title: Differential white matter involvement associated with distinct visuospatial deficits after right hemisphere stroke.
abstract: Visuospatial attention depends on the integration of multiple processes, and people with right hemisphere lesions after a stroke may exhibit severe or no visuospatial deficits. The anatomy of core components of visuospatial attention is an area of intense interest. Here we examine the relationship between the disruption of core components of attention and lesion distribution in a heterogeneous group (N = 70) of patients with right hemisphere strokes regardless of the presence of clinical neglect. Deficits of lateralized spatial orienting, measured as the difference in reaction times for responding to visual targets in the contralesional or ipsilesional visual field, and deficits in re-orienting attention, as measured by the difference in reaction times for invalidly versus validly cued targets, were measured using a computerized spatial orienting task. Both measures were related through logistic regression and a novel ridge regression method to anatomical damage measured with magnetic resonance imaging. While many regions were common to both deficit maps, a deficit in lateralized spatial orienting was more associated with lesions in the white matter underlying the posterior parietal cortex, and middle and inferior frontal gyri. A deficit in re-orienting of attention toward unattended locations was associated with lesions in the white matter of the posterior parietal cortex, insular cortex and less so with white matter involvement of the anterior frontal lobe. An hodological analysis also supports this partial dissociation between the white matter tracts that are damaged in lateralized spatial biases versus impaired re-orienting. Our results underscore that the integrity of fronto-parietal white matter tracts is crucial for visuospatial attention and that different attention components are mediated by partially distinct neuronal substrates.
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: cartera@neuro.wustl.edu.
authors.forename: Alex R
authors.initials: AR
authors.lastname: Carter
authors.affiliation: Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: McAvoy
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Siegel
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: Hong
authors.affiliation: Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Serguei V
authors.initials: SV
authors.lastname: Astafiev
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rengachary
authors.affiliation: Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Kristi
authors.initials: K
authors.lastname: Zinn
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Nicholas V
authors.initials: NV
authors.lastname: Metcalf
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Shulman
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Corbetta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008222:Lymphokines; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D000072458:Orientation, Spatial / Q000502:physiology; D010468:Perceptual Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D011930:Reaction Time / Q000502:physiology; D013028:Space Perception / Q000502:physiology*; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D014796:Visual Perception / Q000502:physiology; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D008222:Lymphokines; C035408:macrophage aggregation factor
keywords: Hemispatial neglect; Logistic regression; Stroke; Visuospatial attention; White matter