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The zero effect: voxel-based lesion symptom mapping of number transcoding errors following stroke.

Marleen Haupt1, Céline R Gillebert2,3, Nele Demeyere4

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Errors in writing numbers with zeros are common after stroke, affecting 14.2% of patients. Lesions near the right putamen specifically impair this number transcoding ability, highlighting its role in auditory perception and attention.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurolinguistics

Background:

  • The number zero presents unique challenges in numerical processing due to its lack of semantic representation.
  • Previous studies suggest difficulties in transcoding numerals involving zero, even in patients with stroke affecting number processing typically lateralized to the left hemisphere.

Purpose of the Study:

  • To investigate the prevalence and neural correlates of transcoding errors involving zero in a large sample of subacute stroke patients.
  • To identify specific brain regions associated with impairments in processing numerals containing zero.

Main Methods:

  • A large cohort of 667 subacute stroke patients were assessed for transcoding errors, without pre-selection based on lesion location or pre-existing impairment.
  • Voxel-based lesion symptom mapping (VLSM) was performed on 153 patients to correlate lesion location with transcoding deficits.

Main Results:

  • A significant prevalence of 14.2% for specific errors in transcoding numerals with zeros was observed.
  • VLSM analysis identified lesions in and around the right putamen as being significantly associated with these transcoding errors.

Conclusions:

  • The findings indicate that subcortical regions, particularly the right putamen, are crucial for number processing, especially tasks involving auditory perception and attention.
  • Damage to the right putamen and its connections can lead to impaired number transcoding, particularly for numerals containing zero, underscoring the complexity of the neural network for numerical cognition.