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The neuroanatomy of spatial awareness: a large-scale region-of-interest and voxel-based anatomical study

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Abstract

Lesion-symptom studies of spatial neglect and the attention deficits associated with this disorder draw a complex picture of the brain areas involved in spatial awareness. Several cortical regions and fiber tracts have been identified as predictors of behavioral performance, a pattern reflecting the large degree of methodological variance and modest sample sizes of many studies. Here, we examined the anatomical predictors of deficits of spatial exploration, reading and line bisection in 134 unselected stroke patients with post-acute, right-hemispheric brain injury. In order to neutralize shortcomings of traditional lesion-symptom analyses we used several methodological approaches: voxel-based lesion-symptom mapping focusing on binary groups or continuous performance measures, region-of-interest analyses and a ‘minimal-lesion’ method, comparing patients with highly selective deficits to specific brain areas. All four approaches converged on the central role of the right temporo-parietal junction and frontoparietal connections conveyed through the superior longitudinal fasciculus for contralateral deployment of attention and detection of task-relevant stimuli.

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References

  • Azouvi, P., Samuel, C., Louis-Dreyfus, A., Bernati, T., Bartolomeo, P., Beis, J.-M., ... Rousseaux, M. (2002). Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 160–166.

  • Baas, U., de Haan, B., Grassli, T., Karnath, H. O., Mueri, R., Perrig, W. J., . . . Gutbrod, K. (2011). Personal neglect-a disorder of body representation? Neuropsychologia, 49(5), 898–905. doi:https://doi.org/10.1016/j.neuropsychologia.2011.01.043.

  • Bartolomeo, P., Thiebaut de Schotten, M., & Doricchi, F. (2007). Left unilateral neglect as a disconnection syndrome. Cerebral Cortex, 17, 2479–2490.

    Article  Google Scholar 

  • Bartolomeo, P., Thiebaut de Schotten, M., & Chica, A. B. (2012). Brain networks of visuospatial attention and their disruption in visual neglect. Frontiers in Human Neuroscience, 6, 110. https://doi.org/10.3389/fnhum.2012.00110.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bates, E., Wilson, S. M., Saygin, A. P., Dick, F., Sereno, M. I., Knight, R. T., & Dronkers, N. F. (2003). Voxel-based lesion-symptom mapping. Nature Neuroscience, 6(5), 448–450. https://doi.org/10.1038/nn1050.

    Article  CAS  PubMed  Google Scholar 

  • Binder, J., Marshall, R., Lazar, R., Benhamin, J., & Mohr, J. P. (1992). Distinct syndromes of hemineglect. Archives of Neurology, 49(11), 1187–1194.

    Article  CAS  Google Scholar 

  • Buxbaum, L. J., Ferraro, M. K., Veramonti, T., Farne, A., Whyte, J., Ladavas, E., . . . Coslett, H. B. (2004). Hemispatial neglect: Subtypes, neuroanatomy, and disability. Neurology, 62(5), 749–756.

  • Carter, R. M., & Huettel, S. A. (2013). A nexus model of the temporal-parietal junction. Trends in Cognitive Sciences, 17(7), 328–336. https://doi.org/10.1016/j.tics.2013.05.007.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carter, A. R., McAvoy, M. P., Siegel, J. S., Hong, X., Astafiev, S. V., Rengachary, J., . . . Corbetta, M. (2017). Differential white matter involvement associated with distinct visuospatial deficits after right hemisphere stroke. Cortex, 88, 81–97. https://doi.org/10.1016/j.cortex.2016.12.009.

  • Chechlacz, M., Rotshtein, P., Bickerton, W. L., Hansen, P. C., Deb, S., & Humphreys, G. W. (2010). Separating neural correlates of allocentric and egocentric neglect: Distinct cortical sites and common white matter disconnections. Cognitive Neuropsychology, 27(3), 277–303.

    Article  Google Scholar 

  • Chechlacz, M., Rotshtein, P., & Humphreys, G. W. (2012). Neuroanatomical dissections of unilateral visual neglect symptoms: ALE meta-analysis of lesion-symptom mapping. Frontiers in Human Neuroscience, 6, 230.

    Article  Google Scholar 

  • Committeri, G., Pitzalis, S., Galati, G., Patria, F., Pelle, G., Sabatini, U., et al. (2007). Neural bases of personal and extrapersonal neglect in humans. Brain, 130, 431–441.

    Article  Google Scholar 

  • Corbetta, M., & Shulman, G. L. (2011). Spatial neglect and attention networks. Annual Review of Neuroscience, 34, 569–599.

    Article  CAS  Google Scholar 

  • Corbetta, M., Ramsey, L., Callejas, A., Baldassarre, A., Hacker, C. D., Siegel, J. S., . . . Shulman, G. L. (2015). Common behavioral clusters and subcortical anatomy in stroke. Neuron, 85(5), 927–941. https://doi.org/10.1016/j.neuron.2015.02.027.

  • Coull, J. T., & Nobre, A. C. (1998). Where and when to pay attention: The neural systems for directing attention to spatial locations and to time intervals as revealed by both PET and fMRI. Journal of Neuroscience, 18(18), 7426–7435.

    Article  CAS  Google Scholar 

  • Decety, J., & Lamm, C. (2007). The role of the right temporoparietal junction in social interaction: How low-level computational processes contribute to meta-cognition. Neuroscientist, 13(6), 580–593. https://doi.org/10.1177/1073858407304654.

    Article  PubMed  Google Scholar 

  • Doricchi, F., & Tomaiuolo, F. (2003). The anatomy of neglect without hemianopia: A key role for parietal-frontal disconnection? NeuroReport, 14(17), 2239–2243.

    Article  Google Scholar 

  • Doricchi, F., Thiebaut de Schotten, M., Tomaiuolo, F., & Bartolomeo, P. (2008). White matter (dis)connections and gray matter (dys)functions in visual neglect: Gaining insights into the brain networks of spatial awareness. Cortex, 44(8), 983–995. https://doi.org/10.1016/j.cortex.2008.03.006.

    Article  PubMed  Google Scholar 

  • Fellrath, J., & Ptak, R. (2015). The role of visual saliency for the allocation of attention: Evidence from spatial neglect and hemianopia. Neuropsychologia, 73, 70–81.

    Article  Google Scholar 

  • Fellrath, J., Mottaz, A., Schnider, A., Guggisberg, A. G., & Ptak, R. (2016). Theta-band functional connectivity in the dorsal fronto-parietal network predicts goal-directed attention. Neuropsychologia, 92, 20–30. https://doi.org/10.1016/j.neuropsychologia.2016.07.012.

    Article  PubMed  Google Scholar 

  • Gauthier, L., Dehaut, F., & Joanette, Y. (1989). The bells test: A quantative and qualitative test for visual neglect. International Journal of Clinical Neuropsychology, 11(2), 49–54.

    Google Scholar 

  • Golay, L., Schnider, A., & Ptak, R. (2008). Cortical and subcortical anatomy of chronic spatial neglect following vascular damage. Behavioral and Brain Functions, 4, 43. https://doi.org/10.1186/1744-9081-4-43.

    Article  PubMed  Google Scholar 

  • He, B. J., Snyder, A. Z., Vincent, J. L., Epstein, A., Shulman, G. L., & Corbetta, M. (2007). Breakdown of functional connectivity in frontoparietal networks underlies behavioral deficits in spatial neglect. Neuron, 53, 905–918.

    Article  CAS  Google Scholar 

  • Himmelbach, M., Erb, M., & Karnath, H.-O. (2006). Exploring the visual world: The neural substrate of spatial orienting. NeuroImage, 32, 1747–1759.

    Article  Google Scholar 

  • Indovina, I., & Macaluso, E. (2007). Dissociation of stimulus relevance and saliency factors during shifts of visuospatial attention. Cerebral Cortex, 17, 1701–1711.

    Article  Google Scholar 

  • Karnath, H. O., & Rorden, C. (2012). The anatomy of spatial neglect. Neuropsychologia, 50, 1010–1017.

    Article  Google Scholar 

  • Karnath, H. O., Ferber, S., & Himmelbach, M. (2001). Spatial awareness is a function of the temporal not the posterior parietal lobe. Nature, 411(21), 950–953.

    Article  CAS  Google Scholar 

  • Karnath, H. O., Himmelbach, M., & Küker, W. (2003). The cortical substrate of visual extinction. NeuroReport, 14(3), 437–442.

    Article  Google Scholar 

  • Karnath, H. O., Fruhmann Berger, M., Küker, W., & Rorden, C. (2004). The anatomy of spatial neglect based on voxelwise statistical analysis: A study of 140 patients. Cerebral Cortex, 14, 1164–1172.

    Article  Google Scholar 

  • Karnath, H. O., Zopf, R., Johannsen, L., Fruhmann Berger, M., Nägele, T., & Klose, U. (2005). Normalized perfusion MRI to identify common areas of dysfunction: Patients with basal ganglia neglect. Brain, 128, 2462–2469.

    Article  Google Scholar 

  • Kerkhoff, G. (2001). Spatial hemineglect in humans. Progress in Neurobiology, 63, 1–27.

    Article  CAS  Google Scholar 

  • Kincade, J. M., Abrams, R. A., Astafiev, S. V., Shulman, G. L., & Corbetta, M. (2005). An event-related functional magnetic resonance imaging study of voluntary and stimulus-driven orienting of attention. Journal of Neuroscience, 25(18), 4593–4604. https://doi.org/10.1523/JNEUROSCI.0236-05.2005.

    Article  CAS  PubMed  Google Scholar 

  • Lunven, M., Thiebaut De Schotten, M., Bourlon, C., Duret, C., Migliaccio, R., Rode, G., & Bartolomeo, P. (2015). White matter lesional predictors of chronic visual neglect: A longitudinal study. Brain, 138(Pt 3), 746–760. https://doi.org/10.1093/brain/awu389.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mah, Y.-H., Husain, M., Rees, G., & Nachev, P. (2014). Human brain lesion-deficit inference remapped. Brain, 137, 2522–2531. https://doi.org/10.1093/brain/awu164.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mars, R. B., Sallet, J., Schüffelgen, U., Jbabdi, S., Toni, I., & Rushworth, M. F. S. (2012). Connectivity-based subdivisions of the human right "temporoparietal junction area": Evidence for different areas participating in different cortical networks. Cerebral Cortex, 22, 1894–1903.

    Article  Google Scholar 

  • Medina, J., Kannan, V., Pawlak, M. A., Kleinman, J. T., Newhart, M., Davis, C., . . . Hillis, A. E. (2009). Neural substrates of visuospatial processing in distinct reference frames: Evidence from unilateral spatial neglect. Journal of Cognitive Neuroscience, 21(11), 2073–2084. https://doi.org/10.1162/jocn.2008.21160.

  • Medina, J., Kimberg, D. Y., Chatterjee, A., & Coslett, H. B. (2010). Inappropriate usage of the Brunner-Munzel test in recent voxel-based lesion-symptom mapping studies. Neuropsychologia, 48(1), 341–343. https://doi.org/10.1016/j.neuropsychologia.2009.09.016.

    Article  PubMed  PubMed Central  Google Scholar 

  • Molenberghs, P., & Sale, M. V. (2011). Testing for spatial neglect with line bisection and target cancellation: Are both tasks really unrelated? PLoS One, 6(7), e23017. https://doi.org/10.1371/journal.pone.0023017.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Molenberghs, P., Sale, M. V., & Mattingley, J. B. (2012). Is there a critical lesion site for unilateral spatial neglect? A meta-analysis using activation likelihood estimation. Frontiers in Human Neuroscience, 6, 78.

    Article  Google Scholar 

  • Mort, D. J., Malhotra, P., Mannan, S. K., Rorden, C., Pambakian, A., Kennard, C., & Husain, M. (2003). The anatomy of visual neglect. Brain, 126, 1986–1997.

    Article  Google Scholar 

  • Nachev, P., Coulthard, E., Jager, H. R., Kennard, C., & Husain, M. (2008). Enantiomorphic normalization of focally lesioned brains. NeuroImage, 39(3), 1215–1226. https://doi.org/10.1016/j.neuroimage.2007.10.002.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pedrazzini, E., & Ptak, R. (2019). Damage to the right temporoparietal junction, but not lateral prefrontal or insular cortex, amplifies the role of goal-directed attention. Scientific Reports, 9(1), 306. https://doi.org/10.1038/s41598-018-36537-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pedrazzini, E., Schnider, A., & Ptak, R. (2017). A neuroanatomical model of space-based and object-centered processing in spatial neglect. Brain Structure and Function, 222, 3605–3613. https://doi.org/10.1007/s00429-017-1420-4.

    Article  PubMed  Google Scholar 

  • Price, C. J., & Friston, K. J. (2002). Degeneracy and cognitive anatomy. Trends in Cognitive Sciences, 6(10), 416–421.

    Article  Google Scholar 

  • Ptak, R., & Fellrath, J. (2013). Spatial neglect and the neural coding of attentional priority. Neuroscience and Biobehavioral Reviews, 37(4), 705–722. https://doi.org/10.1016/j.neubiorev.2013.01.026.

    Article  PubMed  Google Scholar 

  • Ptak, R., & Schnider, A. (2010). The dorsal attention network mediates orienting toward behaviorally relevant stimuli in spatial neglect. Journal of Neuroscience, 30(38), 12557–12565. https://doi.org/10.1523/JNEUROSCI.2722-10.2010.

    Article  CAS  PubMed  Google Scholar 

  • Ptak, R., & Schnider, A. (2011). The attention network of the human brain: Relating structural damage associated with spatial neglect to functional imaging correlates of spatial attention. Neuropsychologia, 49(11), 3063–3070. https://doi.org/10.1016/j.neuropsychologia.2011.07.008.

    Article  PubMed  Google Scholar 

  • Ptak, R., Schnider, A., Golay, L., & Müri, R. (2007). A non-spatial bias favouring fixated stimuli revealed in patients with spatial neglect. Brain, 130(12), 3211–3222.

    Article  Google Scholar 

  • Ptak, R., Di Pietro, M., & Schnider, A. (2012). The neural correlates of object-centered processing in reading: A lesion study of neglect dyslexia. Neuropsychologia, 50(6), 1142–1150. https://doi.org/10.1016/j.neuropsychologia.2011.09.36.

    Article  PubMed  Google Scholar 

  • Ringman, J. M., Saver, J. L., Woolson, R. F., Clarke, W. R., & Adams, H. P. (2004). Frequency, risk factors, anatomy, and course of unilateral neglect in an acute stroke cohort. Neurology, 63, 468–474.

    Article  CAS  Google Scholar 

  • Rojkova, K., Volle, E., Urbanski, M., Humbert, F., Dell'Acqua, F., & Thiebaut de Schotten, M. (2016). Atlasing the frontal lobe connections and their variability due to age and education: A spherical deconvolution tractography study. Brain Structure and Function, 221(3), 1751–1766. https://doi.org/10.1007/s00429-015-1001-3.

    Article  CAS  PubMed  Google Scholar 

  • Ronchi, R., Algeri, L., Chiapella, L., Spada, S., & Vallar, G. (2012). Spatial neglect and perseveration in visuomotor exploration. Neuropsychology, 26(5), 588–603.

    Article  Google Scholar 

  • Rorden, C., Karnath, H.-O., & Bonilha, L. (2007). Improving lesion-symptom mapping. Journal of Cognitive Neuroscience, 19(7), 1081–1088.

    Article  Google Scholar 

  • Rorden, C., Bonilha, L., Fridriksson, J., Bender, B., & Karnath, H. O. (2012). Age-specific CT and MRI templates for spatial normalization. NeuroImage, 61(4), 957–965. https://doi.org/10.1016/j.neuroimage.2012.03.020.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rousseaux, M., Allart, E., Bernati, T., & Saj, A. (2015). Anatomical and psychometric relationships of behavioral neglect in daily living. Neuropsychologia, 70, 64–70. https://doi.org/10.1016/j.neuropsychologia.2015.02.011.

    Article  PubMed  Google Scholar 

  • Saxe, R., & Kanwisher, N. (2003). People thinking about thinking people. The role of the temporo-parietal junction in "theory of mind". NeuroImage, 19(4), 1835–1842.

    Article  CAS  Google Scholar 

  • Shinoura, N., Suzuki, Y., Yamada, R., Tabei, Y., Saito, K., & Yagi, K. (2009). Damage to the right superior longitudinal fasciculus in the inferior parietal lobe plays a role in spatial neglect. Neuropsychologia, 47(12), 2600–2603.

    Article  CAS  Google Scholar 

  • Shulman, G. L., Astafiev, S. V., Franke, D., Pope, D. L., Snyder, A. Z., McAvoy, M. P., & Corbetta, M. (2009). Interaction of stimulus-driven reorienting and expectation in ventral and dorsal frontoparietal and basal ganglia-cortical networks. Journal of Neuroscience, 29(14), 4392–4407. https://doi.org/10.1523/JNEUROSCI.5609-08.2009.

    Article  CAS  PubMed  Google Scholar 

  • Sperber, C., & Karnath, H. O. (2017). Impact of correction factors in human brain lesion-behavior inference. Human Brain Mapping, 38(3), 1692–1701. https://doi.org/10.1002/hbm.23490.

    Article  PubMed  Google Scholar 

  • Sperber, C., & Karnath, H. O. (2018). On the validity of lesion-behaviour mapping methods. Neuropsychologia, 115, 17–24. https://doi.org/10.1016/j.neuropsychologia.2017.07.035.

    Article  PubMed  Google Scholar 

  • Sperber, C., Wiesen, D., & Karnath, H. O. (2019). An empirical evaluation of multivariate lesion behaviour mapping using support vector regression. Human Brain Mapping, 40(5), 1381–1390. https://doi.org/10.1002/hbm.24476.

    Article  PubMed  Google Scholar 

  • Suchan, J., Umarova, R., Schnell, S., Himmelbach, M., Weiller, C., Karnath, H. O., & Saur, D. (2014). Fiber pathways connecting cortical areas relevant for spatial orienting and exploration. Human Brain Mapping, 35(3), 1031–1043. https://doi.org/10.1002/hbm.22232.

    Article  PubMed  Google Scholar 

  • Thiebaut de Schotten, M., Urbanski, M., Duffau, H., Volle, E., Lévy, R., Dubois, B., & Bartolomeo, P. (2005). Direct evidence for a parietal-frontal pathway subserving spatial awareness in humans. Science, 309, 2226–2228.

    Article  CAS  Google Scholar 

  • Thiebaut de Schotten, M., Dell'Acqua, F., Forkel, S. J., Simmons, A., Vergani, F., Murphy, D. G., & Catani, M. (2011). A lateralized brain network for visuospatial attention. Nature Neuroscience, 14(10), 1245–1246. https://doi.org/10.1038/nn.2905.

    Article  CAS  PubMed  Google Scholar 

  • Thiebaut de Schotten, M., Tomaiuolo, F., Aiello, M., Merola, S., Silvetti, M., Lecce, F., . . . Doricchi, F. (2014). Damage to white matter pathways in subacute and chronic spatial neglect: A group study and 2 single-case studies with complete virtual "in vivo" Tractography dissection. Cerebral Cortex, 24(3), 691–706. https://doi.org/10.1093/cercor/bhs351.

  • Toba, M. N., Zavaglia, M., Rastelli, F., Valabregue, R., Pradat-Diehl, P., Valero-Cabre, A., & Hilgetag, C. C. (2017). Game theoretical mapping of causal interactions underlying visuo-spatial attention in the human brain based on stroke lesions. Human Brain Mapping, 38, 3454–3471. https://doi.org/10.1002/hbm.23601.

    Article  PubMed  PubMed Central  Google Scholar 

  • Umarova, R. M., Reisert, M., Beier, T. U., Kiselev, V. G., Kloppel, S., Kaller, C. P., . . . Weiller, C. (2014). Attention-network specific alterations of structural connectivity in the undamaged white matter in acute neglect. Human Brain Mapping, 35(9), 4678–4692. https://doi.org/10.1002/hbm.22503.

  • Urbanski, M., Thiebaut de Schotten, M., Rodrigo, S., Oppenheim, C., Touze, E., Meder, J. F., . . . Bartolomeo, P. (2011). DTI-MR tractography of white matter damage in stroke patients with neglect. Experimental Brain Research, 208(4), 491–505. https://doi.org/10.1007/s00221-010-2496-8.

  • Vallar, G. (2001). Extrapersonal visual unilateral spatial neglect and its neuroanatomy. NeuroImage, 14, S52–S58.

    Article  CAS  Google Scholar 

  • Vallar, G., Bello, L., Bricolo, E., Castellano, A., Casarotti, A., Falini, A., . . . Papagno, C. (2014). Cerebral correlates of visuospatial neglect: A direct cerebral stimulation study. Human Brain Mapping, 35(4), 1334–1350. https://doi.org/10.1002/hbm.22257.

  • Verdon, V., Schwartz, S., Lovblad, K. O., Hauert, C. A., & Vuilleumier, P. (2010). Neuroanatomy of hemispatial neglect and its functional components: A study using voxel-based lesion-symptom mapping. Brain, 133(Pt 3), 880–894. https://doi.org/10.1093/brain/awp305.

    Article  PubMed  Google Scholar 

  • Wiesen, D., Sperber, C., Yourganov, G., Rorden, C., & Karnath, H. O. (2019). Using machine learning-based lesion behavior mapping to identify anatomical networks of cognitive dysfunction: Spatial neglect and attention. NeuroImage, 201. https://doi.org/10.1016/j.neuroimage.2019.07.013.

  • Zimmermann, P., & Fimm, B. (2010). TAP. Tests d'Evaluation de l'Attention. Herzogenrath, Germany: Psytest.

    Google Scholar 

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Funding

This study was funded by grants from the Swiss National Science Foundation (No. 320030-152689) and the Novartis Foundation (No. 16C183).

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Correspondence to Radek Ptak.

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Pedrazzini, E., Ptak, R. The neuroanatomy of spatial awareness: a large-scale region-of-interest and voxel-based anatomical study. Brain Imaging and Behavior 14, 615–626 (2020). https://doi.org/10.1007/s11682-019-00213-5

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