Differential Visuospatial Dysfunction Following Striatal, Frontal White Matter, or Posterior Thalamic Infarction

Abstract

The present study investigated visuospatial functioning in 35 right-hand dominant patients with striatal, frontal white matter, or posterior thalamic infarction, in the right cerebral hemisphere. On tasks of visual detection and discrimination, the groups performed within normal limits and comparably to one another. On tasks of visual synthesis and spatial analysis, each group was significantly impaired, with greatest impairment following infarction of deep grey structures. Correlational analyses indicated that in the striatal and frontal white matter groups, visual synthesis and spatial analysis task performance were strongly correlated with performance on neuropsychological tests of executive control. This relationship was not observed in the posterior thalamic group. The results support the hypothesis of differential patterns of visuospatial performance depending on the anatomical locus of subcortical lesions. The findings are explained in terms of differing subcortical circuitry and suggest that multiple substrates mediate the sequelae of subcortical lesions.