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\title{Dynamic interaction of the~corticospinal tract with the reticulospinal
tract across various phases of~stroke~~~}



\author[1,2,3]{Dongwon Kim}%
\author[1,2]{Leah M O'Shea}%
\author[2]{Naveed R Aghamohammadi}%
\affil[1]{Shirley Ryan AbilityLab}%
\affil[2]{Department of Biomedical Engineering, University of Illinois at Chicago}%
\affil[3]{Department of Physical Medicine and Rehabilitation, Northwestern University}%


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  \date{May 01, 2026}


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\begin{abstract}
There is a consensus that motor recovery post-stroke primarily depends
on the degree of the initial connectivity of the ipsilesional
corticospinal tract (CST). Indeed, if the residual CST connectivity is
sufficient to convey motor commands, the neuromotor system continues to
dominantly use the CST, and motor function recovers up to 80\%. In
contrast, if the residual CST connectivity is insufficient, hand/arm
dexterity barely recovers, even as the phases of stroke progress.
Instead, functional upregulation of the reticulospinal tract (RST) often
occurs. In this study, we construct a computational model that
reproduces the dependence of post-stroke motor recovery on initial CST
connectivity. The model emulates biologically plausible evolutions of
primary motor descending tracts, based on activity-dependent or
use-dependent plasticity and the preferential use of more strongly
connected neural circuits. The model replicates several segments of the
empirical evidence presented by Fugl-Meyer subscores, which presumably
change differently depending on the degree of initial CST connectivity
post-stroke, providing several insights into the interactive dynamics of
primary descending motor tracts. We discuss findings from the proposed
model along with the well-known proportional recovery rule. This
modeling study is expected to benefit the design of therapies for
post-stroke recovery.%
\end{abstract}%



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