{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:34:06Z","timestamp":1791650046797,"version":"4.3.4"},"reference-count":80,"publisher":"Korean Stroke Society","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"STI2030-Major Project","award":["2021ZD0200204"],"award-info":[{"award-number":["2021ZD0200204"]}]},{"name":"Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence"},{"name":"Ministry of Education, China"},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81974356"],"award-info":[{"award-number":["81974356"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82102665"],"award-info":[{"award-number":["82102665"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471651"],"award-info":[{"award-number":["81471651"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Supporting Discipline Construction Project of the Shanghai Health System","award":["2023ZDFC0304"],"award-info":[{"award-number":["2023ZDFC0304"]}]},{"DOI":"10.13039\/100007219","name":"Shanghai Natural Science Foundation","doi-asserted-by":"crossref","award":["23ZR1408500"],"award-info":[{"award-number":["23ZR1408500"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003392","name":"Natural Science Foundation of Fujian Province","doi-asserted-by":"publisher","award":["2025J01724"],"award-info":[{"award-number":["2025J01724"]}],"id":[{"id":"10.13039\/501100003392","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Joint Funds for the Innovation of Science and Technology, Fujian Province","award":["2021Y9130"],"award-info":[{"award-number":["2021Y9130"]}]},{"name":"Shanghai Sailing Program","award":["21YF1404600"],"award-info":[{"award-number":["21YF1404600"]}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["202406100214"],"award-info":[{"award-number":["202406100214"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["j-stroke.org"],"crossmark-restriction":true},"short-container-title":["J Stroke"],"published-print":{"date-parts":[[2026,1,31]]},"abstract":"<jats:p>Background and Purpose Therapeutic target selection in noninvasive brain stimulation for poststroke motor recovery typically relies on the interhemispheric inhibition model, which is effective for mildly affected patients but offers limited benefits for severely affected individuals. The mechanisms governing recovery from moderate-to-severe stroke remain poorly understood, which hinders the development of targeted interventions.Methods We analyzed resting-state functional magnetic resonance imaging data from patients with unilateral subcortical stroke and moderate-to-severe upper limb deficits, both pre- and postintervention, along with data from healthy controls. We developed a novel dynamic lag analysis method for identifying recovery-related homotopic sensorimotor regions with altered interhemispheric interactions. To further uncover the global reorganization pathway, we developed dynamic lateralization approaches to detect large-scale functional connectivity (FC) alterations associated with the identified regions in transient lateralization states.Results Dynamic time-lag analysis revealed significantly reduced synchronized states in the homotopic dorsal premotor cortex (PMd) post-intervention compared with pre-intervention, which correlated with motor recovery. Further dynamic lateralization analysis revealed a prolonged segregation state in patients, characterized by weakened interhemispheric and strengthened intrahemispheric interactions. In this state, patients showed decreased FC in the ipsilesional PMd and increased FC in the contralesional PMd with bilateral subcortical networks. These recovery-related alterations were absent in the traditional static analysis.Conclusions Dynamic analyses targeting interhemispheric interactions are valuable for understanding neural reorganization after stroke. The diminished interactions between the homotopic PMd indicate a compensatory mechanism. Importantly, a state-dependent compensatory pathway was identified, wherein the contralesional PMd assumes the functions of the ipsilesional PMd through enhanced interactions with subcortical structures, potentially guiding more effective interventions.<\/jats:p>","DOI":"10.5853\/jos.2025.01725","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T01:56:41Z","timestamp":1767319001000},"page":"97-114","update-policy":"https:\/\/doi.org\/10.5853\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Dynamic Interactions Between Hemispheres Reveal a Compensatory Pathway for Motor Recovery in Moderate-to-Severe Subcortical 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