Lesions Responsible for Impaired Visual Perception in Poststroke Patients Using Voxel-Based Lesion Symptom Mapping

We aimed to clarify the clinical characteristics that affect visual perception (VP) and elucidate lesion locations correlated with impaired VP. We reviewed 61 patients with stroke. Clinical assessments of a motor-free VP test were used to evaluate VP after stroke. Regression analyses were performed to examine predictors of impaired VP. We generated statistical maps of lesions related to impaired VP using voxel-based lesion symptom mapping (VLSM). The group of patients who had right hemispheric lesions had significantly low VP function. In a regression model, impaired VP was predicted by cognitive function, age, lesion volume, and right hemispheric lesion. Using VLSM, we found lesion location associated with impaired VP after adjusting for age, lesion volume, and Korean version of mini mental status exam. The results showed a lesion pattern with predominant distribution in the right parietal lobe and deep white matter. Age, lesion volume, and cognitive impairment affected the results of VP tests. Even after adjustments, we found that lesions responsible for impaired VP were located in the right parietal lobe and deep white matter. This result confirmed right hemispheric dominance for VP using VLSM. Clin. Anat. 32:689-696, 2019. (c) 2019 Wiley Periodicals, Inc.