Repetitive transcranial magnetic stimulation reveals a causal role of the human precuneus in spatial updating.

As we move through an environment, the positions of surrounding objects relative to our body constantly change, with some objects even leaving our field of view. As a consequence, maintaining orientation requires spatial updating, the continuous monitoring of self-motion cues to update external locations within an egocentric frame of reference. While previous research using functional magnetic resonance imaging has implicated the precuneus in spatial updating, direct evidence for this claim is missing. To address this important question, we applied theta burst repetitive transcranial magnetic stimulation (rTMS) over the precuneus to induce a "virtual lesion". Following stimulation, participants were tested in a large-scale virtual environment in which they had to use visual self-motion information to keep track of the position of virtual objects. Compared to sham stimulation, rTMS affected working memory traces for object locations. Critically, rTMS further impaired the ability to update these locations whenever participants experienced simulated movement. As this effect could not be explained by working memory deficits alone, we conclude that visual spatial updating relies on the construction of updated representations of egocentric object locations within the precuneus. Together, these findings establish the precuneus as performing key computations for the formation of cognitive maps.