{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:52:36Z","timestamp":1791049956166,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2009,6,22]],"date-time":"2009-06-22T00:00:00Z","timestamp":1245628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the functional neuroanatomy that could account for pure Gerstmann syndrome, which is the selective association of acalculia, finger agnosia, left\u2010right disorientation, and agraphia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used structural and functional neuroimaging at high spatial resolution in healthy subjects to seek a shared cortical substrate of the <jats:italic>Grundst\u00f6rung<\/jats:italic> posited by Gerstmann, ie, a common functional denominator accounting for this clinical tetrad. We construed a functional activation paradigm that mirrors each of the four clinical deficits in Gerstmann syndrome and determined cortical activation patterns. We then applied fiber tracking to diffusion tensor images and used cortical activation foci in the four functional domains as seed regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>None of the subjects showed parietal overlap of cortical activation patterns from the four cognitive domains. In every subject, however, the parietal activation patterns across all four domains consistently connected to a small region of subcortical parietal white matter at a location that is congruent with the lesion in a well\u2010documented case of pure Gerstmann syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Our functional neuroimaging findings are not in agreement with Gerstmann's postulate of damage to a common cognitive function underpinning clinical semiology. Our evidence from intact functional neuroanatomy suggests that pure forms of Gerstmann's tetrad do not arise from lesion to a shared cortical substrate but from intraparietal disconnection after damage to a focal region of subcortical white matter. Ann Neurol 2009;66:654\u2013662<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.21776","type":"journal-article","created":{"date-parts":[[2009,6,22]],"date-time":"2009-06-22T16:38:46Z","timestamp":1245688726000},"page":"654-662","source":"Crossref","is-referenced-by-count":74,"title":["A disconnection account of Gerstmann syndrome: Functional neuroanatomy evidence"],"prefix":"10.1002","volume":"66","author":[{"given":"Elena","family":"Rusconi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Pinel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Eger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"LeBihan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Thirion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanislas","family":"Dehaene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kleinschmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,11,24]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/brain\/122.6.1107","article-title":"A pure case of Gerstmann syndrome with a subangular lesion","volume":"122","author":"Mayer E","year":"1999","journal-title":"Brain"},{"key":"e_1_2_6_3_2","first-page":"1010","article-title":"Fingeragnosie. Eine umschriebene St\u00f6rung der Orientierung am eigenen K\u00f6rper","volume":"40","author":"Gerstmann J","year":"1924","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1940.02280080158009"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1992.00530290027007"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1983.04050010066019"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.34.7.877"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2003.99.4.0716"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/88.2.237"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/88.3.585"},{"key":"e_1_2_6_11_2","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1093\/brain\/awh622","article-title":"The rises and falls of disconnection syndrome","volume":"12","author":"Catani M","year":"2005","journal-title":"Brain"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2008.05.001"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.1999.0439"},{"key":"e_1_2_6_14_2","doi-asserted-by":"crossref","first-page":"S98","DOI":"10.1016\/S1053-8119(01)91441-7","article-title":"BrainVISA: software platform for visualization and analysis of multi\u2010modality brain data","volume":"6","author":"Cointepas Y","year":"2001","journal-title":"Neuroimage"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1361-8415(02)00052-X"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(199902)45:2<265::AID-ANA21>3.0.CO;2-3"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.3.403"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0896-6273(02)00575-5"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/89.2.183"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/85.1.47"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1116251"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2008.05.003"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2008.04.002"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cortex.2007.10.010"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/088307380401900408"},{"key":"e_1_2_6_26_2","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S0896-6273(00)80911-3","article-title":"Microstructure of temporo\u2010parietal white matter as a basis for reading ability: evidence from diffusion tensor magnetic resonance imaging","volume":"25","author":"Klingberg T","year":"2000","journal-title":"Neuron"},{"key":"e_1_2_6_27_2","first-page":"2085","article-title":"Disconnection of speech\u2010relevant brain areas in persistent developmental stuttering","volume":"359","author":"Sommer M","year":"2002","journal-title":"Lancet"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2001.0080443"}],"container-title":["Annals of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fana.21776","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ana.21776","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T05:49:47Z","timestamp":1697435387000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ana.21776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1002\/ana.21776"],"URL":"https:\/\/doi.org\/10.1002\/ana.21776","archive":["Portico"],"relation":{},"ISSN":["0364-5134","1531-8249"],"issn-type":[{"value":"0364-5134","type":"print"},{"value":"1531-8249","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11]]}}}