Targeting Brain Networks for Recovery: Multimodal Innovations in Poststroke Therapy.

Abstract

Stroke disrupts brain networks across multiple spatiotemporal scales, producing structural and functional deficits that extend beyond focal injury. Peri-infarct networks are particularly vulnerable yet provide a foundation for neurological recovery driven by neuroplasticity mechanisms, including synaptic remodeling, axonal sprouting, and neuronal network reorganization. This review highlights emerging therapeutic strategies aimed at targeting these networks. Nanomedicine, biomaterials, and biologically driven systems enable the precise delivery of agents, neurotrophic factors, and genetic modulators to enhance and induce plasticity. In parallel, noninvasive neuro-stimulation approaches offer complementary, network-specific modulation that can be synergized with drugs or biomaterial platforms. Finally, advances in artificial intelligence and machine learning are driving precision, feedback-driven interventions that align therapeutics with the dynamic trajectory of poststroke network reorganization.