Controversy still remains about the relative contribution of different brain regions to the syndrome of spatial neglect.  Our focus was to delineate the role that the various sub-regions of the frontal lobe might play. To achieve this, we took a novel approach to VLSM (voxel-based lesion symptom mapping) by studying patients with isolated infarction in the territory of the superior division of the MCA, and thus isolated frontal damage.

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We screened 90 patients in our database for isolated superior division MCA infarcts. Brain lesions were drawn on the MRI or CT images then transformed into stereotaxic space using MRIcroN software.  A student t-test was performed comparing the severity of neglect (letter A’s cancelled, max 10) and arm weakness (NIHSS arm) as a validation, at every brain voxel, with adjustment for multiple comparisons by a false discovery rate (FDR) level of p=0.05.