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

  • Elena Pedrazzini
  • Radek PtakEmail author
Original Research


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.


Spatial neglect Awareness Lesion mapping Anatomy Temporo-parietal junction Superior longitudinal fasciculus 



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

Compliance with ethical standards

Conflict of interest

Elena Pedrazzini and Radek Ptak declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Authors and Affiliations

  1. 1.Laboratory of Cognitive NeurorehabilitationFaculty of Medicine, University of GenevaGenevaSwitzerland
  2. 2.Division of NeurorehabilitationGeneva University HospitalGenevaSwitzerland
  3. 3.Faculty of Psychology and Educational SciencesUniversity of GenevaGenevaSwitzerland
  4. 4.Division of Neurorehabilitation, Department of Clinical NeurosciencesGeneva University HospitalsGeneva 14Switzerland

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