Human Lesion Studies in the 21st Century

Adolphs, Ralph

doi:10.1016/j.neuron.2016.05.014

Cited by 89 publications

(79 citation statements)

References 13 publications

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“…Examination of individuals with focal brain lesions provides evidence to draw causal links between neuroanatomy, physiology, and behavior [1, 8, 14]. We recorded 64-channel EEG in patients with discrete lateral PFC lesions to investigate the influence of PFC damage on local and long-range oscillatory activities during the encoding, maintenance, and active processing of information in working memory.…”

Section: Resultsmentioning

confidence: 99%

Bidirectional Frontoparietal Oscillatory Systems Support Working Memory

et al. 2017

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Summary The ability to represent and select information in working memory provides the neurobiological infrastructure for human cognition. For 80 years, dominant views of working memory have focused on the key role of prefrontal cortex (PFC) [1–8]. However, more recent work has implicated posterior cortical regions [9–12], suggesting that PFC engagement during working memory is dependent on the degree of executive demand. We provide evidence from neurological patients with discrete PFC damage that challenges the dominant models attributing working memory to PFC-dependent systems. We show that neural oscillations, which provide a mechanism for PFC to communicate with posterior cortical regions [13], independently subserve communications both to and from PFC – uncovering parallel oscillatory mechanisms for working memory. Fourteen PFC patients and 20 healthy, age-matched controls performed a working memory task where they encoded, maintained, and actively processed information about pairs of common shapes. In controls, the electroencephalogram (EEG) exhibited oscillatory activity in the low-theta range over PFC and directional connectivity from PFC to parieto-occipital regions commensurate with executive processing demands. Concurrent alpha-beta oscillations were observed over parieto-occipital regions, with directional connectivity from parieto-occipital regions to PFC, regardless of processing demands. Accuracy, PFC low-theta activity, and PFC ➔ parieto-occipital connectivity were attenuated in patients, revealing a PFC-independent, alpha-beta system. The PFC patients still demonstrated task proficiency, which indicates that the posterior alpha-beta system provides sufficient resources for working memory. Taken together, our findings reveal neurologically dissociable PFC and parieto-occipital systems, and suggest that parallel, bidirectional oscillatory systems form the basis of working memory.

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Section: Resultsmentioning

confidence: 99%

Bidirectional Frontoparietal Oscillatory Systems Support Working Memory

et al. 2017

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“…We anticipate the next 5 to 10 years will see a shift in neuropsychological research to meet this emphasis, for example, moving from traditionally small samples of patients with focal damage, to larger, multi-site patient samples. This shift will coincide with an increase in the use of multivariate or classifier-based approaches to examining brain-behavior interactions (Adolphs, 2016). To meet the need for larger samples, we also anticipate a shift from traditional manual lesion-mapping approaches to an increased reliance on automated or semi-automated mapping techniques.…”

Section: Predictions About Further Advancesmentioning

confidence: 99%

Neuropsychology and cognitive neuroscience in the fMRI era: A recapitulation of localizationist and connectionist views.

Sutterer¹,

Tranel²

2017

Neuropsychology

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Objective We highlight the past 25 years of cognitive neuroscience and neuropsychology, focusing on the impact to the field of the introduction in 1992 of functional magnetic resonance imaging (fMRI). Methods We reviewed the past 25 years of literature in cognitive neuroscience and neuropsychology, focusing on the relation and interplay of fMRI studies and studies utilizing the “lesion method” in human participants with focal brain damage. Results Our review highlights the state of localist/connectionist research debates in cognitive neuroscience and neuropsychology ca. 1992, and details how the introduction of fMRI into the field at that time catalyzed a new wave of efforts to map complex human behavior to specific brain regions. This, in turn, eventually evolved into many studies that focused on networks and connections between brain areas, culminating in recent years with large-scale investigations such as the Human Connectome Project. Conclusions We argue that throughout the past 25 years, neuropsychology – and more precisely, the “lesion method” in humans – has continued to play a critical role in arbitrating conclusions and theories derived from inferred patterns of local brain activity or wide-spread connectivity from functional imaging approaches. We conclude by highlighting the future for neuropsychology in the context of an increasingly complex methodological armamentarium.

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“…One point of agreement in these debates is the importance of studying patients with disrupted consciousness following focal brain lesions (Boly et al, ; Dehaene & Changeux, ). Unlike functional neuroimaging, lesion studies enable causal links between symptoms and neuroanatomy (Adolphs, ; Fox, ; Rorden & Karnath, ).…”

Section: Introductionmentioning

confidence: 99%

Cortical lesions causing loss of consciousness are anticorrelated with the dorsal brainstem

Snider

Hsu

Darby

et al. 2020

Human Brain Mapping

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Brain lesions can provide unique insight into the neuroanatomical substrate of human consciousness. For example, brainstem lesions causing coma map to a specific region of the tegmentum. Whether specific lesion locations outside the brainstem are associated with loss of consciousness (LOC) remains unclear. Here, we investigate the topography of cortical lesions causing prolonged LOC (N = 16), transient LOC (N = 91), or no LOC (N = 64). Using standard voxel lesion symptom mapping, no focus of brain damage was associated with LOC. Next, we computed the network of brain regions functionally connected to each lesion location using a large normative connectome dataset (N = 1,000). This technique, termed lesion network mapping, can test whether lesions causing LOC map to a connected brain circuit rather than one brain region. Connectivity between cortical lesion locations and an a priori coma‐specific region of brainstem tegmentum was an independent predictor of LOC (B = 1.2, p = .004). Connectivity to the dorsal brainstem was the only predictor of LOC in a whole‐brain voxel‐wise analysis. This relationship was driven by anticorrelation (negative correlation) between lesion locations and the dorsal brainstem. The map of regions anticorrelated to the dorsal brainstem thus defines a distributed brain circuit that, when damaged, is most likely to cause LOC. This circuit showed a slight posterior predominance and had peaks in the bilateral claustrum. Our results suggest that cortical lesions causing LOC map to a connected brain circuit, linking cortical lesions that disrupt consciousness to brainstem sites that maintain arousal.

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Human Lesion Studies in the 21st Century

Cited by 89 publications

References 13 publications

Bidirectional Frontoparietal Oscillatory Systems Support Working Memory

Bidirectional Frontoparietal Oscillatory Systems Support Working Memory

Neuropsychology and cognitive neuroscience in the fMRI era: A recapitulation of localizationist and connectionist views.

Cortical lesions causing loss of consciousness are anticorrelated with the dorsal brainstem

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