Real object use facilitates object recognition in semantic agnosia

In the present paper we show that, in patients with poor semantic representations, the naming of real objects can improve when naming takes place after patients have been asked to use the objects, compared with when they name the objects either from vision or from touch alone, or together. In addition, the patients were strongly affected by action when required to name objects that were used correctly or incorrectly by the examiner. The data suggest that actions can be cued directly from sensory-motor associations, and that patients can then name on the basis of the evoked action.     

A new selective developmental deficit: Impaired object recognition with normal face recognition

Introduction

Studies of developmental deficits in face recognition, or developmental prosopagnosia, have shown that individuals who have not suffered brain damage can show face recognition impairments coupled with normal object recognition ( [Duchaine and Nakayama, 2005] , [Duchaine et?al., 2006] and [Nunn et?al., 2001] ). However, no developmental cases with the opposite dissociation – normal face recognition with impaired object recognition – have been reported. The existence of a case of non-face developmental visual agnosia would indicate that the development of normal face recognition mechanisms does not rely on the development of normal object recognition mechanisms.

Methods

To see whether a developmental variant of non-face visual object agnosia exists, we conducted a series of web-based object and face recognition tests to screen for individuals showing object recognition memory impairments but not face recognition impairments. Through this screening process, we identified AW, an otherwise normal 19-year-old female, who was then tested in the lab on face and object recognition tests.

Results

AW’s performance was impaired in within-class visual recognition memory across six different visual categories (guns, horses, scenes, tools, doors, and cars). In contrast, she scored normally on seven tests of face recognition, tests of memory for two other object categories (houses and glasses), and tests of recall memory for visual shapes. Testing confirmed that her impairment was not related to a general deficit in lower-level perception, object perception, basic-level recognition, or memory.

Discussion

AW’s results provide the first neuropsychological evidence that recognition memory for non-face visual object categories can be selectively impaired in individuals without brain damage or other memory impairment. These results indicate that the development of recognition memory for faces does not depend on intact object recognition memory and provide further evidence for category-specific dissociations in visual recognition.     

Evidence for perceptual deficits in associative visual (prosop)agnosia: a single-case study

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.     

Associative (prosop)agnosia without (apparent) perceptual deficits: a case-study

In associative agnosia early perceptual processing of faces or objects are considered to be intact, while the ability to access stored semantic information about the individual face or object is impaired. Recent claims, however, have asserted that associative agnosia is also characterized by deficits at the perceptual level, which are too subtle to be detected by current neuropsychological tests. Thus, the impaired identification of famous faces or common objects in associative agnosia stems from difficulties in extracting the minute perceptual details required to identify a face or an object. In the present study, we report the case of a patient DBO with a left occipital infarct, who shows impaired object and famous face recognition. Despite his disability, he exhibits a face inversion effect, and is able to select a famous face from among non-famous distractors. In addition, his performance is normal in an immediate and delayed recognition memory for faces, whose external features were deleted. His deficits in face recognition are apparent only when he is required to name a famous face, or select two faces from among a triad of famous figures based on their semantic relationships (a task which does not require access to names). The nature of his deficits in object perception and recognition are similar to his impairments in the face domain. This pattern of behavior supports the notion that apperceptive and associative agnosia reflect distinct and dissociated deficits, which result from damage to different stages of the face and object recognition process.     

Pointing to places and spaces in a patient with visual form agnosia

Previous investigations of visuospatial abilities in the visual form agnosic patient D.F. suggest that her egocentric sensorimotor processing is intact while her 'allocentric' judgments of spatial position are impaired. The current investigation extends these previous observations by comparing D.F.'s performance at pointing to a set of spatially distributed stimuli, either directly or by 'pantomiming' the responses in an adjacent homologous workspace. The results showed accurate sensorimotor localization when D.F. pointed directly to single targets or to sequences of targets, presumably as she could use egocentric visual coding. In spite of making relatively spared spatial judgments about the arrays, however, D.F. performed quite poorly when copying them and on the pantomimed pointing task. In this latter task good performance presumably depends on an ability to represent both the categorical and coordinate properties of the array (as does copying them), and to translate these into the effector-based coordinates required for accurate action. D.F.'s pantomimed pointing was similar to her copies of target arrays, as in both tasks there was evidence of spared (although somewhat degraded) appreciation of the relative spatial positions of the stimuli. Remarkably, her accuracy in this allocentric task was not worsened by longer pointing sequences. It is possible that D.F.'s degraded performance reflects a relative (though not complete) preservation of categorical coding within the ventral stream, despite a loss of coordinate coding there.     

Face context interferes with local part processing in a prosopagnosic patient

We investigated the role of local and global information on perceptual encoding of faces in patient HJA, who shows prosopagnosia and visual agnosia following occipito-temporal damage. HJA and an age-matched control were tested in a simultaneous matching task which focused on detection of local changes in faces: the inversion of central parts (eyes and mouth) relative to their context (as in the Thatcher illusion). Same-different judgements were made to normal, “thatcherised” and mixed type face pairs. Whole faces (Experiment 1), or face parts (Experiment 2), were presented in upright and inverted orientations. Compared to the control, HJA was severely impaired at matching whole faces, but he improved dramatically when face parts were presented in isolation. This suggests an inhibitory influence of face context on HJAs processing of local parts and a relatively intact ability to process part-based information from a face (when context cannot interfere). Face inversion did not affect HJAs performance. A control experiment (Experiment 3) with non-face stimuli (houses) suggested that the inhibitory influence of context on HJAs performance was restricted to faces. These results indicate that contextual information in a face can have an adverse influence on the processing of local part-based information in prosopagnosia.     

Acquired prosopagnosia as a face-specific disorder: Ruling out the general visual similarity account

Prosopagnosia is classically defined as a disorder of visual recognition specific to faces, following brain damage. However, according to a long-standing alternative view, these patients would rather be generally impaired in recognizing objects belonging to visually homogenous categories, including faces. We tested this alternative hypothesis stringently with a well-documented brain-damaged prosopagnosic patient (PS) in three delayed forced-choice recognition experiments in which visual similarity between a target and its distractor was manipulated parametrically: novel 3D geometric shapes, morphed pictures of common objects, and morphed photographs of a highly homogenous familiar category (cars). In all experiments, PS showed normal performance and speed, and there was no evidence of a steeper increase of error rates and RTs with increasing levels of visual similarity, compared to controls. These data rule out an account of acquired prosopagnosia in terms of a more general impairment in recognizing objects from visually homogenous categories. An additional experiment with morphed faces confirmed that PS was specifically impaired at individual face recognition. However, in stark contrast to the alternative view of prosopagnosia, PS was relatively more impaired at the easiest levels of discrimination, i.e. when individual faces differ clearly in global shape rather than when faces were highly similar and had to be discriminated based on fine-grained details. Overall, these observations as well as a review of previous evidence, lead us to conclude that this alternative view of prosopagnosia does not hold. Rather, it seems that brain damage in adulthood may lead to selective recognition impairment for faces, perhaps the only category of visual stimuli for which holistic/configural perception is not only potentially at play, but is strictly necessary to individualize members of the category efficiently.     

Similar cortical correlates underlie visual object identification and orientation judgment

Visual object perception has been suggested to follow two different routes in the human brain: a ventral, view-invariant occipital–temporal route processes object identity, whereas a dorsal, view-dependent occipital–parietal route processes spatial properties of an object. Using fMRI, we addressed the question whether these routes are exclusively involved in either object recognition or spatial representation. We presented subjects with images of natural objects and involved them either in object identification or object orientation judgment task. For both tasks, we observed activation in ventro-temporal as well as parietal areas bilaterally, with significantly stronger responses for the orientation judgment in both ventro-temporal as well as parietal areas. Our findings suggest that object identification and orientation judgment do not follow strictly separable cortical pathways, but rather involve both the dorsal and the ventral stream.     

Using voice recognition software to treat dysgraphia in a patient with conduction aphasia

Background: Augmentative and alternative communication (AAC) has primarily been utilised for motor speech deficits or as an aid for communicating basic needs in the acute stages of aphasia rehabilitation. However, AAC strategies can be employed for individuals with aphasia across a wide range of severity levels and at different stages of recovery. For individuals with chronic impairments in language, voice recognition software can further enhance communication by providing an alternative means for written expression.

Aims: To investigate the functional and linguistic effects of a treatment program that used voice recognition software to improve written communication in an individual with chronic aphasia.

Methods & Procedures: A 65-year-old woman with conduction aphasia participated in a prospective case study. During baseline testing the individual was evaluated on measures of language (i.e., Boston Diagnostic Aphasia Examination, 3rd edition, Goodglass, Kaplan, & Baressi, 2001 Goodglass, H., Kaplan, E. and Barresi, B. 2001. Boston Diagnostic Aphasia Examination, 3rd, Baltimore, MD: Lippincott Williams & Wilkins.  [Google Scholar]; Boston Naming Test, Kaplan, Goodglass, & Weintraub, 2001 Kaplan, E., Goodglass, H. and Weintraub, S. 2001. Boston Naming Test, 2nd, Philadelphia, PA: Lippincott Williams & Wilkins.  [Google Scholar]), computer skills, and functional communication (i.e., ASHA FACs, Frattali et al., 1995 Frattali, C., Thompson, C. K., Holland, A. L., Wohl, C. B. and Ferketic, M. K. 1995. American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults, Rockville, MD: American Speech-Language-Hearing Association.  [Google Scholar]; Quality of Communication Life Scales, Paul et al., 2004 Paul, D., Frattali, C., Holland, A., Thompson, C., Caperton, C. and Slater, S. 2004. Quality of Communication Life Scale (ASHA QCL), Rockville, MD: American Speech-Language-Hearing Association.  [Google Scholar]). A cursory examination of the oral peripheral structure was administered. Treatment consisted of 10 one-hour sessions of training on the Dragon NaturallySpeaking^© Program. Following treatment, measures of language, computer skills, quality of life, and functional communication were re-administered. Further, to evaluate if skills in written expression could be utilised to communicate via e-mail, a distance-learning program was implemented.

Outcomes & Results: Findings revealed that, with intensive instruction, the participant was able to independently access the computer and the Dragon NaturallySpeaking^© Program. At the conclusion of the treatment phase, functional writing abilities approximated spoken communication. Some minor changes in reading, repetition, and conversation were suggested on formal and informal assessment measures. The participant made substantial gains in using the program in her activities of daily living, but only achieved minor success in demonstrating her skills during distance learning.

Conclusions: The potential benefits of AAC devices may change throughout the course of recovery from aphasia. New technologies may facilitate gains in communication in individuals with aphasia throughout their lifespan. This study demonstrated that intensive training in the use of voice recognition software can enhance functional writing in an individual with chronic aphasia. Although marked progress in written expression was achieved, transfer of skills for use on the Internet was limited. Clinical management should include assessment of various assistive technologies across different modalities of communication for people at different stages of recovery from aphasia.     

Implicit integration in a case of integrative visual agnosia

We present a case (SE) with integrative visual agnosia following ischemic stroke affecting the right dorsal and the left ventral pathways of the visual system. Despite his inability to identify global hierarchical letters [Navon, D. (1977). Forest before trees: The precedence of global features in visual perception. Cognitive Psychology, 9, 353-383], and his dense object agnosia, SE showed normal global-to-local interference when responding to local letters in Navon hierarchical stimuli and significant picture-word identity priming in a semantic decision task for words. Since priming was absent if these features were scrambled, it stands to reason that these effects were not due to priming by distinctive features. The contrast between priming effects induced by coherent and scrambled stimuli is consistent with implicit but not explicit integration of features into a unified whole. We went on to show that possible/impossible object decisions were facilitated by words in a word-picture priming task, suggesting that prompts could activate perceptually integrated images in a backward fashion. We conclude that the absence of SE's ability to identify visual objects except through tedious serial construction reflects a deficit in accessing an integrated visual representation through bottom-up visual processing alone. However, top-down generated images can help activate these visual representations through semantic links.     

Clinical and audiological findings in a case of auditory agnosia

Summary A case is reported of severe agnosia for verbal and non-verbal sounds without associated aphasic disorder. A CT scan revealed bilateral, temporal lobe lesions from two ischaemic accidents that had occurred 9 months apart. The search for subtle deficits in this patient showed normal sensitivity to changes in the intensity and frequency of simple sounds; in contrast, his ability to discriminate sound duration and musical note sequences was severely impaired. The simultaneous recording of the whole auditory-evoked response pattern revealed no abnormality in the early components, which reflect the activation of the auditory nuclei and pathways of the brain stem. However, the middle and late components were delayed and slowed. These results and others in the literature suggest that the neocortex in man, as in other mammals, plays an essential role in the temporal aspects of hearing. Also, the two main ingredients commonly recognized in auditory agnosia, i.e. word deafness and the inability to interpret non-verbal sounds, are caused by the disruption of elementary, bilaterally represented cortical functions which start the processing of every kind of auditory information.     

Dorsal–ventral integration in object recognition

The idea of two parallel hierarchical pathways in vision has fueled a great deal of research and enhanced our understanding of visual processing in the brain. However, after 25 years, it has become clear that the earlier distinctions in terms of neuroanatomy and functional dissociation are less pure than originally considered. Dorsal visual areas may exhibit object-selective responses and many 3-D cues of shape, particularly structure-from-motion, appear to be computed exclusively by dorsal areas. These findings imply a more important role for dorsal visual areas in object recognition than previously considered and also place restrictions on the nature of ventral object representations. These representations will need to include information about the objects in 3-D, making them more viewpoint-invariant. They will also need to be invariant to the 3-D cue used to describe them. Through the discussion of relevant findings in psychophysics, single-unit electrophysiology, neuroanatomy and functional imaging, I suggest that these qualities are indeed present in ventral stream representations. Thus dorsal visual areas that extract 3-D structure of shapes from certain cues, can relate these representations to cue-invariant and view-invariant representations in the ventral stream.     

Preserved implicit form perception and orientation adaptation in visual form agnosia

Visual form agnosia is mainly characterized by profound deficits in visual form and shape discrimination. Previous studies have shown that patients retain the capacity for coordinated motor behaviors, color naming and implicit letter perception. However, it is unknown to what extent other visual functions, such as implicit form and orientation perception, are preserved. To address these questions, we investigated a single visual form agnosic patient, X.F., in two distinct experiments. X.F.'s visual lesions were mainly localized in the bilateral occipitotemporal cortex, with the dorsal visual stream and early visual cortex largely spared. In Experiment 1, X.F. named the color of different forms across 12 blocks of trials. After the first six blocks, the combinations of a form with its color were changed and the new combination was presented for the remaining six blocks. X.F.'s reaction time increased during the switch block and was significantly greater than the overall RT changes between adjacent, non-switch blocks. This indicates that X.F. retained the ability to perceive changes in form despite her inability to discriminate the forms. In Experiment 2, X.F. showed selective orientation adaptation effects to different spatial frequencies; that is, her contrast threshold was significantly higher when the adapting and test orientations were the same than when they were orthogonal, although her orientation discrimination performance was severely impaired. These data provide evidence of a functional dissociation between explicit and implicit visual abilities, and suggest that the residual early visual cortex mediates form and orientation processing in the absence of awareness.     

The fusiform face area is not sufficient for face recognition: evidence from a patient with dense prosopagnosia and no occipital face area

We tested functional activation for faces in patient D.F., who following acquired brain damage has a profound deficit in object recognition based on form (visual form agnosia) and also prosopagnosia that is undocumented to date. Functional imaging demonstrated that like our control observers, D.F. shows significantly more activation when passively viewing face compared to scene images in an area that is consistent with the fusiform face area (FFA) (p < 0.01). Control observers also show occipital face area (OFA) activation; however, whereas D.F.'s lesions appear to overlap the OFA bilaterally. We asked, given that D.F. shows FFA activation for faces, to what extent is she able to recognize faces? D.F. demonstrated a severe impairment in higher level face processing--she could not recognize face identity, gender or emotional expression. In contrast, she performed relatively normally on many face categorization tasks. D.F. can differentiate faces from non-faces given sufficient texture information and processing time, and she can do this is independent of color and illumination information. D.F. can use configural information for categorizing faces when they are presented in an upright but not a sideways orientation and given that she also cannot discriminate half-faces she may rely on a spatially symmetric feature arrangement. Faces appear to be a unique category, which she can classify even when she has no advance knowledge that she will be shown face images. Together, these imaging and behavioral data support the importance of the integrity of a complex network of regions for face identification, including more than just the FFA--in particular the OFA, a region believed to be associated with low-level processing.     

Dissociating 'what' and 'how' in visual form agnosia: a computational investigation.

Patients with visual form agnosia exhibit a profound impairment in shape perception (what an object is) coupled with intact visuomotor functions (how to act on an object), demonstrating a dissociation between visual perception and action. How can these patients act on objects that they cannot perceive? Although two explanations of this 'what-how' dissociation have been offered, each explanation has shortcomings. A 'pathway information' account of the 'what-how' dissociation is presented in this paper. This account hypothesizes that 'where' and 'how' tasks require less information than 'what' tasks, thereby allowing 'where/how' to remain relatively spared in the face of neurological damage. Simulations with a neural network model test the predictions of the pathway information account. Following damage to an input layer common to the 'what' and 'where/how' pathways, the model performs object identification more poorly than spatial localization. Thus, the model offers a parsimonious explanation of differential 'what-how' performance in visual form agnosia. The simulation results are discussed in terms of their implications for visual form agnosia and other neuropsychological syndromes.     

Right perceptual bias and self-face recognition in individuals with congenital prosopagnosia

The existence of a drift to base judgments more on the right half-part of facial stimuli, which falls in the observer's left visual field (left perceptual bias (LPB)), in normal individuals has been demonstrated. However, less is known about the existence of this phenomenon in people affected by face impairment from birth, namely congenital prosopagnosics. In the current study, we aimed to investigate the presence of the LPB under face impairment conditions using chimeric stimuli and the most familiar face of all: the self-face. For this purpose we tested 10 participants with congenital prosopagnosia and 21 healthy controls with a face matching task using facial stimuli, involving a spatial manipulation of the left and the right hemi-faces of self-photos and photos of others. Even though congenital prosopagnosics performance was significantly lower than that of controls, both groups showed a consistent self-face advantage. Moreover, congenital prosopagnosics showed optimal performance when the right side of their face was presented, that is, right perceptual bias, suggesting a differential strategy for self-recognition in those subjects. A possible explanation for this result is discussed.     

Selective space transformation deficit in a patient with spatial agnosia

Abstract

We studied the spatial processing abilities of a 55-year-old male patient, PAO, with a right perisylvian lesion. Although the patient showed no problems in performing object recognition tasks, he was impaired in visuo-spatial tasks. PAO's most prominent deficit was a marked inability to manipulate figures mentally in the absence of an impairment in visuospatial working memory. His deficit would surface whenever a non-predictable rotational change in the spatial frame occurred. In contrast, his perception of spatial location and his ability to cope with size transformations were in the normal range. These results suggest that the deficit described here is selective to the rotational operation. The results are discussed in relation to the model of Kosslyn et al. (Journal of Experimental Psychology: Human Perception and Performance 1992; 18: 562-77) proposing the existence of two separate, categorical and metric, spatial coding systems, only the former of which is held to be impaired.     

Evidence of an eye movement-based memory effect in congenital prosopagnosia

While extensive work has examined the role of covert recognition in acquired prosopagnosia, little attention has been directed to this process in the congenital form of the disorder. Indeed, evidence of covert recognition has only been demonstrated in one congenital case in which autonomic measures provided evidence of recognition (Jones and Tranel, 2001), whereas two investigations using behavioural indicators failed to demonstrate the effect (de Haan and Campbell, 1991; Bentin et al., 1999). In this paper, we use a behavioural indicator, an "eye movement-based memory effect" (Althoff and Cohen, 1999), to provide evidence of covert recognition in congenital prosopagnosia. In an initial experiment, we examined viewing strategies elicited to famous and novel faces in control participants, and found fewer fixations and reduced regional sampling for famous compared to novel faces. In a second experiment, we examined the same processes in a patient with congenital prosopagnosia (AA), and found some evidence of an eye movement-based memory effect regardless of his recognition accuracy. Finally, we examined whether a difference in scanning strategy was evident for those famous faces AA failed to explicitly recognise, and again found evidence of reduced sampling for famous faces. We use these findings to (a) provide evidence of intact structural representations in a case of congenital prosopagnosia, and (b) to suggest that covert recognition can be demonstrated using behavioural indicators in this disorder.     

Integration of tactile input across fingers in a patient with finger agnosia

Finger agnosia has been described as an inability to explicitly individuate between the fingers, which is possibly due to fused neural representations of these fingers. Hence, are patients with finger agnosia unable to keep tactile information perceived over several fingers separate? Here, we tested a finger agnosic patient (GO) on two tasks that measured the ability to keep tactile information simultaneously perceived by individual fingers separate. In experiment 1 GO performed a haptic search task, in which a target (the absence of a protruded line) needed to be identified among distracters (protruded lines). The lines were presented simultaneously to the fingertips of both hands. Similarly to the controls, her reaction time decreased when her fingers were aligned as compared to when her fingers were stretched and in an unaligned position. This suggests that she can keep tactile input from different fingers separate. In experiment two, GO was required to judge the position of a target tactile stimulus to the index finger, relatively to a reference tactile stimulus to the middle finger, both in fingers uncrossed and crossed position. GO was able to indicate the relative position of the target stimulus as well as healthy controls, which indicates that she was able to keep tactile information perceived by two neighbouring fingers separate. Interestingly, GO performed better as compared to the healthy controls in the finger crossed condition. Together, these results suggest the GO is able to implicitly distinguish between tactile information perceived by multiple fingers. We therefore conclude that finger agnosia is not caused by minor disruptions of low-level somatosensory processing. These findings further underpin the idea of a selective impaired higher order body representation restricted to the fingers as underlying cause of finger agnosia.