Abstract
BACKGROUND: Supratentorial focal lesions following ischemic stroke can lead to crossed cerebellar diaschisis (CCD). However, it remains unclear how CCD affects the functional connectivity between the cerebellum and the rest of the brain in ischemic stroke patients. METHODS: This case-control study involved resting-state fMRI data from 65 patients with basal ganglia ischemic stroke (Stroke) and 72 healthy controls (HC). Cerebral, cerebellar, and cerebrocerebellar inter-module functional connectivity in both 7-module and 17-module conditions were calculated and compared between the Stroke and HC groups. Spearman correlation analyses were further conducted to examine the relationships between connectivity alterations and both stroke severity and lesion size in Stroke patients. RESULTS: The Stroke patients exhibited disrupted inter-module functional connectivity, characterized by increased intra-hemispheric and decreased inter-hemispheric connectivity between cerebral modules, increased inter-module connectivity in the cerebellum, and reduced connectivity between ipsilesional cerebral modules and cerebellar modules while increasing connectivity between contralesional cerebral modules and cerebellar modules. Moreover, these connectivity changes, particularly disruptions in the cerebellar connectome, may be associated with lesion size and stroke severity in Stroke patients. CONCLUSIONS: These findings highlight the importance of cerebellar connectome disruptions in ischemic stroke, which may provide valuable insights into the disease's underlying brain mechanisms.