Trial reportStroke2026
Mean Motor Disconnectivity Predicts Hand Function Impairment After Stroke: Beyond Motor Cortex Output.
Trial report in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02544503 (Customized Cortical Stimulation Therapy in the Rehabilitation of Stroke Patients), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Customized Cortical Stimulation Therapy in the Rehabilitation of Stroke Patients
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5 authors.
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Abstract
backgroundPersistent compromised hand function is one of the most common long-term deficits after stroke. It is related to dysfunction of the primary motor cortex (M1) and corticospinal tract (CST) as assessed by magnetic resonance imaging-derived estimates of CST lesion load or by transcranial magnetic stimulation-derived measures, such as motor evoked potential (MEP) status. However, substantial interindividual variability remains with these measures. We tested whether a novel measure, mean motor disconnectivity (MMD), explains additional variation in the hand function of subacute stroke patients.
methodsThirty-two participants (15 M/17 F; age, 58.6±9.65 years) after unilateral ischemic stroke involving the CST and related upper extremity weakness were studied within 4 weeks of stroke in a cross-sectional study design at Emory University between 2015 and 2021. The primary outcome measure was skilled hand function assessed using the Jebsen-Taylor test. Gross hand function and proximal UE function were secondary outcome measures. Transcranial magnetic stimulation was used to measure MEP status. Lesion masks were hand-drawn on each participant's structural magnetic resonance imaging image and were used to calculate lesion volume, CST lesion load, and MMD across a 20-region bilateral motor network consisting of the precentral gyrus, postcentral gyrus, thalamus, caudate, putamen, and brainstem regions. MMD is the mean of the disconnection values across the 20×20 nodes of this network of the adult human connectome; disconnection values quantify how severely a participant's lesion disrupts structural connectivity between region pairs.
resultsUnivariable analysis indicated MEP status (MEP+/-), CST lesion load, and MMD were significantly correlated with preserved hand function; lesion volume was not. Adding MMD to a model containing MEP status significantly improved the fit of a multivariable model.
conclusionsMMD explains additional variability in skilled hand function after accounting for MEP status, suggesting that disconnectivity measures capture stroke impact on motor areas beyond M1. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02544503.
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