Network change in the ipsilesional cerebellum is correlated with motor recovery following unilateral pontine infarction

BACKGROUND AND PURPOSE: Patients with acute pontine infarcts generally have good short-term motor outcomes; however, the mechanisms underlying this recovery of function remain unclear. METHODS: Twenty well-recovered patients with acute pontine infarcts and 20 well-recovered patients with acute striato-capsular infarcts were recruited. Fugl-Meyer assessment and resting-state functional magnetic resonance imaging were performed 1, 4 and 12 weeks after onset. Patients were further assigned to better and worse recovery subgroups according to the degree of motor recovery at the twelfth week after stroke. Voxel-wise degree centrality (DC)-behavior correlation analysis was used to identify brain regions related to changes in motor function within 12 weeks after stroke. RESULTS: A significant correlation was found between DC and Fugl-Meyer scores within 12 weeks in the ipsilesional cerebellar crus I and crus II in patients with pontine infarction and in the ipsilesional middle temporal gyrus in patients with striato-capsular infarction (all P < 0.001, AlphaSim corrected). The mean DC in these areas was higher both in the better and worse recovery subgroups at the fourth than at the first week (all P < 0.05). In addition, the mean DC values in these areas were higher in patients with better recovery at the twelfth than at the first week (P < 0.05), but such change was not found in patients with worse recovery. CONCLUSIONS: These results indicate that network changes in the ipsilesional cerebellum are correlated with motor recovery following pontine infarction. Motor recovery mechanisms may vary between pontine and striato-capsular infarcts, according to lesion location.