Connectomic Alterations Following Acute Ischemic Stroke in the MCA Territory

Inclusion Criteria: * Age \> 18 years; * Diagnosis of acute ischemic stroke with confirmed occlusion of the M1 or more distal MCA territory. * Received reperfusion therapy via mechanical thrombectomy or IV thrombolytics(Tenecteplase, or Alteplase). * Presence of a motor deficit on initial clinical exam (e.g., NIHSS \> 0) and on immediate post-intervention exam. * Patients or health-care proxy must be able to provide informed consent. * Must be able to undergo sequential MRI at Lenox Hill Hospital, including resting-state fMRI (rs-fMRI) and diffusion MRI (dMRI) for, respectively, functional, and structural connectomic analyses. Exclusion Criteria: * Age \< 17 years; * Large vessel occlusions proximal to M1 (e.g., ICA), completed M1 occlusions. * Pre-stroke Modified Rankin Scale score ≥ 3 * Known neurodegenerative disease or prior stroke affecting motor pathways. * Inability to undergo MRI due to cardiac pacemaker, claustrophobia, and metal implants that cannot be removed prior to MRI. * Pregnancy. Because of potential risk of serial MRI to fetus, women of child-bearing age require a pregnancy test at screening and agree to contraceptive practices during the study. * Poor image quality or incomplete imaging datasets.