Neuroanatomy of space, body, and posture perception in patients with right hemisphere stroke.

OBJECTIVE

To specify the neuroanatomical correlates of biases in the representations of the gravitational vertical (subjective vertical [SV]) and body axis (subjective straight ahead [SSA]), as well as postural difficulties, in patients with hemispheric stroke.

METHODS

The analysis focused on right hemisphere lesions in 21 neglect patients and 21 non-neglect patients (using MRIcro software) and related performance in 2 experimental tasks (SV and SSA) and a clinical balance assessment. Voxel-based lesion-symptom mapping was used to highlight brain areas in which lesions best explained the severity of task biases (p < 0.01).

RESULTS

The bias in the representation of body orientation was found to be strongly related to lesions of the anterior parietal cortex and the middle part of the superior temporal gyrus. The SV errors were associated with more widespread lesions of the posterior parietal and temporal cortices. Imbalance was preferentially associated with lesions of the posterior insula and the adjacent temporoparietal cortex.

CONCLUSION

This study evidenced a cortical dissociation for body-centered and gravitational representations biases, which may reflect the differential involvement of these brain regions in spatial information processing. The lesions involved in representation biases (especially of the SV) and postural difficulties overlapped to some extent in the temporoparietal, superior temporal, and posterior insular regions of the cortex.