The missing pathway in current visuospatial processing models
Spatial configuration learning depends on the parahippocampal place area (PPA), a functionally heterogenous area which current visuo-spatial processing models place downstream from parietal cortex and area V4 of early visual cortex (EVC). Here, we present evidence for the medial occipital longitudinal tract (MOLT), a novel white matter pathway connecting the PPA with EVC earlier than V4. By using multimodal imaging and neuropsychological assessments in the unique case of Patient 1, we demonstrate that an occipital stroke sparing the PPA but disconnecting the MOLT can lead to chronic deficits in configuration learning. Further, through an advanced, data-driven clustering analysis of diffusion MRI structural connectivity in a large control cohort, we demonstrate that the PPA sits at the confluence of the MOLT and the parieto-medial-temporal branch of the dual-stream model. The MOLT may therefore support multi-stage learning of object configuration by allowing direct reciprocal exchange between the PPA and EVC.