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Mapping Lesions in Action: Voxel-based Lesion-Activity Mapping

Poster Session D - Monday, March 9, 2026, 8:00 – 10:00 am PDT, Fairview/Kitsilano Ballroom

Frank Garcea^1-4, Emma Strawderman^1-2, Steven Meyers^1,5, Webster Pilcher^1,4, Bradford Mahon^1,6,7; ¹Department of Neurosurgery, University of Rochester Medical Center, USA, ²Department of Neuroscience, University of Rochester Medical Center, USA, ³Department of Brain and Cognitive Sciences, University of Rochester, USA, ⁴Del Monte Institute for Neuroscience, University of Rochester Medical Center, USA, ⁵Department of Imaging Sciences, University of Rochester Medical Center, USA, ⁶Department of Psychology, Carnegie Mellon University, USA, ⁷Neuroscience Institute, Carnegie Mellon University, USA

Understanding how focal brain damage disrupts cognitive and neural function is a central challenge in cognitive neuroscience. At the 2025 CNS meeting, a symposium on voxel-based lesion-symptom mapping (VLSM) highlighted what VLSM can and cannot reveal about brain-behavior relations. A key issue raised was the need for methods to test how lesions alter neural processing in functionally connected areas distal to the site of injury. Here, we introduce Voxel-based Lesion-Activity Mapping (VLAM), a new approach relating lesion topography to task-evoked neural responses. We validated VLAM using a functional MRI (fMRI) dataset collected from 109 pre-operative brain tumor patients with left-hemisphere lesions. We tested the hypothesis that lesions to parietal areas supporting object-directed grasping (left anterior intraparietal sulcus) and use (left supramarginal gyrus) will disrupt neural responses for manipulable objects in left ventral temporal cortex (VTC). VLAM analyses supported this hypothesis: Participants with lesions in these left parietal areas exhibited weaker neural responses for manipulable objects in the left VTC. Control analyses showed that parietal lesions did not affect responses to place stimuli in the left VTC, indicating a domain-specific parietal attenuation in left VTC. These findings reveal that category-specific neural responses for manipulable objects in VTC emerge, in part, via inputs from parietal regions that support object-direction action. More broadly, we establish VLAM as a new method for investigating how lesions alter neural responses in distal, functionally connected areas.

Topic Area: PERCEPTION & ACTION: Motor control