This study, through a series of univariate and multivariate (classification) analyses, investigated fMRI task-based functional connectivity (FC) at pre- and post-treatment time-points in 18 individuals with chronic post-stroke dysgraphia. The investigation examined the effects of lesion and treatment-based recovery on functional organization, focusing on both inter-hemispheric (homotopic) and intra-hemispheric connectivity. The work confirmed, in the chronic stage, the “network phenotype of stroke injury” proposed by Siegel et al. (2016) consisting of abnormally low inter-hemispheric connectivity as well as abnormally high intra-hemispheric (ipsilesional) connectivity. In terms of recovery-based changes in FC, this study found overall hyper-normalization of these abnormal inter and intra-hemispheric connectivity patterns, suggestive of over-correction. Specifically, treatment-related homotopic FC increases were observed between left and right dorsal frontal-parietal regions. With regard to intra-hemispheric connections, recovery was dominated by increased ipsilateral connectivity between frontal and parietal regions along with decreased connectivity between the frontal regions and posterior parietal-occipital-temporal areas. Both inter and intra-hemispheric changes were associated with treatment-driven improvements in spelling performance. We suggest an interpretation according to which, with treatment, as posterior orthographic processing areas become more effective, executive control from frontal-parietal networks becomes less necessary.

本研究通过一系列单变量和多变量（分类）分析，调查了 18 名慢性卒中后书写障碍患者在治疗前和治疗后时间点的基于任务的功能连接性（FC）。该调查检查了病变和基于治疗的恢复对功能组织的影响，重点关注半球间（同位）和半球内连接。这项工作在慢性阶段证实了 Siegel 等人提出的“中风损伤的网络表型”。(2016) 包括异常低的半球间连通性以及异常高的半球内（同侧）连通性。在 FC 中基于恢复的变化方面，本研究发现这些异常的半球间和半球内连接模式的整体超正常化，暗示过度修正。具体而言，在左右背侧额顶区域之间观察到与治疗相关的同位 FC 增加。关于半球内连接，恢复主要是额叶和顶叶区域之间的同侧连接增加以及额叶区域和后顶叶-枕叶-颞叶区域之间的连接减少。半球间和半球内的变化都与治疗驱动的拼写性能改善有关。我们建议一种解释，根据这种解释，随着后部正字处理区域变得更加有效，来自额顶叶网络的执行控制变得不那么必要了。在左右背侧额顶区域之间观察到与治疗相关的同位 FC 增加。关于半球内连接，恢复主要是额叶和顶叶区域之间的同侧连接增加以及额叶区域和后顶叶-枕叶-颞叶区域之间的连接减少。半球间和半球内的变化都与治疗驱动的拼写性能改善有关。我们建议一种解释，根据这种解释，随着后部正字处理区域变得更加有效，来自额顶叶网络的执行控制变得不那么必要了。在左右背侧额顶区域之间观察到与治疗相关的同位 FC 增加。关于半球内连接，恢复主要是额叶和顶叶区域之间的同侧连接增加以及额叶区域和后顶叶-枕叶-颞叶区域之间的连接减少。半球间和半球内的变化都与治疗驱动的拼写性能改善有关。我们建议一种解释，根据这种解释，随着后部正字处理区域变得更加有效，来自额顶叶网络的执行控制变得不那么必要了。恢复的主要因素是额叶和顶叶区域之间的同侧连接性增加，以及额叶区域和后顶叶-枕叶-颞叶区域之间的连接性降低。半球间和半球内的变化都与治疗驱动的拼写性能改善有关。我们建议一种解释，根据这种解释，随着后部正字处理区域变得更加有效，来自额顶叶网络的执行控制变得不那么必要了。恢复的主要因素是额叶和顶叶区域之间的同侧连接性增加，以及额叶区域和后顶叶-枕叶-颞叶区域之间的连接性降低。半球间和半球内的变化都与治疗驱动的拼写性能改善有关。我们建议一种解释，根据这种解释，随着后部正字处理区域变得更加有效，来自额顶叶网络的执行控制变得不那么必要了。