{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:05:19Z","timestamp":1783944319375,"version":"3.55.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-stroke constipation is prevalent after frontal lobe infarction and may reflect disrupted cortical\u2013autonomic regulation. Neurorehabilitation strategies targeting cortical plasticity may offer therapeutic benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether mirror therapy combined with defecation motor imagery and repetitive transcranial magnetic stimulation (rTMS) improves bowel function, and to explore associated cortical changes using EEG-derived event-related desynchronization (ERD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective study, 98 patients with frontal lobe infarction and Rome IV-defined constipation were analyzed. Forty-eight received mirror therapy + motor imagery + rTMS in addition to routine rehabilitation, and 50 received routine care alone. Primary outcomes included Wexner Constipation Score, weekly bowel frequency, and PAC-QOL. EEG \u03bc\/\u03b2-band ERD during defecation motor imagery was quantified. Between-group differences and correlations were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 8 weeks, the intervention group showed significantly greater improvement in Wexner score, bowel frequency, and PAC-QOL compared with controls (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.01; Cohen's d 0.60\u20130.82). Enhanced \u03bc\/\u03b2 ERD was observed only in the intervention group. ERD changes correlated moderately with Wexner improvement (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.56).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined mirror therapy, motor imagery, and rTMS were associated with improved bowel function and increased task-related cortical activation. EEG-derived ERD may serve as a candidate biomarker for bowel-focused neurorehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1818303","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:08:04Z","timestamp":1783940884000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Mirror therapy combined with defecation motor imagery and repetitive transcranial magnetic stimulation improves post-stroke constipation: a retrospective study with EEG biomarker analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiansong","family":"Yu","sequence":"first","affiliation":[{"name":"Rehabilitation Medicine Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University","place":["Taizhou, Zhejiang, 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