Lesion-behavior mapping indicates a strategic role for parietal substrates of associative memory

Numerous neuroimaging studies indicate that ventral parietal cortex (VPC), especially angular gyrus, plays an important role in episodic memory. However, the nature of the mnemonic processes supported by this region is far from clear. We previously found that stroke lesions in VPC and lateral temporal cortex caused deficits in cued recall of unimodal word pairs and picture pairs, and cross-modal picture-sound pairs, with larger deficits in the cross-modal task. However, those findings leave open the question whether those regions' integrity is necessary for maintenance of associative representations, or for strategic processes required for their recall. We addressed this question using associative recognition versions of those tasks. We additionally manipulated semantic relatedness of the associated memoranda, to assess VPC's involvement in semantic processing in the context of episodic memory. We analyzed performance of 62 first-event, sub-acute phase stroke patients (31 right- and 31 left-hemisphere damage) relative to 65 healthy participants, and employed voxel-based lesion-behavior mapping (VLBM) to identify task-relevant structures. Patients displayed greater false associative recognition of semantically related compared to unrelated recombined pairs. VLBM analysis implicated right lateral temporo-parietal regions in associative recognition deficits in the cross-modal pairs task, specifically for related recombined and new pairs, seemingly because of difficulty overcoming semantic relatedness bias effects on episodic discrimination. In contrast, damage to ventral parietal and lateral temporal cortex was not implicated in memory for unrelated memoranda. We interpret this pattern of lesion-behavior effects as indicating lateral temporo-parietal cortex involvement in strategic, rather than representational, roles in episodic associative memory.