Mapping delusions of space onto a structural disconnectome that decouples familiarity and place networks

Alves, Pedro Nascimento; Silva, Daniela P.; Fonseca, Ana Catarina; Martins, Isabel Pavão

doi:10.1016/j.cortex.2021.11.008

Cited by 6 publications

(5 citation statements)

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“…Interhemispheric unbalance models propose that delusional misidentifications result from right hemisphere damage and left hemisphere unleashing [6 ]. Whereas previous evidence shows that the emergence of spatial delusions is predicted by disconnection of right temporal regions 8 , 9 ], here we showed that the disconnection of left temporal regions best predicts the syndrome's duration. This result may provide structural–functional support to the role of left hemisphere dysfunction in the pathophysiology of reduplicative paramnesia 6 , 31 ].…”

Section: Discussioncontrasting

confidence: 91%

“…It has been demonstrated that delusional misidentifications are associated with structural–functional decoupling of belief and familiarity‐associated functional networks [ 9 , 21 ]. Neurosynth is a validated brain‐mapping platform that performs large‐scale automated extraction of meta‐analytic functional maps of terms of interest [22 ].…”

Section: Methodsmentioning

confidence: 99%

“…At the structural and functional levels, spatial delusions are associated with a dual pattern of structural disconnection involving right frontothalamic and right occipitotemporal circuits [ 8 ], which prompts structural–functional decoupling of belief, familiarity, and place‐associated functional networks [ 9 ]. At the clinical level, the striking incongruence between the patient's conviction and the surrounding environment may markedly disturb the patient's behavior [ 3 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical presentation and neural correlates of stroke‐associated spatial delusions

Alves

Fonseca

Pinho‐e‐Melo

et al. 2022

Euro J of Neurology

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Background and purpose: Incongruent beliefs about self-localization in space markedly disturb patients' behavior. Spatial delusions, or reduplicative paramnesias, are characterized by a firm conviction of place reduplication, transformation, or mislocation. Evidence suggests they are frequent after right hemisphere lesions, but comprehensive information about their clinical features is lacking. Methods:We prospectively screened 504 acute right-hemisphere stroke patients for the presence of spatial delusions. Their behavioral and clinical features were systematically assessed. Then, we analyzed the correlation of their duration with the magnitude of structural disruption of belief-associated functional networks. Finally, we described the syndrome subtypes and evaluated whether the clinical categorization would be predicted by the structural disruption of familiarity-associated functional networks using an unsupervised k-means clustering algorithm.Results: Sixty patients with spatial delusions were identified and fully characterized. Most (93%) localized the misidentified places closer to home than the hospital. The median time duration was 3 days (interquartile range = 1-7 days), and it was moderately correlated with the magnitude of structural-functional decoupling of belief-associated functional networks (r = 0.39, p = 0.02; beta coefficient regressing for lesion volume = 3.18, p = 0.04). Each clinical subtype had characteristic response patterns, which were reported, and representative examples were provided. Clustering based on structural disruption of familiarity-and unfamiliarity-associated functional networks poorly matched the clinical categorization (lesion: Rand index = 0.47; structural disconnection: Rand index = 0.51). Conclusions:The systematic characterization of the peculiar clinical features of strokeassociated spatial delusions may improve the syndrome diagnosis and clinical approaches.The novel evidence about their neural correlates fosters the clarification of the pathophysiology of delusional misidentifications.

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Section: Discussioncontrasting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical presentation and neural correlates of stroke‐associated spatial delusions

Alves

Fonseca

Pinho‐e‐Melo

et al. 2022

Euro J of Neurology

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“…The intricate neural networks engaged in spatial perception have been brought to light, with aberrations in the right ventrolateral prefrontal and right temporal clusters linked to spatial delusions ( 47 ). Importantly, the integral role of the left retro splenial and right frontal cortex in spatial information processing has been underscored, underlining their pivotal contribution to spatial cognition and awareness ( 48 ).…”

Section: Resultsmentioning

confidence: 99%

“…Both structural ( 51 ) and functional LNM ( 24 , 29 ) pinpointed the fronto-parieto-temporal network as integral to cognitive function, thereby asserting a potent correlation between this network and cognitive impairment. Furthermore, studies revealed that damage to the right ventrolateral prefrontal and right temporal cluster ( 47 ), coupled with alterations in the left retro splenial and right frontal cortex ( 7 ), could precipitate spatial perception deficits and engender delusions of space. Intriguingly, both functional LNM ( 54 ) and structural disconnectome-based analyses ( 57 ) associated the left dorsolateral prefrontal cortex with depression.…”

Section: Discussionmentioning

confidence: 99%

Functional and structural lesion network mapping in neurological and psychiatric disorders: a systematic review

Nabizadeh

Aarabi

2023

Front. Neurol.

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BackgroundThe traditional approach to studying the neurobiological mechanisms of brain disorders and localizing brain function involves identifying brain abnormalities and comparing them to matched controls. This method has been instrumental in clinical neurology, providing insight into the functional roles of different brain regions. However, it becomes challenging when lesions in diverse regions produce similar symptoms. To address this, researchers have begun mapping brain lesions to functional or structural networks, a process known as lesion network mapping (LNM). This approach seeks to identify common brain circuits associated with lesions in various areas. In this review, we focus on recent studies that have utilized LNM to map neurological and psychiatric symptoms, shedding light on how this method enhances our understanding of brain network functions.MethodsWe conducted a systematic search of four databases: PubMed, Scopus, and Web of Science, using the term “Lesion network mapping.” Our focus was on observational studies that applied lesion network mapping in the context of neurological and psychiatric disorders.ResultsFollowing our screening process, we included 52 studies, comprising a total of 6,814 subjects, in our systematic review. These studies, which utilized functional connectivity, revealed several regions and network overlaps across various movement and psychiatric disorders. For instance, the cerebellum was found to be part of a common network for conditions such as essential tremor relief, parkinsonism, Holmes tremor, freezing of gait, cervical dystonia, infantile spasms, and tics. Additionally, the thalamus was identified as part of a common network for essential tremor relief, Holmes tremor, and executive function deficits. The dorsal attention network was significantly associated with fall risk in elderly individuals and parkinsonism.ConclusionLNM has proven to be a powerful tool in localizing a broad range of neuropsychiatric, behavioral, and movement disorders. It holds promise in identifying new treatment targets through symptom mapping. Nonetheless, the validity of these approaches should be confirmed by more comprehensive prospective studies.

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Disconnection Syndromes

Mendez

2024

Reference Module in Neuroscience and Biobehavioral Psychology

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Mapping delusions of space onto a structural disconnectome that decouples familiarity and place networks

Cited by 6 publications

References 48 publications

Clinical presentation and neural correlates of stroke‐associated spatial delusions

Clinical presentation and neural correlates of stroke‐associated spatial delusions

Functional and structural lesion network mapping in neurological and psychiatric disorders: a systematic review

Disconnection Syndromes

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