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Cognitive and Behavioral Disorders in Patients with Superior Parietal Lobule Infarcts

Published online by Cambridge University Press:  10 June 2022

Emre Kumral Open the ORCID record for Emre Kumral [Opens in a new window] ,
Fatma Ece Çetin  and
Hüseyin Nezih Özdemir Open the ORCID record for Hüseyin Nezih Özdemir [Opens in a new window]
Emre Kumral*
Affiliation:
Department of Neurology, Ege University, Faculty of Medicine, İzmir, Turkey
Fatma Ece Çetin
Affiliation:
Department of Neurology, Acibadem Hospital, Bursa, Turkey
Hüseyin Nezih Özdemir
Affiliation:
Department of Neurology, Ege University, Faculty of Medicine, İzmir, Turkey
*
Corresponding author: Emre Kumra, Stroke Unit, Department of Neurology, Ege University, Faculty of Medicine, Bornova, Izmir, 35100, Turkey. Email: emre.kumral@ege.edu.tr
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Abstract:

Background/Objective:

The superior parietal lobule (SPL) plays a strategic role in somatosensory and visuomotor integration. This study aims to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated SPL stroke.

Methods

We assessed neuropsychological and behavioral findings in 14 patients with isolated SPL stroke among 4200 patients with ischemic stroke. All patients underwent neuroimaging, clinical and neuropsychological assessment after stroke.

Results:

Of the 14 patients enrolled, the first complaints were tactile and visuospatial disorders at stroke onset. Except for 6 patients with only 1 cognitive impairment, the majority of patients (57%) experienced more than 1 cognitive impairment category. Functional hemispheric asymmetries have been found in different cognitive processes, such as between visuospatial and body image functions and language process. Among visuospatial abilities disorders, spatial disorientation, visuospatial neglect, and visual extinction were found in two-thirds (63%) of patients with right SPL lesion. Body schema and image disorders were observed in all patients with right-sided lesions, such as alien hand, autotopagnosia for body parts (36%), autotopagnosia for sensory sensations (36%), and fading limb (21%). Two-thirds (57%) of patients with left SPL had impairment in language abilities.

Conclusion

Our findings after stroke suggest that SPL plays a pivotal role in the regulation of visuospatial abilities, body schema and body image processing, and language skills through bilateral frontoparietal networks and interhemispheric parietal networks.

Résumé :

RÉSUMÉ :

Troubles cognitifs et comportementaux chez des patients atteints d’infarctus du lobule pariétal supérieur.

Contexte/objectif :

Le lobule pariétal supérieur (LPS) joue un rôle stratégique dans l’intégration somatosensorielle et visuomotrice. Cette étude vise à évaluer les caractéristiques cliniques, neurocognitives et comportementales de l’AVC isolé du LPS.

Méthodes :

Sur 4200 patients atteints d’un AVC ischémique, nous avons évalué les résultats neuropsychologiques et comportementaux de 14 patients atteints d’un AVC isolé du LPS. À noter que tous ces patients avaient subi une évaluation clinique, neuropsychologique et en neuro-imagerie après leur AVC.

Résultats :

Sur les 14 patients recrutés, leurs premières remarques ont porté sur des troubles tactiles et visuospatiaux au début de leur AVC. À l’exception de 6 patients ne présentant qu’un seul trouble cognitif, la majorité d’entre eux, soit 57 %, ont présenté plus d’une catégorie de troubles cognitifs. Des asymétries hémisphériques fonctionnelles ont par exemple été constatées dans le cadre de différents processus cognitifs, notamment entre les fonctions visuospatiales et d’image corporelle et le processus du langage. Parmi les troubles des capacités visuospatiales, la désorientation spatiale, la négligence visuospatiale, l’extinction visuelle ont été notées chez presque deux tiers (63 %) des patients présentant une lésion du LPS droit. Des troubles du schéma corporel et de l’image du corps ont été observés chez tous les patients présentant des lésions du côté droit, par exemple la main étrangère, l’autotopagnosie des parties du corps (36 %), l’autotopagnosie des sensations sensorielles (36 %) et l’évanouissement du membre (fading limb) (21 %). Enfin, environ deux tiers (57 %) des patients dont le LPS gauche était atteint ont présenté des troubles du langage.

Conclusion :

Ces résultats après un AVC suggèrent donc que le LPS, outre les compétences linguistiques, joue un rôle central dans la régulation des capacités visuospatiales, du schéma corporel et du traitement de l’image corporelle par l’entremise des réseaux fronto-pariétaux bilatéraux et des réseaux pariétaux inter-hémisphériques.

Keywords

Superior parietal lobuleIschemic strokeParietal arteryMemoryBody image
Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 50 , Issue 4 , July 2023 , pp. 542 - 550
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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