PubMed · 13618100
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F M FORSTER, C D SHIELDS. 1959. Cortical sensory defects causing disability.. https://pubmed.ncbi.nlm.nih.gov/13618100/
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The current manuscript takes a critical look at the case of Goldstein and Gelb's patient, Schn, reported to be the first well-defined example of apperceptive visual agnosia. While doubts have been cast on the validity of the original investigations, we propose that perhaps the case of Schn should be reclassified as an example of integrative agnosia. Be that as it may, what is not in doubt is that the case of Schn has had a lasting impact on the development of neuropsychological theorem.
Associative visual agnosia is classically defined as normal visual perception stripped of its meaning [Archiv für Psychiatrie und Nervenkrankheiten 21 (1890) 22/English translation: Cognitive Neuropsychol. 5 (1988) 155]: these patients cannot access to their stored visual memories to categorize the objects nonetheless perceived correctly. However, according to an influential theory of visual agnosia [Farah, Visual Agnosia: Disorders of Object Recognition and What They Tell Us about Normal Vision, MIT Press, Cambridge, MA, 1990], visual associative agnosics necessarily present perceptual deficits that are the cause of their impairment at object recognition Here we report a detailed investigation of a patient with bilateral occipito-temporal lesions strongly impaired at object and face recognition. NS presents normal drawing copy, and normal performance at object and face matching tasks as used in classical neuropsychological tests. However, when tested with several computer tasks using carefully controlled visual stimuli and taking both his accuracy rate and response times into account, NS was found to have abnormal performances at high-level visual processing of objects and faces. Albeit presenting a different pattern of deficits than previously described in integrative agnosic patients such as HJA and LH, his deficits were characterized by an inability to integrate individual parts into a whole percept, as suggested by his failure at processing structurally impossible three-dimensional (3D) objects, an absence of face inversion effects and an advantage at detecting and matching single parts. Taken together, these observations question the idea of separate visual representations for object/face perception and object/face knowledge derived from investigations of visual associative (prosop)agnosia, and they raise some methodological issues in the analysis of single-case studies of (prosop)agnosic patients.
Studies of patients with category-specific agnosia (CSA) have given rise to multiple theories of object recognition, most of which assume the existence of a stable, abstract semantic memory system. We applied an episodic view of memory to questions raised by CSA in a series of studies examining normal observers' recall of newly learned attributes of familiar objects. Subjects first learned to associate arbitrarily assigned colors or textures to objects in a training phase, and then attempted to report the newly learned attribute of each object in a recall task. Our subjects' pattern of recall errors was similar both quantitatively and qualitatively to the identification deficits among patients with CSA for biological objects. Furthermore, errors tended to reflect conceptually and structurally based confusions. We suggest that object identification involves recruitment and integration of information across distributed episodic memories and that this process is susceptible to interference from objects that are structurally similar and conceptually related.