Clinical recovery from stroke lesions and related outcomes

•Prognosis of motor function in patients with stroke was related to injury in several white matter areas.•Injury of caudate nucleus associated with recovery of gait as a pattern generator.•Rehabilitation strategies should be differently conducted, based on stroke lesion.

Stroke lesions affect neurological status and are a critical determinant of treatment. This study investigated stroke lesions in terms of clinical recovery and related outcomes. Twenty-seven stroke patients were assessed via longitudinal observational study. Brain lesions were evaluated using MRI. The Fugl-Meyer Assessment and clinical evaluations were performed monthly between 1 and 6 months after onset. The anterior limb (ICAL) and genu (ICG) of the internal capsule were associated with recovery of the upper limbs in chronic stroke patients. Involvement of the anterior half of the middle third of the corona radiata, the ICAL, the ICG, and the caudate nucleus were related to recovery of the lower limbs. Involvement of the middle third of the corona radiata, the ICAL, the ICG, and the lentiform nucleus were associated with sensory recovery. Clinical recovery from stroke, in terms of motor and sensory function, was related to injury in several white matter areas, such as the corona radiata and internal capsule, and was also associated with the basal ganglia as a gait pattern generator. Clinicians should be aware of stroke lesions, and should design therapeutic strategies accordingly, also with respect to treatment duration.