Abstract TP325: White Matter Disconnectivity as a Biomarker of Aiming Errors in Spatial Neglect

Introduction: Spatial neglect (SN) is asymmetric action, imagery, or orientation after brain lesion, causing disability. People with SN are half as likely to return home, have longer hospitalizations, one-third the community mobility, and require triple the caregiver supervision, yet >50% remain undiagnosed. Motor-intentional “Aiming” SN is particularly under-recognized, despite responsiveness to targeted interventions such as prism adaptation therapy. We aimed to identify white matter (WM) tract disconnectivity patterns that predict Aiming spatial errors to detect high-risk patients. Hypothesis: Disconnectivity involving superior colliculus, frontal-basal ganglia circuits, cortical frontal networks, and anterior/mid-corpus callosum would best predict Aiming SN. Methods: Eighteen right-brain stroke survivors (mean age 62.7±11.6, 9 male, 2.2±1.3 months post-stroke) with SN were included across three sites (NCT05983185). MRI lesion maps were overlaid on HCP1065 tractography atlas to calculate the percentage of each WM tract affected. Tracts lesioned in