A systematic review of alterations in sensorimotor networks following stroke: implications for integration and functional outcomes across recovery stages

Introduction: Stroke can result in a wide range of impairments, with sensorimotor dysfunction being among the most common, particularly when the sensorimotor network (SMN) is affected. As the SMN plays a critical role in movement control and coordination, understanding the changes in this network post-stroke is essential for informing recovery and rehabilitation strategies. Methods: A systematic review was conducted following PRISMA guidelines. Two electronic databases, PubMed and Scopus, were searched for relevant studies investigating the effects of stroke on the SMN across different phases of recovery. Reference lists of selected articles were also reviewed using Google Scholar. A total of 20 eligible studies involving 618 stroke patients and 606 healthy controls were included. Results: The review revealed consistent findings of altered functional connectivity within the SMN following stroke. Despite initial impairments, most studies reported improvement in SMN connectivity over time, attributed to compensatory mechanisms, cortical reorganisation, and functional rewiring. Stroke location significantly influenced recovery outcomes. Supratentorial strokes were associated with poorer motor assessments and slower recovery, while infratentorial strokes had comparatively better outcomes. Lesions in the pontine region were found to cause severe disturbances in both sensory and motor functions depending on lesion extent. Discussion: The findings underscore the brain's capacity for neuroplasticity and reorganisation following stroke. Understanding the temporal and spatial changes in the SMN post-stroke can inform more targeted and effective rehabilitation strategies. These insights are crucial for tailoring interventions that align with individual stroke profiles and promote optimal functional recovery.