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@ARTICLE{Esser:1044494,
      author       = {Esser, Frauke and Paul, Theresa and Rizor, Elizabeth and
                      Binder, Ellen and Hensel, Lukas and Rehme, Anne K. and
                      Ringmaier, Corinna and Schönberger, Anna and Tscherpel,
                      Caroline and Vossel, Simone and Garcea, Frank E. and
                      Grefkes, Christian and Fink, Gereon Rudolf and Grafton,
                      Scott T. and Volz, Lukas J.},
      title        = {{D}istinct {D}isconnection {P}atterns {E}xplain
                      {T}ask-{S}pecific {M}otor {I}mpairment and {O}utcome {A}fter
                      {S}troke},
      journal      = {Stroke},
      volume       = {56},
      number       = {8},
      issn         = {0039-2499},
      address      = {New York, NY},
      publisher    = {Association},
      reportid     = {FZJ-2025-03231},
      pages        = {},
      year         = {2025},
      note         = {This work was funded by the Deutsche Forschungsgmeinschaft
                      (DFG, German Research Foundation) project ID
                      431549029-SFB1451. Dr. Rehme was funded by the DFG (German
                      Research Foundation) project ID310098283.},
      abstract     = {ackground: Stroke is increasingly understood as a network
                      disorder with symptoms often arising from disruption of
                      white matter connectivity. Previous connectome-based
                      lesion-symptom mapping studies revealed that poststroke
                      motor deficits are not only associated with damage to the
                      core sensorimotor network but also with nonsensorimotor
                      connections. However, whether task-specific initial
                      impairment and outcome are based on distinct disconnection
                      patterns remains unknown.Methods: To address this question,
                      we included lesion information and assessments of distinct
                      aspects of upper limb motor impairment of 113 patients with
                      early subacute stroke (mean age, 65.95 years). We used
                      connectome-based lesion-symptom mapping, based on a
                      normative structural connectome, and a machine learning
                      algorithm to predict individual levels of task-specific
                      motor impairment and outcome >3 months later.Results: We
                      identified task-specific disconnection patterns that
                      significantly predicted initial motor impairment and outcome
                      and a task-general reach-to-grasp network including both
                      sensorimotor and nonsensorimotor areas. More complex
                      reach-to-grasp movements showed a substantial overlap in
                      disconnections for the prediction of impairment and outcome.
                      Conversely, disconnections indicative of more basal aspects
                      of motor control substantially differed between the
                      prediction of initial impairment and outcome at the chronic
                      stage poststroke. Similarly, the significance of
                      interhemispheric disconnections changed in a task- and
                      time-dependent fashion.Conclusions: In summary, our study
                      identified distinct disconnection patterns indicative of
                      specific aspects of motor impairment and outcome after
                      stroke, highlighting a time- and task-dependent role of the
                      contralesional hemisphere and suggesting a domain-general
                      compensatory role of nonsensorimotor temporal areas. From a
                      mechanistic perspective, differences in disconnection
                      patterns predictive of initial motor impairment versus
                      outcome suggest a stronger dependence of basal motor control
                      on the brain's structural reserve during motor recovery. Our
                      results extend our current network-level understanding of
                      task-specific motor impairment and recovery, and emphasize
                      the potential of connectome-based lesion-symptom mapping for
                      future clinical applications.Keywords: brain imaging; motor
                      cortex; motor skills; recovery of function; stroke.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5252 - Brain Dysfunction and Plasticity (POF4-525) / DFG
                      project G:(GEPRIS)431549029 - SFB 1451:
                      Schlüsselmechanismen normaler und krankheitsbedingt
                      gestörter motorischer Kontrolle (431549029) / DFG project
                      G:(GEPRIS)310098283 - Neurale Grundlagen der Interaktion von
                      Post-stroke Depression und motorischer Rehabilitation nach
                      Schlaganfall (310098283)},
      pid          = {G:(DE-HGF)POF4-5252 / G:(GEPRIS)431549029 /
                      G:(GEPRIS)310098283},
      typ          = {PUB:(DE-HGF)16},
      doi          = {10.1161/STROKEAHA.125.050929},
      url          = {https://juser.fz-juelich.de/record/1044494},
}