Mechanisms of motor recovery after stroke: biomarkers, plasticity, and functional outcomes

Stroke remains a leading cause of long‑term adult disability worldwide, and motor impairment is the most frequent and functionally disabling sequela. To move neurorehabilitation beyond empiricism, we invite work that defines the mechanisms by which the injured brain reorganizes and the biomarkers that reliably stratify patients, track plasticity, and predict functional gains.This Research Topic seeks mechanistic, biomarker‑driven studies that link neural plasticity to measurable motor recovery after stroke, integrating multimodal neurophysiology, imaging, and interventional approaches to predict and improve functional outcomes. Submissions should advance translational understanding from cellular and circuit mechanisms to patient‑level recovery trajectories.Recovery after stroke reflects a complex interplay of structural integrity (e.g., corticospinal tract), cortical reconfiguration, interhemispheric dynamics, and subcortical network engagement; these processes vary widely across individuals and over time. A mechanistic focus—linking synaptic, circuit, and systems‑level plasticity to behavior—will accelerate targeted, personalized interventions and improve trial design.We emphasize multimodal biomarkers that combine electrophysiology (EEG, EMG), neurostimulation metrics (TMS‑evoked MEPs), hemodynamic imaging (fNIRS, fMRI), and structural measures (DTI of CST). These modalities can be used for patient stratification, longitudinal monitoring, and mechanistic readouts of therapy‑induced plasticity. Recent evidence supports the predictive value of MRI/DTI metrics and peripheral/central biomarkers for motor outcome.We welcome studies that interrogate how neuromodulation (tDCS, rTMS), closed‑loop BCIs, FES, and robotic therapy induce specific plasticity mechanisms (e.g., Hebbian timing, synaptogenesis, axonal sprouting) and how those mechanisms mediate clinical gains. Work on closed‑loop, multimodal systems that demonstrate causal links between induced neural changes and behavioral recovery is particularly encouraged.Topics of Interest (but not limited to):● Neuroplasticity and cortical reconfiguration: Synaptic plasticity, cortical map reorganization, recruitment of nonprimary motor areas, and time‑dependent changes in network topology.● Corticospinal tract integrity and diaschisis: Quantitative DTI metrics, lesion load, motor evoked potentials, and remote functional suppression affecting recovery potential.● Multimodal biomarkers: Integrated EEG, EMG, fNIRS, fMRI, TMS, and peripheral biomarkers for stratification, longitudinal monitoring, and mechanistic readouts.● Interhemispheric dynamics and network balance: Ipsilesional versus contralesional interactions, transcallosal inhibition, and large‑scale network rebalancing.● Subcortical and cerebellar contributions: Role of basal ganglia, thalamus, and cerebellum in motor relearning and compensation.● Mechanisms of intervention‑induced plasticity: Cellular and circuit mechanisms triggered by neuromodulation, peripheral stimulation, and task‑specific training.● Technology‑driven rehabilitation mechanisms: Closed‑loop BCIs, adaptive neuromodulation, robotic assistance, functional electrical stimulation, and virtual reality mechanisms.● Dose, intensity, and timing of therapy: Dose‑response relationships, critical windows of heightened plasticity, and optimal scheduling for maximal transfer to function.● Translational and preclinical models: Linking animal models of axonal sprouting, synaptogenesis, and circuit rewiring to human biomarkers and clinical endpoints.● Machine learning and predictive modeling: Multimodal data fusion, interpretable predictive models, external validation, and individualized prognosis.● Study design and statistical methods: Adaptive trials, longitudinal mixed models, causal inference approaches, and power considerations for mechanistic endpoints.● Functional and behavioral mapping: Correlating neurophysiological and imaging changes with standardized clinical scales, performance metrics, and real‑world function.● Biological moderators of recovery: Age, genetics, inflammation, metabolic status, medications, and comorbidities that influence plasticity and outcomes.● Standardization and harmonization: Minimum data sets, acquisition protocols, quality control standards, and reporting checklists for biomarker studies.● Ethics, equity, and implementation: Access to advanced therapies, ethical considerations for neuromodulation and BCIs, and pathways for clinical translation.● Open science and data sharing: Repositories, interoperable formats, preregistration, and reproducible analysis pipelines to accelerate cumulative knowledge.We invite original research, clinical trials, systematic reviews, meta‑analyses, and methodological papers that provide mechanistic insight, validate biomarkers, or demonstrate translational impact on motor recovery.Goal: accelerate a shift to precision neurorehabilitation by defining how and for whom interventions work, using robust biomarkers and mechanistic endpoints to predict and enhance functional outcomes. Topic editors: Simone Carozzo, Noureddin Nakhostin Ansari Source: https://www.frontiersin.org/research-topics/84317/mechanisms-of-motor-recovery-after-stroke-biomarkers-plasticity-and-functional-outcomes