Despite intense research, the neural correlates of stroke-induced deficits of spatial cognition remain controversial. For example, several cortical regions and white-matter tracts have been designated as possible anatomic predictors of spatial neglect. However, many studies focused on local anatomy, an approach that does not harmonize with the notion that brain-behavior relationships are flexible and may involve interactions among distant regions. We studied in humans of either sex resting-state fMRI connectivity associated with performance in line bisection, reading and visual search, tasks commonly used for he clinical diagnosis of neglect. We defined left and right frontal, parietal, and temporal areas as seeds (or regions of interest, ROIs), and measured whole-brain seed-based functional connectivity (FC) and ROI-to-ROI connectivity in subacute right-hemisphere stroke patients. Performance on the line bisection task was associated with decreased FC between the right fusiform gyrus and left superior occipital cortex. Complementary increases and decreases of connectivity between both temporal and occipital lobes predicted reading errors. In addition, visual search deficits were associated with modifications of FC between left and right inferior parietal lobes and right insular cortex. These distinct connectivity patterns were substantiated by analyses of FC between left- and right-hemispheric ROIs, which revealed that decreased interhemispheric and right intrahemispheric FC was associated with higher levels of impairment. Together, these findings indicate that intrahemispheric and interhemispheric cooperation between brain regions lying outside the damaged area contributes to spatial deficits in a way that depends on the different cognitive components recruited during reading, spatial judgments, and visual exploration.

SIGNIFICANCE STATEMENT Focal damage to the right cerebral hemisphere may result in a variety of deficits, often affecting the domain of spatial cognition. The neural correlates of these disorders have traditionally been studied with lesion-symptom mapping, but this method fails to capture the network dynamics that underlie cognitive performance. We studied functional connectivity in patients with right-hemisphere stroke and found a pattern of correlations between the left and right temporo-occipital, inferior parietal, and right insular cortex that were distinctively predictive of deficits in reading, spatial judgment, and visual exploration. This finding reveals the importance of interhemispheric interactions and network adaptations for the manifestation of spatial deficits after damage to the right hemisphere.

尽管进行了大量研究，但中风引起的空间认知功能障碍的神经相关性仍存在争议。例如，几个皮质区域和白色物质已被指定为空间忽视的可能的解剖学预测指标。然而，许多研究集中在局部解剖学上，这种方法与脑与行为之间的关系是灵活的，并且可能涉及遥远地区之间的相互作用这一观念并不协调。我们在人类中研究了性别静息状态fMRI连通性与线平分，阅读和视觉搜索的性能相关联，这些任务通常被用于临床忽视的诊断。我们将左右额叶，顶叶和颞叶区域定义为种子（或感兴趣区域，ROI），在亚急性右半球卒中患者中测量了基于全脑种子的功能连接（FC）和ROI到ROI的连接。线平分任务的表现与右梭状回和左枕上皮质之间的FC降低有关。颞叶和枕叶之间连通性的互补增加和减少预测了阅读错误。另外，视觉搜索缺陷与左，右下顶叶和右岛突皮层之间的FC改变有关。这些不同的连通性模式通过左半球和右半球ROI之间的FC分析得以证实，这表明半球间FC和右半球内FC减少与较高的损伤水平相关。一起，

意义声明右脑半球的局灶性损伤可能导致多种缺陷，通常影响空间认知领域。传统上已经通过病灶症状图谱研究了这些疾病的神经相关性，但是这种方法无法捕捉到构成认知表现基础的网络动态。我们研究了右半球卒中患者的功能连接性，发现左右颞枕，顶下壁和右岛突皮层之间的相关性模式可以明显预测阅读，空间判断和视觉探索的缺陷。这一发现揭示了半球间相互作用和网络适应对于右半球受损后空间缺陷表现的重要性。