LAUSR

Stroke recovery with changes in volume and perfusion of grey matter (GM) tissues remains largely unknown. We hypothesized that GM atrophy co‐existed with GM plasticity presenting with increased volume and perfusion in specific regions in the period of post‐stroke recovery. Twelve well‐recovered stroke patients with pure subcortical lesions in the middle cerebral artery‐perfused zone were included. All of them underwent structural and perfusion magnetic resonance imaging (MRI) examinations at admission and a mean of 6 months after stroke onset. Differences in GM volume (GMV) on structural images and cerebral blood flow (CBF) derived from perfusion images between two examinations were compared using voxel‐based morphometry. The associations between changes in GMV and CBF with clinical scores were analysed. Decreased GMV was found in post‐central gyrus, pre‐central gyrus, precuneus, angular gyrus, insula, thalamus and cerebellum, and increased GMV was found in hippocampus, orbital gyrus and lingual gyrus (all corrected P < 0.05) at the follow‐up examination. Increased CBF was found in subcallosal cingulate gyrus, hippocampus and lingual gyrus (all corrected P < 0.05) at the follow‐up examination. Only decreased GMV in the anterior lobe of cerebellum was negatively associated with improvement of Barthel index (β = −0.683, P = 0.014). Our study provides the imaging evidence of GM atrophy co‐existing with GM plasticity involving in increased volume and perfusion in specific regions (including cognition, vision and emotion) in well‐recovered stroke patients, which advances our understanding of neurobiology of stroke recovery.