title: The anatomy of visuospatial construction revealed by lesion-symptom mapping.
abstract: 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.
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands. Electronic address: J.M.Biesbroek@umcutrecht.nl.
authors: J Matthijs
authors: JM
authors: Biesbroek
authors: Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands.
authors: Martine J E
authors: MJ
authors: van Zandvoort
authors: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Hugo J
authors: HJ
authors: Kuijf
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands.
authors: Nick A
authors: NA
authors: Weaver
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands.
authors: L Jaap
authors: LJ
authors: Kappelle
authors: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Pieter C
authors: PC
authors: Vos
authors: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Birgitta K
authors: BK
authors: Velthuis
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands.
authors: Geert Jan
authors: GJ
authors: Biessels
authors: Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, PO box 85500, G.03.232, 3508 GA Utrecht, The Netherlands; Experimental Psychology, Helmholtz Institute, Utrecht University, The Netherlands.
authors: Albert
authors: A
authors: Postma
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007600:Judgment / Q000502:physiology; 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 / Q000502:physiology*; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014795:Visual Pathways / Q000502:physiology*
keywords: Judgment of Line Orientation; Lesion studies; Lesion-symptom mapping; Rey Complex Figure; Visuospatial construction; Visuospatial perception