The anatomy of visuospatial construction revealed by lesion-symptom mapping.
Visuospatial construction is a complex cognitive operation that is composed of a purely constructional component (visuoconstruction proper), and visuoperceptive, attentional, and decision-making components. The anatomical correlates of visuospatial construction and its cognitive subcomponents are poorly understood. The purpose of the present study was to determine the anatomical correlates of visuospatial construction by applying lesion-symptom mapping in a cohort of 111 patients with first-ever ischemic stroke. We employed the Rey-Osterrieth Complex Figure (ROCF) copy test and the Judgment of Line Orientation (JLO); both tests measure visuoperception, while only the ROCF has a constructional component. We first performed assumption-free voxel-based lesion-symptom mapping, which revealed large shared right hemispheric correlates for the ROCF and JLO in the frontal lobe, superior temporal lobe, and supramarginal gyrus. These shared anatomical correlates reflect the visuoperceptive component of the ROCF and JLO. Anatomical correlates were discordant in the right superior parietal lobule, and angular and middle occipital gyri: lesions in these regions were associated with poor performance on the ROCF, but not the JLO. Secondly, these findings were reproduced with a region of interest-based analysis that yielded a statistically significant correlation between infarct volume in the right inferior and superior parietal, angular and middle occipital cortices, and poor performance on the ROCF, but not the JLO. This discordance in anatomical correlates of the ROCF and JLO reflects the visuoconstructive component of the ROCF. These findings provide new insights in the anatomical correlates of the visuoperceptive and visuoconstructive components of the ROCF and provide evidence for a crucial role of the right inferior and superior parietal, angular and middle occipital gyri in visuoconstruction proper.
['Biesbroek|J Matthijs|JM|', 'van Zandvoort|Martine J E|MJ|', 'Kuijf|Hugo J|HJ|', 'Weaver|Nick A|NA|', 'Kappelle|L Jaap|LJ|', 'Vos|Pieter C|PC|', 'Velthuis|Birgitta K|BK|', 'Biessels|Geert Jan|GJ|', 'Postma|Albert|A|', '|||']
D000328:Adult D000368:Aged D001921:Brain D001931:Brain Mapping D005260:Female D007839:Functional Laterality D006801:Humans D007600:Judgment D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009483:Neuropsychological Tests D009949:Orientation D010775:Photic Stimulation D012372:ROC Curve D012189:Retrospective Studies D013028:Space Perception D020521:Stroke D014057:Tomography, X-Ray Computed D014795:Visual Pathways
Visuospatial construction Lesion-symptom mapping Judgment of Line Orientation Lesion studies Rey Complex Figure Visuospatial perception