Optic aphasia, optic apraxia, and loss of dreaming

A 47-year-old man with a left temporo-occipital infarct in the area of the posterior cerebral artery is presented. The neuropsychological examination did not reveal aphasia or gross mental deficits. The patient presented with alexia without agraphia, color agnosia, but few visual perceptual deficits. The main impairment was in confrontation naming; he was incapable of naming objects and pictures, not from lack of recognition (excluding visual agnosia) but from lack of access to the appropriate word (optic aphasia). The patient also exhibited a deficit in the evocation of gesture from the visual presentation of an object (optic apraxia) and a difficulty in "conjuring up" visual images of objects (impaired visual imagery) and loss of dreams. The fundamental deficit of this patient is tentatively explained in terms of visuoverbal and visuogestural disconnection and a deficit of mental imagery.     

Spatial neglect, Balint-Homes' and Gerstmann's syndrome, and other spatial disorders

Brain-damaged patients with lesion or dysfunction involving the parietal cortex may show a variety of neuropsychological impairments involving spatial cognition. The more frequent and disabling deficit is the syndrome of unilateral spatial neglect that, in a nutshell, consists in a bias of spatial representation and attention ipsilateral to of extrapersonal, personal (ie, the body) space, or both, toward the side of the hemispheric lesion. The deficit is more frequent and severe after damage to the right hemisphere, involving particularly the posterior-inferior parietal cortex at the temporo-parietal junction. Damage to these posterior parietal regions may also impair visuospatial short-term memory, which may be associated with and worsen spatial neglect. The neural network supporting spatial representation, attention and short-term memory is, however, more extensive, including the right premotor cortex. Also disorders of drawing and building objects (traditionally termed constructional apraxia) are a frequent indicator of posterior parietal damage in the left and in the right hemispheres. Other less frequent deficits, which, however, have a relevant localizing value, include optic ataxia (namely, the defective reaching of visual objects, in the absence of elementary visuo-motor impairments), which is typically brought about by damage to the superior parietal lobule. Optic ataxia, together with deficits of visual attention, of estimating distances and depth, and with apraxia of gaze, constitutes the severely disabling Balint-Holmes' syndrome, which is typically associated with bilateral posterior parietal and occipital damage. Finally, lesions of the posterior parietal lobule (angular gyrus) in the left hemisphere may bring about a tetrad of symptoms (left-right disorientation, acalculia, finger agnosia, and agraphia) termed Gerstmann's syndrome, that also exists in a developmental form.     

Prosopagnosia and visual object agnosia: A behavioral study

A left-handed woman developed visual object agnosia, prosopagnosia, and visual disorientation after resection of the right occipital lobe. Color agnosia and alexia were absent. When asked to identify objects presented visually, the patient's errors represented visually related objects (underspecifications) or perseverations. Identification was facilitated when she observed the object being used in a natural way. Identification was impaired by surrounding the object with unrelated objects, decreasing the background illumination, decreasing the duration of exposure of the object to the patient, and probably also by decreasing the visual angle subtended by the object. In addition, there were disturbances of visualization (i.e., imaging in the absence of a visual stimulus) that paralleled the perceptual difficulties. We conclude that: (1) A deficit in visual perception, characterized by insufficient feature analysis of visual stimuli, was the basis of the visual agnosia in this case. (2) The visual agnosia could not be explained by (a) a vision-language disconnection syndrome, (b) decay of visual memory traces, or (c) deficiencies in the visual fields (pathologic Funktionswandel). (3) The ability to visualize (visual imagery) probably utilizes some of the same neural pathways used in perception. (4) The results in this case probably can be generalized to some but not all cases of visual agnosia; in particular, the deficit in most previously reported patients with prosopagnosia is similar to that of our case. However, agnosic alexia and color agnosia usually have a different neuropsychological basis.     

Visual Object Agnosia without Alexia or Prosopagnosia: Arguments for Separate Knowledge Stores

We review the points raised by Farah (this issue) in her discussion of the paper by Rumiati, Humphreys, Riddoch, and Bateman (1994), in which a case study was presented of a patient, Mr W., with visual object agnosia without either prosopagnosia or alexia. We reiterate the argument that Mr W. had impaired stored knowledge about the visual characteristics of objects, and that this was more severe than his deficit at a semantic level. In addition, we summarize supporting evidence from another patient (Humphreys & Rumiati, submitted), who showed the same pattern of breakdown as Mr W. We suggest that stored visual knowledge can be specific to the form of stimulus (words, objects, and faces), that these different forms of knowledge may be represented in distinct neural areas, and that agnosia can result after damage to stimulus-specific sites of knowledge representation.     

Auditory agnosia: apperceptive or associative disorder?

Neuropsychological testing of a patient with auditory agnosia showed that certain difficulties in the initial analysis of sounds may be the cause of his inability to understand spoken words and other sounds. Abnormalities included a slow reaction time to brief auditory stimuli (but not to equally brief visual stimuli or to longer auditory stimuli) and the need for approximately 1/4 sec of silence between two tones before the patient was able to hear them as separate. He could identify words and word associations if he was able to view the object whose name or word associate he was hearing. The findings imply that this patient's deficit in comprehending speech was probably apperceptive rather than associative in origin.     

Incomplete Kluver-Bucy syndrome and fluent aphasia

A case of probable herpetic viral encephalitis is presented. The clinical picture following the acute phase of disease was dominated by severe fluent aphasia, prominent oral tendencies, visual agnosia, and a decrease in fear reactions. Most of these symptoms, with the obvious exception of aphasia, are similar to those observed by Kluver and Bucy in rhesus monkeys that underwent bitemporal lobectomy. These manifestations may be explained by the tendency of the herpes simplex virus to invade the temporal lobes. "Agnosia" in the auditory field and changes in vocal behavior were observed by H. Kluver and P. C. Bucy (1939, Archives of Neurology and Psychiatry, 42, 949-1000) in some of their bitemporal monkeys. The association of sensory aphasia, as observed in this case, with the auditory "agnosia" observed in some bitemporal monkeys, is discussed.     

聋人副中央凹字N+1预视效益的眼动研究

聋人听觉受损后,在低水平的视觉认知任务中,表现出副中央凹注意增强效应。这种增强效应是否也会发生在高水平的汉语认知加工任务中？本研究采用边界范式,探究副中央凹注意增强效应对聋人读者合体字N+1预视效益的影响。研究发现,高技能聋人读者,可以获得合体字N+1语音和语义预视效益。研究表明,副中央凹注意增强促进了高技能聋人读者N+1预视信息的获得。     

Persistent visual aura following catheter ablation in a patient with WPW syndrome

We report a patient who has had persistent visual disturbances since she underwent catheter ablation to treat her Wolff-Parkinson-White (WPW) syndrome. We examined her visual symptoms carefully and quantitatively by means of our newly developed method combining image-processing and psychophysics. We first simulated the patient's visual symptoms using image-processing techniques. Since the simulation indicated that she would be very sensitive to the edges of the visual stimuli, we evaluated her sensitivity to the edges using psychophysics. The results indicated that she was hypersensitive to the clear-cut edges of the visual stimuli. Her visual symptoms were very similar to those of visual aura of migraine, rather than those of photosensitive epilepsy. Magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT), electroenchepalogram (EEG), and visual-evoked potentials (VEP) in the patient were normal. No abnormalities in her fundus, visual field, or electroretinogram were found, either. Transesophageal echocardiography with bubble study indicated that she had a preexisting right-to-left shunt. We hypothesize that visual aura of migraine was triggered and made persistent by the catheter ablation in this patient. Although the relationship between migraine, catheter ablation, and right-to-left shunts is unknown, previous studies on the transcatheter closure of patent foramen ovale suggest a possible link between them. Catheter ablation in patients with migraine and preexisting shunts may lead to exacerbations in migraine symptoms.     

听觉障碍对聋人视觉功能影响的理论之争：缺陷还是补偿？

听觉通道受损,是否会影响聋人的视觉功能？有三种理论对此做出了解释。缺陷理论：聋人视觉功能存在缺陷,包括听觉脚手架假说和劳动分工假说。补偿理论：聋人视觉功能会表现出增强,包括响应增强假说、知觉增强假说、超通道功能假说和背侧通路假说。整合理论：聋人视觉功能既可能表现为缺陷,也可能表现为增强,与实验任务和被试年龄有关。本文评述了听觉障碍对聋人视觉功能影响的三种理论,并对其今后的发展趋势进行了展望。     

Animals and artifacts may not be treated equally: differentiating strong and weak forms of category-specific visual agnosia

We examined a categorical dissociation hypothesis of category-specific agnosia using hierarchical regression to predict the naming responses of three agnosia patients while controlling a wide variety of perceptual and conceptual between-category differences. The living-nonliving distinction remained a significant predictor for two of the patients after controlling for all the other factors. For one remaining patient, the categorical variable was not significant once the form-function correlation of different objects was controlled. We argue that the visual system may use various subprocesses at different stages, some of which reflect true categorical organization and some of which reflect a unitary feature-based system that distinguishes kinds.     

Superior single dimension relative to "exclusive or" categorization performance by a patient with category-specific visual agnosia: empirical data and an ALCOVE simulation

ELM, a patient with category-specific visual agnosia, was tested on a single-dimension categorization problem, and the "exclusive or" (XOR) categorization problem. Stimuli were computer-generated shapes in which exemplars within a shape set shared values across two visual dimensions (curvature and thickness). In single-dimension categorization only curvature was relevant, and ELM performed as well as normal participants. In the XOR problem, categorization depended on being able to extract from memory values on curvature AND thickness for each exemplar, and ELM was significantly impaired on this task. A computer simulation using ALCOVE (Kruschke, 1992) reproduced ELM's behavior by changing a single (specificity) parameter related to how easily proximate objects within a multidimensional shape space could be disambiguated.     

How I see me depends on how I see we: the role of attachment style in social comparison

The self-concept is a social, flexible construct that shifts in response to the salience of a relationship partner. Three related experiments found that the tendency to pursue closeness in relationships (as measured by attachment style) served as a moderator of the shift. Specifically, individuals who avoid closeness in relationships became less similar to salient friends via contrast effects, whereas those who pursued closeness in relationships became more similar to salient friends via assimilation effects. Results are discussed in terms of their implications for the nature of the self-concept and the importance of friendships.     

Developmental changes in the linguistic brain after puberty

The development of reading skills is a complex and very long-lasting process. In an influential study Booth et al. demonstrated age-related changes in the activation of a network of left hemisphere regions, including the inferior frontal area, the superior temporal gyrus, and the angular gyrus. Interestingly, they found that the angular gyrus, which is involved in the mapping between phonological and orthographic representation, is automatically activated in adults during visual orthographic tasks not requiring this operation.     

Shape Integration for Visual Object Recognition and Its Implication in Category-Specific Visual Agnosia

A series of experiments was conducted on a patient (ELM) with bilateral inferior temporal lobe damage and category-specific visual agnosia in order to specify the nature of his functional impairment. In Experiment 1, ELM performed a task of picture/word matching that used line drawings of fruits and vegetables as stimuli. The pattern of confusions exhibited by the patient suggested a failure in processing the full range of shape features necessary for the unique specification of the target relative to other structurally related items. This hypothesis of a shape integration impairment was tested and verified by subsequent visual recognition experiments (Experiments 2-4), which used synthetic stimuli with shapes precisely defined on the dimensions of elongation, curvature, and tapering. Furthermore, it was determined (Experiment 5) that the integration deficit is specific to the retrieval of shape knowledge from memory and does not affect the encoding of the properties of visual stimuli. It is argued that these findings have critical implications for cognitive theories of visual object recognition and for an interpretation of the visual function of the inferior temporal cortex. Finally, it was shown that the patient's deficit for structural knowledge integration is modulated by the semantic properties of the objects (Experiment 6), thereby demonstrating the applicability of the present findings to an explanation of category-specific visual agnosia.     

Phonological alexia with optic and tactile anomia: a neuropsychological and anatomical study

We describe a patient with phonological alexia caused by a small hemorrhage in the posterior-inferior portion of the left temporal lobe. The lesion induced a highly selective impairment of phonological reading without concomitant oral language deficits other than anomia for objects presented in the visual and tactile modalities. We propose that an intact dorsal pathway from inferior visual association areas to Wernicke's area via the angular gyrus could mediate reading by the lexical route, while damage to a ventral pathway disrupted the patient's ability to read nonwords. We suggest further that although visually and tactually presented objects could be recognized and both verbally and nonverbally identified, they could not be named because of a disconnection from the area of word representations.     

Dorsal stream deficits suggest hidden dyslexia among deaf poor readers: correlated evidence from reduced perceptual speed and elevated coherent motion detection thresholds

Prelingual deafness and developmental dyslexia have confounding developmental effects on reading acquisition. Therefore, standard reading assessment methods for diagnosing dyslexia in hearing people are ineffective for use with deaf people. Recently, Samar, Parasnis, and Berent (2002) reported visual evoked potential evidence that deaf poor readers, compared to deaf good readers, have dorsal stream visual system deficits like those previously found for hearing dyslexics. Here, we report new psychometric and psychophysical evidence that deficits in dorsal stream function, likely involving extrastriate area MT, are associated with relatively poor reading comprehension in deaf adults. Poorer reading comprehension within a group of 23 prelingually deaf adults was associated with lower scores on the Symbol Digit Modality Test, a perceptual speed test commonly used to help identify dyslexia in hearing people. Furthermore, coherent dot motion detection thresholds, which reflect the functional status of area MT, correlated negatively with reading scores in each visual quadrant. Elevated motion thresholds for deaf poor readers were not due to general cognitive differences in IQ but were specifically correlated with poor perceptual speed. With IQ controlled, a highly reliable right visual field advantage for coherent motion detection was found. Additional analyses suggested that the functional status of dorsal stream motion detection mechanisms in deaf people is related to reading comprehension, but the direction and strength of lateralization of those mechanisms is independent of reading comprehension. Our results generally imply that dyslexia is a hidden contributor to relatively poor reading skill within the deaf population and that assessment of dorsal stream function may provide a diagnostic biological marker for dyslexia in deaf people.     

Brain activations associated with sign production using word and picture inputs in deaf signers

Effective literacy education in deaf students calls for psycholinguistic research revealing the cognitive and neural mechanisms underlying their written language processing. When learning a written language, deaf students are often instructed to sign out printed text. The present fMRI study was intended to reveal the neural substrates associated with word signing by comparing it with picture signing. Native deaf signers were asked to overtly sign in Chinese Sign Language (CSL) common objects indicated with written words or presented as pictures. Except in left inferior frontal gyrus and inferior parietal lobule where word signing elicited greater activation than picture signing, the two tasks engaged a highly overlapping set of brain regions previously implicated in sign production. The results suggest that word signing in the deaf signers relies on meaning activation from printed visual forms, followed by similar production processes from meaning to signs as in picture signing. The present study also documents the basic brain activation pattern for sign production in CSL and supports the notion of a universal core neural network for sign production across different sign languages.     

工作记忆负荷、形状干扰对聋人与听力正常人注意捕获影响的眼动研究

通过记录和分析被试的行为和眼动指标,本研究试图探讨不同工作记忆负荷下,形状干扰对聋人与听力正常人不同视野位置上刺激信息捕获注意的异同。研究结果表明：（1）形状干扰刺激虽然没有影响被试视觉加工的认知绩效,但被试的眼动模式会由于工作记忆负荷的改变而改变,高工作记忆负荷时,有形状干扰的注视次数高于无形状干扰。（2）工作记忆负荷、视野位置影响被试视觉加工任务的完成,被试在不同视野位置的加工过程表现出不一致的眼动模式。（3）聋人视觉加工在高工作记忆负荷时存在一定的劣势,但其对不同视野位置的信息加工及形状干扰所产生的注意捕获效应与听力正常人一致。     

Visually discriminated behavior in a "blind" adolescent retardate

A 16-yr-old retarded male, diagnosed organically blind and treated by those around him as a blind person, was given practice in discriminating visual stimuli. After training, he responded with significantly better than chance accuracy in a choice situation in which stimuli were as small as 18 pt Futura Medium type. In addition, he was trained to look at the experimenter's eyes when instructed to do so. Control procedures revealed that it was the reinforcement contingency that functioned to establish and maintain eye contact. Eye contact with the experimenter generalized in a limited way to situations in which this behavior was not reinforced, though not to a neutral individual. When the boy was required to use visual cues to help himself in a cafeteria line, he soon emitted the necessary behaviors, where formerly he had been assisted by others. Resumption of assistance markedly decreased self-help, suggesting that continued use of any newly learned skills would depend on the response of the individuals in his environment. The boy also learned eating behavior that appeared to require the use of visual cues.