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Purpose In this study, we aimed to develop a nonhuman primate (NHP) stroke model for remote lesion studies and characterize its behavioral and neuroimaging features.Methods Seventeen cynomolgus monkeys were subjected to middle cerebral artery occlusion (MCAO) just distal to the M1 branch.Seven monkeys were included in the sham-operated group underwent the same procedure without MCAO.Neurological assessment and magnetic resonance imaging (MRI) and angiography were performed before and 1 week after operation.Results In the MCAO group, 6 monkeys showed occlusion of the distal M1 segment and infarcts (average infarct volume : 24.7 + 2.1%) predominantly in the cortical and subcortical regions with no hippocampal and thalamic involvement.These animals displayed obvious neurological deficits (mean neurological score: 41 ± 2).In the other 11 monkeys, the main trunk of the MCA was blocked, and there were larger infarcts (average infarct volume : 31.5 + 2.0%) primarily in the basal ganglia and subcortical areas with partial hippocampal and thalamic involvement; the substantia nigra was not affected.These monkeys exhibited more severe neurological impairments (mean neurological score: 50-+ 2).All sham-operated monkeys displayed normal behavior, but MRI revealed small cortical infarcts in three of them.Conclusions MCAO or even a sham operation might cause cerebral infarction in NHP.Therefore, neurological assessment may not be reliable for screening an eligible NHP stroke model, but MRI can serve as a confirmative approach.Our model is suitable for studying secondary cerebral infarction damage in remote regions, including the thalamus, hippocampus, and substantia nigra.