A Stroke Changed Her Everyday Life

One evening approximately six months before seeking further treatment, an elderly woman referred to here as Mrs. Chen suddenly became dizzy and collapsed.

She was subsequently diagnosed with an ischemic stroke.

Although emergency treatment helped stabilize her condition, the neurological effects of the stroke continued to affect almost every part of her daily life.

Her right arm could not be lifted normally, and her right hand was unable to grip everyday objects. She walked unsteadily and frequently depended on family members for support. Simple activities such as dressing, eating, and moving around the home became difficult.

Her speech also became less clear, creating additional barriers when communicating with her family.

For Mrs. Chen and those caring for her, the period following the stroke was not only physically demanding but also emotionally challenging.

Many people associate stroke rehabilitation mainly with hemiplegia or weakness on one side of the body. However, the effects of a stroke can be much more complex.

Depending on the location and extent of the brain injury, patients may experience:

• Weakness or paralysis of an arm or leg
• Numbness or abnormal sensations
• Impaired balance and coordination
• Difficulty speaking or understanding language
• Problems with swallowing
• Reduced hand dexterity
• Memory or attention difficulties
• Fatigue, anxiety, or depression

Every patient presents a different combination of symptoms. For this reason, a rehabilitation program that is effective for one person may not be equally suitable for another.

This individual variation is one of the greatest challenges in post-stroke rehabilitation.

Movement is controlled by an extensive neurological network involving the cerebral cortex, deeper brain structures, the spinal cord, peripheral nerves, and muscles.

When a stroke damages part of this network, the problem may not be limited to a single muscle or limb. Communication between different brain regions can also become disrupted.

As a result, several functions may be affected simultaneously, including:

• Voluntary movement
• Postural control
• Balance
• Coordination
• Fine motor skills
• Speech and language processing

Conventional rehabilitation remains an essential part of stroke recovery. Physical therapy, occupational therapy, speech therapy, swallowing training, medication management, and secondary stroke prevention can all play important roles.

However, some patients continue to experience significant functional limitations despite undergoing standard rehabilitation.

For these patients, doctors may consider whether additional technologies could be used alongside conventional treatment.

In recent years, non-invasive brain stimulation technologies, including transcranial magnetic stimulation and transcranial electrical stimulation, have increasingly been studied as supplementary approaches for selected neurological and psychiatric conditions.

These technologies are designed to modulate the excitability and activity of specific brain networks without surgery.

One of the most important clinical questions is:

Which area of the brain should be stimulated?

The position and organization of functional brain networks can differ from one person to another. A target based only on a standard anatomical template may not precisely represent an individual patient’s functional brain organization.

This is where personalized brain mapping may offer additional value.

Near the end of the previous year, Mrs. Chen and her family visited Shulan Hangzhou Hospital to explore further rehabilitation options.

The medical team performed functional magnetic resonance imaging and individualized brain function analysis.

Using these imaging results, doctors created a personalized map of Mrs. Chen’s functional brain networks. The map was then used to help identify potential intervention targets related to her symptoms and neurological condition.

Rather than relying only on a generalized brain template, the medical team could evaluate the patient’s individual network organization and functional connectivity.

This approach may help move neuromodulation planning from experience-based target selection toward more individualized and image-guided treatment.

Mrs. Chen subsequently received a multidisciplinary rehabilitation program that incorporated individualized neuromodulation planning under medical supervision.

After approximately three months, her family reported several encouraging changes.

Her speech became clearer, making communication with family members easier. The range of movement in her right arm gradually improved, and she regained more control over forearm rotation.

Her affected leg also became stronger. Her walking posture appeared more stable, and she was eventually able to walk for short distances without continuous physical assistance from family members.

These changes represented meaningful progress for Mrs. Chen and her caregivers.

However, stroke recovery varies considerably between patients. One individual’s experience should not be interpreted as a guaranteed outcome for others. Treatment decisions must be based on the patient’s diagnosis, imaging findings, physical condition, rehabilitation stage, and medical history.

Individualized functional brain parcellation is an imaging-based method used to identify functional brain regions and networks within an individual patient’s own brain anatomy.

The process commonly uses resting-state functional magnetic resonance imaging, also known as resting-state fMRI.

Instead of assuming that every patient has identical functional boundaries, the technology analyzes the organization of brain networks at the individual level.

The resulting map can be described as a personalized brain function fingerprint.

It may allow doctors and researchers to:

• Identify individual differences in functional brain organization
• Evaluate connectivity between different brain regions
• Study abnormal neurological circuits associated with symptoms
• Select potential targets for non-invasive neuromodulation
• Improve the personalization of neurological rehabilitation planning

The technology is intended to support clinical decision-making. It does not replace neurological examinations, conventional imaging, rehabilitation assessments, or multidisciplinary medical judgment.

Functional MRI does not directly record electrical signals from individual neurons.

Instead, it measures changes associated with blood oxygen levels in different areas of the brain. This is commonly known as the blood-oxygen-level-dependent signal, or BOLD signal.

When a brain region becomes more active, local blood flow and oxygen use change. Functional MRI detects these changes and helps researchers estimate patterns of functional activity and connectivity.

Doctors can then analyze how different regions of the brain interact and whether certain functional networks appear disrupted.

For stroke patients, this information may help identify brain regions associated with motor control, language, attention, balance, or other affected functions.

The selection of a neuromodulation target is not determined by a single scan result.

Doctors may consider several factors, including:

1. The location and extent of the stroke
2. The patient’s neurological symptoms
3. Functional MRI findings
4. Connectivity between different brain regions
5. The reliability of the identified functional network
6. The physical characteristics of the stimulation technology
7. The patient’s rehabilitation goals and overall medical condition

By combining brain imaging with clinical assessment, the medical team can develop a more individualized intervention strategy.

Personalized brain mapping and image-guided neuromodulation have been investigated in several neurological and psychiatric fields.

Potential clinical or research applications include:

• Post-stroke motor dysfunction
• Post-stroke aphasia
• Depression
• Parkinson’s disease
• Alzheimer’s disease
• Chronic pain
• Post-traumatic stress disorder
• Selected neurodevelopmental conditions

The level of evidence, regulatory status, and clinical suitability differs between conditions. Some applications remain experimental or are available only in specialized clinical or research settings.

Patients should consult qualified specialists before considering these technologies.

Functional MRI and non-invasive brain stimulation have different safety requirements.

MRI-related considerations

MRI may not be suitable for certain patients with implanted electronic devices or magnetic metal components, including some:

• Cardiac pacemakers
• Cochlear implants
• Aneurysm clips
• Neurostimulators
• Metallic foreign bodies

Not all implants are prohibited. Some modern devices are MRI-conditional, meaning scanning may be possible under specific conditions. The radiology team must verify the exact implant model before examination.

Brain stimulation-related considerations

Patients with a history of epilepsy, seizures, certain brain injuries, or medications that affect seizure thresholds may require additional assessment before transcranial magnetic stimulation.

Pregnant patients and people with severe or unstable cardiovascular conditions should also receive an individualized medical evaluation.

A complete medical history and formal safety screening are essential before treatment.

Stroke rehabilitation is rarely a simple or rapid process.

For many patients, progress depends on early medical treatment, consistent rehabilitation, family support, secondary stroke prevention, and long-term follow-up.

Personalized brain mapping does not replace these foundations. Instead, it may provide doctors with additional information about how an individual patient’s functional brain networks are organized.

When appropriately combined with rehabilitation medicine and non-invasive neuromodulation, this approach may help selected patients receive more precisely targeted care.

Mrs. Chen’s experience offers hope to families facing the difficult consequences of stroke. More importantly, it highlights a broader development in neurological rehabilitation: treatment is gradually moving from standardized protocols toward strategies informed by each patient’s unique brain networks and functional needs.

Shulan Hangzhou Hospital provides multidisciplinary medical services for patients with complex neurological and rehabilitation needs.

Depending on the patient’s condition, assessment and treatment may involve specialists in:

• Neurology
• Rehabilitation medicine
• Medical imaging
• Neurosurgery
• Physical therapy
• Occupational therapy
• Speech and swallowing therapy
• Non-invasive neuromodulation

International patients considering stroke rehabilitation in China should prepare relevant medical records, including brain MRI or CT scans, hospital discharge summaries, medication lists, rehabilitation records, and recent neurological assessments.

A preliminary medical review can help determine whether further evaluation at Shulan Hangzhou Hospital may be appropriate.

This article is provided for general health education only. It does not constitute medical advice, diagnosis, treatment recommendations, or a guarantee of clinical results.

The patient story described above represents an individual experience. Recovery outcomes vary according to the type and severity of stroke, treatment timing, rehabilitation participation, age, underlying medical conditions, and many other factors.

Patients experiencing symptoms of stroke, including sudden facial weakness, arm weakness, speech difficulty, severe dizziness, loss of balance, or sudden vision changes, should seek emergency medical assistance immediately.

Treatment and rehabilitation decisions must be made by qualified healthcare professionals following an in-person medical assessment.

Source material provided by:

International Health Care Center, Shulan Hangzhou Hospital
Contributors: Zhou Sijia and Wang Xuanying