Finger agnosia: fiction or reality?
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The cortical visual mechanisms involved in processing spatial relationships remain subject to debate. According to one current view, the "dorsal stream" of visual areas, emanating from primary visual cortex and culminating in the posterior parietal cortex, mediates this aspect of visual processing. More recently, others have argued that while the dorsal stream provides egocentric coding of visual location for motor control, the separate "ventral" stream is needed for allocentric spatial coding. We have assessed the visual form agnosic patient DF, whose lesion mainly affects the ventral stream, on a prehension task requiring allocentric spatial coding. She was presented with transparent circular disks. Each disk had circular holes cut in it. DF was asked to reach out and grasp the disk by placing her fingers through the holes. The disks either had three holes (for forefinger, middle finger, and thumb) or two holes (for forefinger and thumb). The distance between the forefinger and thumb holes, and the orientation of the line formed by them, were independently varied. DF was quite unable to adjust her grip aperture or her hand orientation in the three-hole task. Although she was able to orient her hand appropriately for the two-hole disks, she still remained unable to adjust her grip aperture to the distance between the holes. These findings are consistent with the idea that allocentric processing of spatial information requires a functioning ventral stream, even when the information is being used to guide a motor response.
Previous studies have reported that the visual form agnosic D.F. is able to use information about visual targets for the control of motor acts, but has great difficulty in using the same visual information for perceptual report. This intact visuomotor performance may be mediated by relatively intact parieto-frontal cortical mechanisms. The present study investigated the ability of D.F. to use binocular and monocular information about the orientation of an object in the depth plane for perceptual and visuomotor purposes. A square plaque was presented at seven different orientations in depth to D.F. and to three age- and sex-matched control subjects. Subjects were required to reach out and grasp the plaque using a precision grip (index finger and thumb) under binocular and monocular viewing conditions, and in separate trials to match the orientation of a hand-held plaque to the perceived orientation of the target object, also under both binocular and monocular conditions. D.F.'s performance in grasping trials was found to be normal under binocular conditions, but was substantially worsened by removal of binocular vision. She was severely impaired at matching the orientation of the test square, although under binocular conditions her performance rose clearly above chance. The data suggest that the separation of cortical processing for visuomotor and visual perceptual purposes also applies, at least in part, to information about the orientation in depth of an object. The impaired performance under monocular viewing conditions on the visuomotor task is in agreement with recent physiological data and suggests that posterior parietal systems depend critically on binocular input for the processing of orientation in depth when ventral-stream information is unavailable.
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Investigations of the visual recognition abilities of the patient M.S. are reported. M.S. is unable to achieve overt recognition of any familiar faces, and many everyday objects. In Task 1 he showed semantic priming from name primes but not from face primes in a name recognition task. In Task 2 he showed no advantage in learning true (face + correct name) rather than untrue (face + someone else's name) pairings of faces and names. In Task 3 semantic priming of lexical decision was only found for object picture primes that M.S. was able to recognize overtly. In Task 4 faster matching of photographs of familiar than unfamiliar objects was only found for objects that M.S. was able to recognize overtly. These findings demonstrate an absence of covert recognition effects for M.S., consistent with the view that his impairment is primarily "perceptual" in nature.
Experiments were designed to examine the imagery abilities of an agnosic patient, M.S., who has consistently shown more severe deficits in recognizing visually, and in retrieving knowledge of living as compared with non-living items. Judgements of visual similarity were required for named objects and for object-pictures, as well as for the factual properties of these stimuli. The same disproportionate difficulty in processing living ('natural') objects was found in these tasks as well as in forced-choice recognition. In contrast, no deficit was found on analogous tasks concerned with word-shape similarities. These findings have a bearing on concepts of semantic memory.
Two cases studies of subjects suffering from severe developmental constructional apraxia are presented. These two subjects demonstrated normal to high ability in reading, writing and arithmetical tests. The analysis of cognitive tests performed by them indicates that extreme developmental, perceptual, spatial and motor deficits may be dissociated from the acquisition of efficient reading ability.
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 Moiré and texture perception, i.e. she suffers from a selective loss of global visual perception. The alexic patient performs well with Moiré 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.
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