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However, most current repair strategies primarily focus on peripheral regeneration, with limited understanding of its relationship to central neural changes. Here, we performed clinical resting\u2010state functional magnetic resonance (rs\u2010fMRI) in patients with facial nerve injury and identified the sensorimotor network alterations associated with the nerve injury. Guided by the results, we developed a tissue\u2010engineered fibrous nerve guidance conduit (NGC) integrating aligned nanofibers, sustained nerve growth factor delivery, and Schwann\u2010like cells derived from bone marrow mesenchymal stem cells. In vitro, the combined biochemical and cellular cues enhanced neurite extension. In a rat facial nerve injury model, implantation of the Schwann\u2010like cells\u2010loaded tissue\u2010engineered NGC promoted axonal regeneration and remyelination, achieving facial motor function recovery comparable to autografts. Moreover, rs\u2010fMRI and voxel\u2010based morphometric analyses revealed that peripheral nerve repair with the engineered conduit was accompanied by enhanced functional connectivity within the sensorimotor network and normalization of gray matter alterations. Taken together, these results suggest that biomaterial\u2010assisted nerve repair may extend beyond local regeneration to influence central network dynamics, highlighting a strategy for integrating peripheral repair with central functional reorganization.<\/jats:p>","DOI":"10.1002\/smll.75162","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T16:17:31Z","timestamp":1786378651000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tissue\u2010Engineered Fibrous Nerve Conduits Link Facial Nerve Repair with Central Network Reorganization"],"prefix":"10.1002","volume":"22","author":[{"given":"Bowen","family":"Gong","sequence":"first","affiliation":[{"name":"Beijing Laboratory of Biomedical Materials State Key Laboratory of Organic\u2010Inorganic Composites Beijing University of Chemical Technology  Beijing P. R. 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