Cortical functional hierarchy disruption following subcortical stroke

Abstract Background: Subcortical structures are pivotal for cortico-subcortical communication, yet are highly vulnerable to stroke. Damage to these structures can produce widespread cortical dysfunction, but how subcortical stroke reshapes the macroscale hierarchical organization of cortical networks remains poorly understood. Clarifying this relationship is critical for understanding subcortical contributions to brain-wide communication and for identifying reliable neural markers of clinical outcome. Methods: We analyzed resting-state fMRI data from two independent cohorts of patients with subcortical stroke (discovery, 55 patients, 49 controls;