Voxel-based lesion–symptom mapping


For more than a century, lesion–symptom mapping studies have yielded valuable insights into the relationships between brain and behavior, but newer imaging techniques have surpassed lesion analysis in examining functional networks. Here we used a new method—voxel-based lesion–symptom mapping (VLSM)—to analyze the relationship between tissue damage and behavior on a voxel-by-voxel basis, as in functional neuroimaging. We applied VLSM to measures of speech fluency and language comprehension in 101 left-hemisphere-damaged aphasic patients: the VLSM maps for these measures confirm the anticipated contrast between anterior and posterior areas, and they also indicate that interacting regions facilitate fluency and auditory comprehension, in agreement with findings from modern brain imaging.

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Figure 1: Representative slices from VLSM maps computed for fluency and auditory comprehension performance of 101 aphasic stroke patients.
Figure 2: Representative slices from maps of voxel-by-voxel ANCOVAs covarying out particular anatomically defined voxels of interest.


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The authors thank D.P. Wilkins and C. Ludy for comments, suggestions and assistance. This work was funded by the Department of Veterans Affairs Medical Research, the National Institute of Neurological Disorders and Stroke (PO1 NS17778, NINDS 21135, PO1 NS40813) and the National Institute of Deafness and Communication Disorders (NIH/NIDCD 2 R01 DC00216).

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Correspondence to Nina F. Dronkers.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Fig. 1.

Methods for comparing VLSM maps. (a) A scatterplot of the correlation between fluency and comprehension t-scores, with voxels treated as subjects (r = 0.59). (b) Differences between the t-statistics for each of the tasks. The color codes are common across both panels, showing differences between t-scores. Red, voxels more important for fluency; blue, voxels more important for comprehension; green, voxels that were roughly equally relevant for both tasks. Faded colors denote lack of relevance to either measure. (JPG 55 kb)

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Bates, E., Wilson, S., Saygin, A. et al. Voxel-based lesion–symptom mapping. Nat Neurosci 6, 448–450 (2003). https://doi.org/10.1038/nn1050

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