title: Lesion sites that predict the ability to gesture how an object is used.
abstract: We used a two stage procedure to predict which stroke patients would have chronic difficulties gesturing how to use an object when object recognition and hand movements were intact. First, we searched our PLORAS database by behavior and identified 5 patients who had chronic difficulty gesturing object use but no difficulty recognising objects, comprehending words or moving their hands. High definition lesion analyses showed that all 5 patients had damage to the white matter underlying the left ventral supramarginal gyrus, (A) close to the cortex, (B) deep towards the midline and (C) extending into the temporal lobe. In addition, 2 patients had damage to (D) the left posterior middle temporal cortex, and 3 patients had damage to (E) the left dorsal supramarginal gyrus and (F) the left premotor cortex. Second, we searched our database by lesion location for patients who had damage to any part of regions ABCDEF. The incidence of gesturing difficulties was higher in patients with damage to ABCD (7/9), ABCE (7/10) or ABCDE (10/13) than ABCF (7/13), ABC (8/16) or partial damage to ABCF (6/32). Thus behaviour was best predicted by the combination of regions that were damaged (a "network-lesion") rather than on the basis of each region alone or overall lesion size. Our results identify which parts of the temporal and parietal lobes impair the ability to gesture object use and which parts need to be intact to support it after damage. Our methods provide a framework for future studies aiming to predict the consequences of brain damage.
authors.affiliation: Wellcome Trust Centre for Neuro-imaging, Institute of Neurology, University College London, UK. c.price@fil.ion.ucl.ac.uk
authors.forename: C J
authors.initials: CJ
authors.lastname: Price
authors.forename: J T
authors.initials: JT
authors.lastname: Crinion
authors.forename: A P
authors.initials: AP
authors.lastname: Leff
authors.forename: F M
authors.initials: FM
authors.lastname: Richardson
authors.forename: T M
authors.initials: TM
authors.lastname: Schofield
authors.forename: S
authors.initials: S
authors.lastname: Prejawa
authors.forename: S
authors.initials: S
authors.lastname: Ramsden
authors.forename: K
authors.initials: K
authors.lastname: Gazarian
authors.forename: M
authors.initials: M
authors.lastname: Lawrence
authors.forename: L
authors.initials: L
authors.lastname: Ambridge
authors.forename: M
authors.initials: M
authors.lastname: Andric
authors.forename: S L
authors.initials: SL
authors.lastname: Small
authors.forename: M L
authors.initials: ML
authors.lastname: Seghier
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D032882:Comprehension / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005868:Gestures; D006225:Hand / Q000294:innervation; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000473:pathology*; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D020521:Stroke / Q000150:complications / Q000473:pathology*
chemical_list: D010100:Oxygen