biostudies-literaturePark GNIBIB NIH HHSEuropean Research CouncilNIA NIH HHSWellcome Trust100942https://www.ebi.ac.uk/biostudies/studies/S-EPMC12949600biostudies-literatureUnknown8(1)<h4>Background</h4>Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.<h4>Methods</h4>In this multicohort, retrospective, observational study, we included individuals with chronicThe Lancet. Digital healthAssociations between contralesional neuroplasticity and motor impairment through deep learning-derived MRI regional brain age in chronic stroke (ENIGMA): a multicohort, retrospective, observational study.PMC12949600759370P41 EB015922093957P01 AG052350101088715U54 EB020406Schweighofer NSoekadar SRHanlon CAVecchio DLotze MKhlif MSBanaj NSeo NJPark GGeranmayeh FCramer SCHordacre BMacIntosh BJBrodtmann AWestlye LTWittenberg GFAndrushko JWBuetefisch CMFeng WWerden EErmer ERThompson PMMohamed FBDimyan MKautz SANordvik JEBorich MRBoyd LARobertson ADLiu JPiras FTavenner BPKim HLiew SLSchranz CDonnelly MRRevill KPWinstein CJConforto ABThielman GTFerris JKJahanshad NKhan MHEgorova-Brumley NSrivastava SBrown TRYu CDomin MThomopoulos SIfalseAssociations between contralesional neuroplasticity and motor impairment through deep learning-derived MRI regional brain age in chronic stroke (ENIGMA): a multicohort, retrospective, observational study.<h4>Background</h4>Stroke leads to complex chronic structural and functional brain changes that specifically affect motor outcomes. The brain predicted age difference (PAD) has emerged as a sensitive biomarker of both sensorimotor and cognitive function after stroke. Our previous study showed a higher global brain PAD associated with poorer motor function after stroke. However, the association between local stroke lesion load, regional brain age, and motor impairment is unclear. This study aimed to investigate the associations between focal lesion damage, regional brain PAD in both hemispheres, and motor outcomes in chronic stroke, and to identify key predictors of motor impairment.<h4>Methods</h4>In this multicohort, retrospective, observational study, we included individuals with chronic2026-01-01T00:00:00Z2026 Jan2026-07-16T23:24:49.613Z2026-07-12T03:11:18.925ZS-EPMC129496004157756510.1016/j.landig.2025.100942