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February 2, 2026Journal of NeuroEngineering and RehabilitationOpen Access

Beyond proportional recovery in wake-up stroke: unsupervised recovery clusters based on the NIHSS

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Authors

AZAndrea ZanolaABAntonio Luigi BisognoVVVeronika Vadinova

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Overview

Post-stroke rehabilitation reveals varied recovery patterns in patients, suggesting new therapeutic approaches.

Key Points

  • This research aims to identify different recovery patterns in post-stroke patients using the NIHSS and clustering techniques.
  • Selected 201 patients from the WAKE-UP trial, all with moderate impairment.
  • Employed Repeated Spectral Clustering (RSC) to identify recovery patterns based on NIHSS scores.
  • Analyzed recovery ratios from 22-36 hours to 90 days post-stroke.
  • Compared clusters with factors like lesion volume, stroke side, and treatments.
  • Identified six distinct recovery clusters ranging from full recovery to deterioration.
  • Most NIHSS scores declined non-proportionally during recovery.
  • Left-sided strokes were more common in lower recovery clusters.
  • Favorable clusters were associated with a recovery ratio above average within two weeks.

Cite This Study

Zanola et al. (2026) studied this question.

synapsesocial.com/papers/6980fd60c1c9540dea80f172https://doi.org/10.1186/s12984-025-01872-w
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Beyond proportional recovery in wake-up stroke: unsupervised recovery clusters based on the NIHSS2025
  2. 2Heterogeneous Recovery Trajectories and Prognostic Factors After Ischemic Stroke2026 · 5 citations
  3. 3Abstract TP347: Sleep Regularity Index in Post-Stroke Recovery2026
  4. 4Clinical profiles and functional outcomes in elderly stroke survivors undergoing neurorehabilitation: a retrospective cohort study2024 · 5 citations
  5. 5Development of a Risk Prediction Model for Post-Stroke Functional Recovery Based on Clinical and Nursing Factors2026