ObjectiveTo investigate the abnormal changes of gray matter structure covariant network in post-stroke aphasia (PSA) patients. MethodsFrom June, 2019 to March, 2022, 15 PSA patients (patient group) from Dongzhimen Hospital, Beijing University of Chinese Medicine and Beijing Bo'ai Hospital were recruited, as well as 15 healthy subjects (control group). Their brain structure magnetic resonance imaging data were collected. The brain covariant network was constructed based on gray matter volume correlation, and graph theory analysis method was used to evaluate the global and node network level topology properties of structural covariant network. The differences of gray matter covariant network properties between patients and controls were compared. ResultsThere was no significant difference in the global network level topology properties between two groups (P > 0.05). At the nodal level, compared with the control group, the betweenness decreased in the right middle frontal gyrus, right posterior cingulate gyrus, right amygdala, left middle occipital gyrus, and increased in the right inferior frontal gyrus and the right suboccipital gyrus of the insula operculum (P < 0.05); the node degree decreased in the left superior frontal gyrus, left anterior cingulate and paracingulate gyrus, left hippocampus and left amygdala, while it increased in the right inferior frontal gyrus, left supplementary motor area, right superior occipital gyrus, right inferior occipital gyrus, and right lentiform pallidus (P < 0.05); the node efficiency decreased in the left anterior cingulate and paracingulate gyrus, left hippocampus, left amygdala, left temporal pole: superior temporal gyrus, and increased in the inferior frontal gyrus of right insula, left supplementary motor area and right suboccipital gyrus (P < 0.05). ConclusionThe abnormal reduction of node network properties in some brain regions in the left hemisphere of PSA patients may be a characteristic structural covariation pattern, and there may be some compensation in the right hemisphere of the structural network in some brain regions.