Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnexion to the inferior parietal lobule through the superior longitudinal fasciculus III: a single case study

Dataset for the single case described in the paper  CORTEX-D-23-00454R1 "Obrenovic M, Mouthon M, Chavan C, Saj A, Dieguez S, Aellen J, Chabwine JN. Acute right opercular stroke-associated polyopic heautoscopy and hallucinations caused by disconnexion to the inferior parietal lobule through the superior longitudinal fasciculus III: a single case study. Cortex"
It contains two separate folder for this case: 
1. behavour: Folder which contains the details clinical and investigation report (in French and English) as well as the Neuropsychological test answer of the patient.
2. MRI: Folder which contains the MRI images. You will find brain anatomical scans (T1w, T1w with contrast agent, T2w, FLAIR and dwi images) as well as the diffusion imagery (Diffusion tensor tractography).

Here you can find the abstract of the paper:

Illusory neuropsychiatric symptoms such as hallucinations or the feeling of a presence (FOP) can occur in diffuse brain lesion or dysfunction, in psychiatric diseases as well as in healthy individuals. Their occurrence due to focal brain lesions is rare, most probably due to underreporting, which limits progress in understanding their underlying mechanisms and anatomical determinants.

In this single case study, an 86-year-old patient experienced, in the context of an acute right central opercular ischemic stroke, visual hallucinatory symptoms (including palinopsia), differently lateralized auditory hallucinations and FOP. This unusual clinical constellation could be precisely documented and illustrated while still present, allowing a realistic and immersive visual experience validated by the patient. The acute stroke appeared to be their most plausible cause (after exclusion of other etiologies). Furthermore, accurate analysis of tractographic data suggested that disruption in the posterior bundle of the superior longitudinal fasciculus connecting the stroke lesion to the inferior parietal lobule was the anatomical substrate explaining all illusory symptoms, in coherence with existing literature. We could finally elaborate on symptoms taxonomy and phenomenology (e.g. polyopic heautoscopy, hallucinatory FOP, etc), and on patient’s remarkable distancing from them (with some therapeutic implications supported by plausibly engaged mechanisms).

This case not only authentically enriched the description of such rare combination of heterogenous illusory symptoms through this novel visualization-based reporting approach, but disclosed an unrevealed anatomo-clinical link relating all of them to the acute stroke lesion through an association fiber, thereby contributing to the understanding of these intriguing symptoms and their determinants.