Post-stroke lesion correlates of errors in verbal and spatial production tasks

IntroductionTraditional lateralization models assign post-stroke verbal impairments to the left hemisphere and spatial impairments to the right hemisphere. When considering error measures, this dichotomy may be too simplistic, as performance monitoring may involve domain-general and domain-specific...

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Main Authors: Antonino Visalli, Natasha Maldonado, Mete Dadak, Heinrich Lanfermann, Karin Weißenborn, Bruno Kopp
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Psychology
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1517876/full
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author Antonino Visalli
Antonino Visalli
Natasha Maldonado
Mete Dadak
Heinrich Lanfermann
Karin Weißenborn
Bruno Kopp
author_facet Antonino Visalli
Antonino Visalli
Natasha Maldonado
Mete Dadak
Heinrich Lanfermann
Karin Weißenborn
Bruno Kopp
author_sort Antonino Visalli
collection DOAJ
description IntroductionTraditional lateralization models assign post-stroke verbal impairments to the left hemisphere and spatial impairments to the right hemisphere. When considering error measures, this dichotomy may be too simplistic, as performance monitoring may involve domain-general and domain-specific components. Furthermore, the error-monitoring hypothesis predicts domain-incongruent specialization, with left hemisphere dominance for spatial and right hemisphere dominance for verbal errors.MethodsWe performed voxel-based lesion-behavior mapping in N = 110 acute stroke patients who completed a cognitively demanding, error-prone, five-point spatial design fluency task and a verbal word-fragment completion task.ResultsSignificant associations were found between lesion location and error rates in both tasks, spatial fluency (correlation = 0.36, p < 0.001) and verbal completion (correlation = 0.31, p = 0.001). Right inferior frontal lesions correlated with errors in both tasks. In addition, left frontal white matter (WM) lesions were associated with spatial errors, whereas right frontal WM lesions were associated with verbal errors. After adjusting for demographics, the left WM cluster remained significant for spatial errors and the right WM cluster for verbal errors, while the right inferior frontal association with spatial errors was no longer significant.DiscussionPost-stroke performance monitoring involves two distinct neural systems. One is a domain-general system, probably centered in the right inferior frontal region, that supports overall accuracy. The other is a widely distributed, reverse lateralized system, with left lesions associated with spatial accuracy and right lesions associated with verbal accuracy. This suggests that performance monitoring relies on more complex hemispheric interactions than traditional models suggest.
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spelling doaj-art-82c6462f20f34493a4d96dcfeb56c3af2025-08-20T02:19:57ZengFrontiers Media S.A.Frontiers in Psychology1664-10782025-04-011610.3389/fpsyg.2025.15178761517876Post-stroke lesion correlates of errors in verbal and spatial production tasksAntonino Visalli0Antonino Visalli1Natasha Maldonado2Mete Dadak3Heinrich Lanfermann4Karin Weißenborn5Bruno Kopp6Department of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Biomedical, Metabolic and Neuroscience, University of Modena and Reggio Emilia, Reggio Emilia, ItalyDepartment of Neurology, Hannover Medical School, Hannover, GermanyInstitute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, GermanyInstitute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyIntroductionTraditional lateralization models assign post-stroke verbal impairments to the left hemisphere and spatial impairments to the right hemisphere. When considering error measures, this dichotomy may be too simplistic, as performance monitoring may involve domain-general and domain-specific components. Furthermore, the error-monitoring hypothesis predicts domain-incongruent specialization, with left hemisphere dominance for spatial and right hemisphere dominance for verbal errors.MethodsWe performed voxel-based lesion-behavior mapping in N = 110 acute stroke patients who completed a cognitively demanding, error-prone, five-point spatial design fluency task and a verbal word-fragment completion task.ResultsSignificant associations were found between lesion location and error rates in both tasks, spatial fluency (correlation = 0.36, p < 0.001) and verbal completion (correlation = 0.31, p = 0.001). Right inferior frontal lesions correlated with errors in both tasks. In addition, left frontal white matter (WM) lesions were associated with spatial errors, whereas right frontal WM lesions were associated with verbal errors. After adjusting for demographics, the left WM cluster remained significant for spatial errors and the right WM cluster for verbal errors, while the right inferior frontal association with spatial errors was no longer significant.DiscussionPost-stroke performance monitoring involves two distinct neural systems. One is a domain-general system, probably centered in the right inferior frontal region, that supports overall accuracy. The other is a widely distributed, reverse lateralized system, with left lesions associated with spatial accuracy and right lesions associated with verbal accuracy. This suggests that performance monitoring relies on more complex hemispheric interactions than traditional models suggest.https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1517876/fulldesign fluencyword-fragment completionerror monitoringbrain lateralizationstrokevoxel-based lesion-behavior mapping
spellingShingle Antonino Visalli
Antonino Visalli
Natasha Maldonado
Mete Dadak
Heinrich Lanfermann
Karin Weißenborn
Bruno Kopp
Post-stroke lesion correlates of errors in verbal and spatial production tasks
Frontiers in Psychology
design fluency
word-fragment completion
error monitoring
brain lateralization
stroke
voxel-based lesion-behavior mapping
title Post-stroke lesion correlates of errors in verbal and spatial production tasks
title_full Post-stroke lesion correlates of errors in verbal and spatial production tasks
title_fullStr Post-stroke lesion correlates of errors in verbal and spatial production tasks
title_full_unstemmed Post-stroke lesion correlates of errors in verbal and spatial production tasks
title_short Post-stroke lesion correlates of errors in verbal and spatial production tasks
title_sort post stroke lesion correlates of errors in verbal and spatial production tasks
topic design fluency
word-fragment completion
error monitoring
brain lateralization
stroke
voxel-based lesion-behavior mapping
url https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1517876/full
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