Neuronal substrates of Corsi Block span: Lesion symptom mapping analyses in relation to attentional competition and spatial bias

Spatial working memory problems are frequently reported following brain damage within both left and right hemispheres but with the severity often being grater in individuals with right hemisphere lesions. Clinically, deficits in spatial working memory have also been noted in patients with visuospatial disorders such as unilateral neglect. Here, we examined neural substrates of short-term memory for spatial locations based on the Corsi Block tapping task and the relationship with the visuospatial deficits of neglect and extinction in a group of chronic neuropsychological patients. Principal Component Analysis (PCA) was used to distinguish shared and dissociate functional components. The neural substrates of spatial short-term memory deficits and the components identified by PCA were examined using whole brain voxel-based morphometry and tract-wise lesion deficits analyses. We found that bilateral lesions within occipital cortex (middle occipital gyrus) and right posterior parietal cortex, along with disconnection of the right parieto-temporal segment of arcuate fasciculus, were associated with low spatial memory span. A single component revealed by PCA accounted for over half of the variance and was linked to damage to right posterior brain regions (temporo-parietal junction, the inferior parietal lobule and middle temporal gyrus extending into middle occipital gyrus). We also found link to disconnections within several association pathways including the superior longitudinal fasciculus, arcuate fasciculus, inferior fronto-occipital fasciculus and inferior longitudinal fasciculus. These results indicate that different visuospatial deficits converge into a single component mapped within posterior parietal areas and fronto-parietal white matter pathways. Furthermore, the data presented here fit with the role of posterior parietal cortex/temporo-parietal junction in maintaining a map of salient locations in space, with Corsi Block performance being impaired when the spatial map is damaged.