Abstract: | Anatomical and physiological investigations indicate two majordistinct functional streams within the extrastriate visual cortexof the macaque monkey, and behavioral observations suggest thatthe ventral (occipitotemporal) pathway is the cornerstone forobject recognition whereas the dorsal (occipitoparietal) pathwayis primarily involved in visuospatial perception and visuomotorperformance. In the context of this dichotomy we conducted apsychophysical and neuropsychological study of visual perceptualabilities in two stroke patients, each with lesions involvingseveral extrastriate areas. Magnetic resonance imaging demonstratedbilateral lesions; in one patient (E.W.) the lesion involvesthe ventral medial portions of the occipital and temporal lobes,and in the other (A.F.) the lesion involves dorsally the occipital-parietalarea, including the region of the temporal-parietal-occipitaljunction. E.W. suffers from achromatopsia of central origin,prosopagnosia, visual agnosia, and alexia without agraphia.His depth and motion perception, including recognition of movingobjects, are normal. He has superior visual field loss bilaterally,and slightly impaired acuity, and complains that the world appearsin a deep twilight even on a sunny day. In contrast, A.F. showsspecific deficits of stereopsis, spatial localization, and severalaspects of motion perception. He is also impaired at recognizingobjects presented from unconventional views, but recognitionof prototypical views of objects, and color and form discriminationare normal, as is his ability to recognize faces. The anatomical characteristics of the lesions of these two patientspermit a direct experimental comparison of the effects of lesionsconfined to the parietal or temporal pathways. E.W.'s and A.F.'sperformance on the psychophysical and neuropsychological tasksdiscussed here supports the functional distinction between adorsal and a ventral extrastriate system but additionally suggeststhe existence of a pathway involved in identification-from-motionthat is separate from both the dorsal early motion/spatial analysispathway and the ventral color/static-form pathway. |