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We aimed to determine the evolution of structural brain networks in stroke patients with motor deficits and relate changes in their global topology to residual symptom burden and functional impairment. In this prospective cohort study, ischaemic stroke patients with supratentorial infarcts and motor symptoms were assessed longitudinally by advanced diffusion MRI and detailed clinical testing of upper extremity motor function at four time points from the acute to the chronic stage. For each time point, structural connectomes were reconstructed, and whole-hemisphere global network topology was quantified in terms of integration and segregation parameters. Using non-linear joint mixed-effects regression modelling, network evolution was related to lesion volume and clinical outcome. Thirty patients were included for analysis. Graph-theoretical analysis demonstrated that, over time, brain networks became less integrated and more segregated with decreasing global efficiency and increasing modularity. Changes occurred in both stroke and intact hemispheres and, in the latter, were positively associated with lesion volume. Greater change in topology was associated with larger residual symptom burden and greater motor impairment 1, 3 and 12 months after stroke. After ischaemic stroke, brain networks underwent characteristic changes in both ipsi- and contralesional hemispheres. Topological network changes reflect the severity of damage to the structural network and are associated with functional outcome beyond the impact of lesion volume.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaa001","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T14:41:34Z","timestamp":1578667294000},"source":"Crossref","is-referenced-by-count":60,"title":["Structural brain networks and functional motor outcome after stroke\u2014a prospective cohort study"],"prefix":"10.1093","volume":"2","author":[{"given":"Eckhard","family":"Schlemm","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg\u2013Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Schulz","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg\u2013Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"B\u00f6nstrup","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg\u2013Eppendorf, 20246 Hamburg, Germany"},{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Universit\u00e4tsklinikum Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Krawinkel","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurologie, Kopf- und Neurozentrum, Universit\u00e4tsklinikum Hamburg\u2013Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Fiehler","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neuroradiologische Diagnostik und Intervention, Universit\u00e4tsklinikum Hamburg\u2013Eppendorf, Hamburg, 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