A Systematic Review of Alterations in Sensorimotor Networks Following Stroke: Implications for Integration and Functional Outcomes Across Recovery Stages

Nur Shaheera Aidilla Sahrizan^1,2Noorazrul Yahya³Zhe Kang Law¹Wan Asyraf Wan Zaidi¹Umi Nabilah Ismail¹Amirul Azri¹Naela Afifah⁴Hanani Abdul Manan^2*

• ¹National University of Malaysia, Bangi, Selangor Darul Ehsan, Malaysia
• ²Department of Radiology, Universiti Kebangsaan Malaysia Medical Center (UKMMC), Cheras, Malaysia
• ³Fakulti Sains Kesihatan, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
• ⁴Universiti Kebangsaan Malaysia Medical Center (UKMMC), Cheras, Malaysia

A stroke can have many different effects and the areas involved will determine the impairment of the particular patients. Involvement of the sensorimotor area may lead to impairments in sensorimotor integration, leading to difficulties in controlling intended movement or actions. The prevalence of stroke and the effects of this stroke on sensorimotor networks (SMN) is high compared to other networks therefore, this study aims to systematically evaluate the effect of stroke on the SMN in the acute phase throughout the chronic phase to understand how recovery mechanisms work. Two electronic databases (PubMed and Scopus) were searched for relevant stroke studies and the references of the selected studies were cross-checked using Google Scholar, adhering to PRISMA guidelines. Twenty eligible studies were selected, comprising 618 patients with different types and locations of stroke, and 606 healthy controls (HC). The studies consistently reported that the functional connectivity in the SMN was altered after stroke. However, results indicate that most patients had significant improvement throughout the phases and compensatory mechanisms, cortical reorganisation, and functional rewiring play a role in the recovery processes. The location of the stroke significantly influences sensorimotor integration and recovery outcomes. Patients with supratentorial stroke exhibited worse motor assessment and slower recovery outcomes compared to patients with infratentorial stroke, while patients with lesions located in the pontine can experience profound disturbances in both sensory and motor functions, depending on the specific location and extent of the lesion. Recovery from sensorimotor deficits indicates that the brain can recover and reorganise itself. Understanding these mechanisms post-stroke opens avenues for targeted rehabilitation strategies, which can help healthcare providers utilise optimum therapy for stroke survivors, taking into account the intricate relationship between SMN and cognitive functions.