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However, the neurobiological biomarkers associated with recovery of poststroke depression remain unclear. In this longitudinal observational study, we set out to investigate the effect of lesion\u2010induced focal damage and network\u2010level disconnectivity, and longitudinal structural connectivity on poststroke depression and its recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010two participants underwent a psychological assessment utilizing the Montgomery\u2013Asberg Depression Rating Scale (MADRS\u2010SIGMA) at 3 and 12\u2009months post first\u2010ever stroke. First, we evaluated the relationship between lesions and MADRS scores at the 3 months using voxel\u2010based lesion\u2010symptom mapping and lesion network mapping. Next, we assessed the longitudinal relationship between structural connectivity and MADRS scores (change from 3 to 12\u2009months) using multi\u2010shell diffusion\u2010weighted MRI data (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) collected at both timepoints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patient lesions mapped to a connected brain network centered on the left dorsolateral prefrontal cortex (P\n                      <jats:sub>FDR<\/jats:sub>\n                      \u2009&lt;0.05). Longitudinal diffusion MRI analysis revealed that increased quantitative anisotropy in the identified structural network was associated with improved depressive symptoms longitudinally (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014), independent of demographic and clinical covariates. Significant associations between the lesions and focal brain structures were not identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Depressive symptoms and their improvement mapped to a specific structural brain network. Knowledge of the integrity of this network could prove useful for predicting poststroke depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      START\u2010PrePARE Australian New Zealand Clinical Trials,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.anzctr.org.au\">www.anzctr.org.au<\/jats:ext-link>\n                      , Registry number: ACTRN12610000987066. EXTEND\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrial.gov\">ClinicalTrial.gov<\/jats:ext-link>\n                      identifier: NCT00887328.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70075","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T13:31:41Z","timestamp":1778765501000},"page":"676-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Network\u2010level disconnectivity tracks poststroke depressive symptom improvement"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4501-7338","authenticated-orcid":false,"given":"Aleksi J.","family":"Sihvonen","sequence":"first","affiliation":[{"name":"Centre of Excellence in Music, Mind, Body and Brain, Cognitive Brain Research Unit (CBRU), University of Helsinki  Helsinki Finland"},{"name":"Department of Neurology, Neurocenter Helsinki University Central Hospital  Helsinki Finland"},{"name":"Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Australia"},{"name":"Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia L. E.","family":"Brownsett","sequence":"additional","affiliation":[{"name":"Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Australia"},{"name":"Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health  Brisbane Queensland Australia"},{"name":"Centre of Research Excellence in Aphasia Recovery and Rehabilitation La Trobe University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Copland","sequence":"additional","affiliation":[{"name":"Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences The University of Queensland  Brisbane Australia"},{"name":"Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health  Brisbane Queensland Australia"},{"name":"Centre of Research Excellence 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