title: Common and distinct neural mechanisms of visual and tactile extinction: A large scale VBM study in sub-acute stroke.
abstract: Extinction is diagnosed when patients respond to a single contralesional item but fail to detect this item when an ipsilesional item is present concurrently. Extinction has been studied mainly in the visual modality but it occurs also in other sensory modalities (touch, audition) and hence can be considered a multisensory phenomenon. The functional and neuroanatomical relations between extinction in different modalities are poorly understood. Here, we used voxel-based mophometry (VBM) to examine the neuronal substrates of visual versus tactile extinction in a large group of sub-acute patients (n = 454) with strokes affecting different vascular territories. We found that extinction deficits in tactile and visual modalities were significantly correlated (r = 0.341; p < 0.01). Several lesions within the right hemisphere were linked to extinction including the inferior parietal lobule, the superior parietal lobule, the middle frontal and occipital gyri, while lesions involving the superior temporal gyrus, inferior temporal gyrus and putamen were associated with tactile extinction. Damage within the middle temporal gyrus and superior temporal sulcus was linked to both deficits. We conclude that extinction in different modalities emerges after damage to both common (supra-modal) and distinct (modality specific) brain regions, and that contrasting sites emerge after damage to different vascular territories. We discuss the implications for understanding extinction as a multisensory disorder.
authors.affiliation: Department of Experimental Psychology, University of Oxford, 9 South Parks Road, Oxford, OX1 3UD, UK ; Behavioural Brain Sciences Centre, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Chechlacz
authors.forename: Anna
authors.initials: A
authors.lastname: Terry
authors.forename: Nele
authors.initials: N
authors.lastname: Demeyere
authors.forename: Hassan
authors.initials: H
authors.lastname: Douis
authors.forename: Wai-Ling
authors.initials: WL
authors.lastname: Bickerton
authors.forename: Pia
authors.initials: P
authors.lastname: Rotshtein
authors.forename: Glyn W
authors.initials: GW
authors.lastname: Humphreys
keywords: Stroke; Tactile extinction; Visual extinction; Voxel-based morphometry