Deficits in the ability to draw objects, despite apparently intact perception and motor abilities, are defined as constructional apraxia. Constructional deficits, often diagnosed based on performance on copying complex figures, have been reported in a range of pathologies, perhaps reflecting the contribution of several underlying factors to poor figure drawing. The current study provides a comprehensive analysis of brain-behavior relationships in drawing disorders based on data from a large cohort of subacute stroke patients (n = 358) using whole-brain voxel-wise statistical analyses linked to behavioral measures from a complex figure copy task. We found that (i) overall poor performance on figure copying was associated with subcortical lesions (BG and thalamus), (ii) lateralized deficits with respect to the midline of the viewer were associated with lesions within the posterior parietal lobule, and (iii) spatial positioning errors across the entire figure were associated with lesions within visual processing areas (lingual gyrus and calcarine) and the insula. Furthermore, deficits in reproducing global aspects of form were associated with damage to the right middle temporal gyrus, whereas deficits in representing local features were linked to the left hemisphere lesions within calcarine cortex (extending into the cuneus and precuneus), the insula, and the TPJ. The current study provides strong evidence that impairments in separate cognitive mechanisms (e.g., spatial coding, attention, motor execution, and planning) linked to different brain lesions contribute to poor performance on complex figure copying tasks. The data support the argument that drawing depends on several cognitive processes operating via discrete neuronal networks and that constructional problems as well as hierarchical and spatial representation deficits contribute to poor figure copying.
We presented participants with a temporal order judgment (TOJ) task with vibratory stimuli presented to the ends of held tools. We manipulated whether the hands and tools were uncrossed or crossed, predicting that participants would respond more accurately if the responding body part and tool tip were in the same hemispace (see Yamamoto and Kitazawa, 2001). Participants were split into two groups (24 subjects in each group). One group responded manually with the stimulated tools, the other group responded with foot pedals. Contrasting previous findings, we found no significant effect of manipulating tool position when the hands were uncrossed, regardless of response type. Effects of response type were also observed, as participants were significantly more accurate when responding with the stimulated tools compared to responding with foot pedals. Interactions were also found between response type and sex. Compared to males, females made a substantially greater number of confusion errors when responding with feet, but not when responding with tools. Additionally, compared to males, females made substantially more confusion errors with the arms crossed, reflecting previously reported results in tactile TOJ on the hands (Cadieux et al., 2010). These results suggest potential differences in spatial mapping and tactile processing in males and females.
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