Visuomotor performance in a patient with visual agnosia due to an early lesion (original) (raw)
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The anatomy of object recognition - visual form agnosia caused by medial occipitotemporal stroke.
The influential model on visual information processing by Milner and Goodale (1995) has suggested a dissociation between action- and perception-related processing in a dorsal versus ventral stream projection. It was inspired substantially by the observation of a double dissociation of disturbed visual action versus perception in patients with optic ataxia on the one hand and patients with visual form agnosia (VFA) on the other. Unfortunately, almost all cases withVFAreported so far suffered from inhalational intoxication, the majority with carbon monoxide (CO). Since CO induces a diffuse and widespread pattern of neuronal and white matter damage throughout the whole brain, precise conclusions from these patients with VFA on the selective role of ventral stream structures for shape and orientation perception were difficult. Here, we report patient J.S., who demonstrated VFA after a well circumscribed brain lesion due to stroke etiology. Like the famous patient D.F. with VFA after CO intoxication studied by Milner, Goodale, and coworkers (Goodale et al., 1991, 1994; Milner et al., 1991; Servos et al., 1995; Mon-Williams et al., 2001a,b; Wann et al., 2001; Westwood et al., 2002; McIntosh et al., 2004; Schenk and Milner, 2006), J.S. showed an obvious dissociation between disturbed visual perception of shape and orientation information on the one side and preserved visuomotor abilities based on the same information on the other. In both hemispheres, damage primarily affected the fusiform and the lingual gyri as well as the adjacent posterior cingulate gyrus.Weconclude that these medial structures of the ventral occipitotemporal cortex are integral for the normal flow of shape and of contour information into the ventral stream system allowing to recognize objects.
Neuropsychologia, 2006
The current dominant view of the visual system is marked by the functional and anatomical dissociation between a ventral stream specialised for perception and a dorsal stream specialised for action. The "double-dissociation" between visual agnosia (VA), a deficit of visual recognition, and optic ataxia (OA), a deficit of visuo-manual guidance, considered as consecutive to ventral and dorsal damage, respectively, has provided the main argument for this dichotomic view. In the first part of this paper, we show that the currently available empirical data do not suffice to support a double-dissociation between OA and VA. In the second part, we review evidence coming from human neuropsychology and monkey data, which cast further doubts on the validity of a simple double-dissociation between perception and action because they argue for a far more complex organisation with multiple parallel visual-to-motor connections: 1. A dorso-dorsal pathway (involving the most dorsal part of the parietal and pre-motor cortices): for immediate visuo-motor control-with OA as typical disturbance. The latest research about OA is reviewed, showing how these patients exhibit deficits restricted to the most direct and fast visuo-motor transformations. We also propose that mild mirror ataxia, consisting of misreaching errors when the controlesional hand is guided to a visual goal though a mirror, could correspond to OA with an isolated "hand effect". 2. A ventral stream-prefrontal pathway (connections from the ventral visual stream to pre-frontal areas, by-passing the parietal areas): for "mediate" control (involving spatial or temporal transpositions . Mediate responses as direct evidence for intention: Neuropsychology of Not to-, Not now-and Not there-tasks. In S. Johnson (Ed.), Cognitive Neuroscience perspectives on the problem of intentional action (pp. 67-105). MIT Press.])-with VA as typical disturbance. Preserved visuo-manual guidance in patients with VA is restricted to immediate goal-directed guidance, they exhibit deficits for delayed or pantomimed actions. 3. A ventro-dorsal pathway (involving the more ventral part of the parietal lobe and the pre-motor and pre-frontal areas): for complex planning and programming relying on high representational levels with a more bilateral organisation or an hemispheric lateralisation-with mirror apraxia, limb apraxia and spatial neglect as representatives. Mirror apraxia is a deficit that affects both hands after unilateral inferior parietal lesion with the patients reaching systematically and repeatedly toward the virtual image in the mirror. Limb apraxia is localized on a more advanced conceptual level of object-related actions and results from deficient integrative, computational and "working memory" capacities of the left inferior parietal lobule. A component of spatial working memory has recently been revealed also in spatial neglect consecutive to lesion involving the network of the right inferior parietal lobule and the right frontal areas. We conclude by pointing to the differential temporal constraints and integrative capabilities of these parallel visuo-motor pathways as keys to interpret the neuropsychological deficits.
The functional neuroanatomy of object agnosia: A case study
Journal of Vision, 2010
Cortical reorganization of visual and object representations following neural injury was examined using fMRI and behavioral investigations. We probed the visual responsivity of the ventral visual cortex of an agnosic patient who was impaired at object recognition following a lesion to the right lateral fusiform gyrus. In both hemispheres, retinotopic mapping revealed typical topographic organization and visual activation of early visual cortex. However, visual responses, object-related, and-selective responses were reduced in regions immediately surrounding the lesion in the right hemisphere, and also, surprisingly, in corresponding locations in the structurally intact left hemisphere. In contrast, hV4 of the right hemisphere showed expanded response properties. These findings indicate that the right lateral fusiform gyrus is critically involved in object recognition and that an impairment to this region has widespread consequences for remote parts of cortex. Finally, functional neural plasticity is possible even when a cortical lesion is sustained in adulthood.
Dissociation of local and global processing in visual agnosia
Vision Research, 1994
Subsequent to strokes in the right and left inferomedial occipito-temporal lobes, two patients became prosopagnosic and alexic, respectively. They also show a complementary dissociation of the analysis of handwritten text. The patient with the right posterior stroke can read it but not recognize whose handwriting it is; the patient with the left posterior stroke cannot read the text but knows who wrote it. The analysis of spatial vision revealed that the prosopagnosic patient has no problem with seeing texture elements when presented in isolation. Yet she performs poorly with Moire and texture perception, i.e. she sulfers from a selective loss of global visual perception. The alexic patient performs well with Moire patterns but neither with (complex) texture elements nor with textures. She seemingly can locally and globally process patterns composed of simple figural elements but fails with stimuli that require the integration of features. This finding of a concomitant dissociation of local and global visual processes in the two patients supports the view that prosopagnosia as well as alexia are the most conspicuous aspects of more general alterations of visual perception.
Journal of Neurology, Neurosurgery & Psychiatry, 1998
Recognition of diVerent kinds of visual stimuli was studied in a patient who acquired apperceptive visual agnosia after a bilateral occipitotemporal lesion which partially spared the primary visual cortex. Impairment in recognising static objects perceived visually sharply contrasts with the relatively well preserved ability to recognise objects from gestures illustrating their use, and to recognise actions shown in line drawings. It is suggested that the occipitoparieto-frontal pathway is involved in the recognition of actions, and in the recognition of objects when sensorimotor experience is evoked.
Perception and Action in ‘Visual Form Agnosia’
Brain, 1991
A single case study of a patient with 'visual form agnosia' is presented. A severe visual recognition deficit was accompanied by impairments in discriminating shape, reflectance, and orientation, although visual acuity and colour vision, along with tactile recognition and intelligence, were largely preserved. Neuropsychological and behavioural investigations have indicated that the patient is able to utilize visual pattern information surprisingly well for the control of hand movements during reaching, and can even read many whole words, despite being unable to make simple discriminative judgements of shape or orientation. She seems to have no awareness of shape primitives through Gestalt grouping by similarity, continuity or symmetry. It is proposed that many of these perceptual disorders might be the combined result of (1) a selective loss of the cortical elaboration of the magnocellular visual processing stream, and (2) a selective output disconnection from a central processor of visual boundaries and shape primitives in the occipital cortex.