Fatigue in perinatal stroke is associated with the functional connectivity of the sensorimotor network

Fatigue is prevalent in youth with perinatal stroke, but the causes are unclear. Predictive coding models of adult post-stroke fatigue suggest that fatigue may arise from dysfunction in predictive processing networks. To date, the association between fatigue and neural network connectivity in youth with perinatal stroke has not been examined. The present study examined the association between fatigue and the functional connectivity of predictive processing neural networks, measured using resting-state functional magnetic resonance imaging, in individuals with perinatal stroke. Participants who reported experiencing fatigue had weaker functional connectivity between the non-lesioned middle frontal and supramarginal gyri and between the non-lesioned intracalcarine cortex and the lesioned paracingulate cortex. In contrast, participants reporting fatigue had stronger functional connectivity between the lesioned inferior temporal gyrus and non-lesioned insula. These results suggest that fatigue in youth with hemiparetic cerebral palsy caused by perinatal stroke is associated with the functional connectivity of hubs previously associated with predictive processing and fatigue. These results suggest potential cortical and behavioral targets for the treatment of fatigue in individuals with perinatal stroke.