Quantitative assessment of covariation between neuropsychological function and location of naturally occurring lesions in humans.

Studies of localization of brain function in humans depend on analysis of covariation between the location of naturally occurring lesions and measures of neuropsychological ability. Such an analysis presents two problems: how to represent numerically the infinite variety of lesion locations, sizes, and shapes; and how to assess covariation between the location measure and performance. We present a mathematical model of lesion location and its relationship with performance. To demonstrate its utility, the model is applied to a sample of 53 patients with naturally occurring brain lesions who were administered a standard battery of neuropsychological tests. Importance functions derived for the neuropsychological measures generally conform to expectations. Sensory and motor abilities were localized correctly within the contralateral hemispheres, and language functions were localized in the left frontal region. Lesion location accounts for substantially more variation in performance than does lesion volume, with location accounting for more than 50% for some left-hemisphere functions.