Impairments in Multisensory Integration after Stroke

The integration of information from multiple senses leads to a plethora of behavioral benefits, most predominantly to faster and better detection, localization, and identification of events in the environment. Although previous studies of multisensory integration (MSI) in humans have provided insights into the neural underpinnings of MSI, studies of MSI at a behavioral level in individuals with brain damage are scarce. Here, a well-known psychophysical paradigm (the redundant target paradigm) was employed to quantify MSI in a group of stroke patients. The relation between MSI and lesion location was analyzed using lesion subtraction analysis. Twenty-one patients with ischemic infarctions and 14 healthy control participants responded to auditory, visual, and audiovisual targets in the left and right visual hemifield. Responses to audiovisual targets were faster than to unisensory targets. This could be due to MSI or statistical facilitation. Comparing the audiovisual RTs to the winner of a race between unisensory signals allowed us to determine whether participants could integrate auditory and visual information. The results indicated that (1) 33% of the patients showed an impairment in MSI; (2) patients with MSI impairment had left hemisphere and brainstem/cerebellar lesions; and (3) the left caudate, left pallidum, left putamen, left thalamus, left insula, left postcentral and precentral gyrus, left central opercular cortex, left amygdala, and left OFC were more often damaged in patients with MSI impairments. These results are the first to demonstrate the impact of brain damage on MSI in stroke patients using a well-established psychophysical paradigm.