Fig. 3: Distribution of brain lesions associated with secondary mania in 56 patients with eligible lesion images.

a Comparison between right vs. left-sided lesions. Each lesion was traced manually onto a common brain atlas (MNI) and projected on the closest depicted slice. Numbers above slices indicate z-coordinates in MNI space. The color code indicates maximal number of lesions overlapping on a single voxel. b Subtraction plot contrasting 29 right-sided stroke patients with secondary bipolar disorder (red-yellow) versus 439 unselected right hemisphere stroke patients (blue-green). In this plot, a value of, for example, 30, reflects that the voxel is damaged 30% more frequently in patients with secondary bipolar disorder than in unselected patients (for more details on the method see Rorden and Karnath⁷). To improve visualization, lesions of mania patients were projected onto the closest depicted slice before plot generation.