reduction between M1 and motor-related regions emerged as a hallmark, persisting across different phases after stroke onset. These alterations were largely replicable through validation analysis. Our findings indicated the imbalance of connectivity in patients with post-stroke motor dysfunctions.