Brain-behavior correlations in hemispatial neglect using CT and SPECT: the Sunnybrook Stroke Study.
OBJECTIVE
Structural and functional lesion localization in patients with hemispatial neglect.


METHODS
Location and severity of brain damage on CT and SPECT correlated with neglect performance as assessed with a battery of drawings, line bisection, and line and shape cancellation subtests.


METHODS
Participants included 120 consecutive stroke patients with a single right-hemisphere-damaged lesion on CT who were admitted to the Acute Stroke Care Unit at Sunnybrook Health Science Centre. Of these, 88 also had a SPECT.


RESULTS
On CT, 82 patients with neglect (compared with 38 without neglect) had more extensive damage in the parietal and sensorimotor cortex and white matter fiber bundles, including the posterior-superior longitudinal and inferior-frontal fasciculi (p < 0.05). Parietal and anterior cingulate damage best predicted neglect score using the CT data (p < 0.05), and regional blood flow in the parietal cortex best predicted neglect score using the SPECT data (p < 0.05) after controlling for the influence of age and lesion size on multiple linear regression.


CONCLUSIONS
Damage in the parietal and anterior cingulate cortex and posterior white matter fiber bundles correlated with hemispatial neglect. Combining structural- and functional-imaging techniques with neurobehavioral analysis can elucidate brain-behavior relationships.
Leibovitch
F S
FS
Department of Medicine, Research Program in Aging, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
Black
S E
SE
Caldwell
C B
CB
Ebert
P L
PL
Ehrlich
L E
LE
Szalai
J P
JP
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006179:Gyrus Cinguli / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D010296:Parietal Lobe / Q000098:blood supply / Q000503:physiopathology; D010468:Perceptual Disorders / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D012737:Sex Factors; D013003:Somatosensory Cortex / Q000098:blood supply / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed