Parcellation of parietal cortex: Convergence between lesion-symptom mapping and mapping of the intact functioning brain

Spatial-attentional deficits are highly prevalent following stroke. They can be clinically detected by means of conventional bedside tests such as target cancellation, line bisection and the visual extinction test. Until recently, lesion mapping studies and functional imaging of the intact brain did not agree very well on exactly which parietal areas play a key role in selective attention: the inferior parietal lobule or the intraparietal sulcus. Recently, the use of a contrastive approach in patients akin to that commonly used in functional imaging studies in healthy volunteers together with voxel-based lesion-symptom mapping have allowed to bring the patient lesion mapping much closer to the functional imaging results obtained in healthy controls. In this review we focus on converging evidence obtained from patient lesion studies and from fMRI studies in the intact brain in humans. This has yielded novel insights into the functional segregation between the middle third of the intraparietal sulcus, the superior parietal lobule and the temporoparietal junction in the intact brain and also enhanced our understanding of the pathogenetic mechanisms underlying deficits arising in patients. (C) 2008 Elsevier B.V. All rights reserved.