Brain-behavior correlations in hemispatial neglect using CT and SPECT

OBJECTIVE: Structural and functional lesion localization in patients with hemispatial neglect. DESIGN: Location and severity of brain damage on CT and SPECT correlated with neglect performance as assessed with a battery of drawings, line bisection, and line and shape cancellation subtests. PATIENTS: Participants included 120 consecutive stroke patients with a single right-hemisphere-damaged lesion on CT who were admitted to the Acute Stroke Care Unit at Sunnybrook Health Science Centre. Of these, 88 also had a SPECT. RESULTS: On CT, 82 patients with neglect (compared with 38 without neglect) had more extensive damage in the parietal and sensorimotor cortex and white matter fiber bundles, including the posterior-superior longitudinal and inferior-frontal fasciculi (p < 0.05). Parietal and anterior cingulate damage best predicted neglect score using the CT data (p < 0.05), and regional blood flow in the parietal cortex best predicted neglect score using the SPECT data (p < 0.05) after controlling for the influence of age and lesion size on multiple linear regression. CONCLUSIONS: Damage in the parietal and anterior cingulate cortex and posterior white matter fiber bundles correlated with hemispatial neglect. Combining structural- and functional-imaging techniques with neurobehavioral analysis can elucidate brain-behavior relationships.