Associations Between Early Functional Brain Network Topology and 6-Month Upper Limb Motor Outcomes in Stroke Patients.

To investigate early functional correlates of different upper limb motor outcomes 6 months post-stroke. This case-control study enrolled 57 stroke patients and 15 controls who underwent resting-state functional magnetic resonance imaging scans between 2022 and 2024. Hemiplegic upper limb motor function was repeatedly evaluated using Fugl-Meyer assessment–upper extremity (FMA-UE) within 6 months post-stroke. Motor outcome was classified into bad, moderate or good based on the final scores. Resting-state functional network topology was compared and correlated with motor outcomes. The good outcome group demonstrated better initial upper limb function and faster recovery. The moderate outcome group showed comparable initial performance to the bad outcome group but faster recovery. All groups exhibited small-world characteristics; however, both the good outcome group and healthy controls exhibited higher global/local network efficiency. The bad outcome group lacked interhemispheric connections compared to moderate outcomes and showed fewer ipsilesional / interhemispheric connections versus good outcomes. The good outcome group demonstrated stronger limbic functional connectivity than moderate outcomes. The above connections were positively correlated with upper limb motor function. While interhemispheric connectivity is associated with motor recovery, favorable outcomes are also linked to additional restoration of ipsilesional intrahemispheric connections.