Cases reported "Agnosia"

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1/359. Prosodic preservation in landau-kleffner syndrome: a case report.

    landau-kleffner syndrome (LKS) is a rare acquired condition of auditory verbal agnosia and convulsive disorder in children. It has been proposed that there is a functional relationship between electrical disturbance and the speech defect. Prosody or the melody of language, as described by Monrad-Krohn (1947), is one aspect of non-verbal communication which is distributed bilaterally in the brain. Prosodic parameters of expression and perception in one 7.5-year-old child were tested to see if they were preserved as a means of communication. The child was observed during video-electroencephalogram (EEG) monitoring over a 48-hour period. All utterances were recorded and subject to analysis for the salience and variation of acoustic correlates of prosody. Prosodic comprehension was measured using specific perceptual tasks previously presented to normal children between the ages of 5.5 and 8.5. Despite being unable to meaningfully use or perceive phonemes, the child was able to use variations in fundamental frequency, duration and intensity of utterances, to convey both emotional and propositional intent. Similarly, the child was able to discriminate prosodic contours of a male adult voice to an age equivalent to 5.5 to 6.5 years. This argues in favour of the notion for educating such children not only through the visual channel but also through the auditory channel. ( info)

2/359. Memories are made of this: the effects of time on stored visual knowledge in a case of visual agnosia.

    We report the effects of the passage of time on the longterm visual knowledge for objects in a patient with visual agnosia (H.J.A.). The naming of real objects was found to have improved, although this was not associated with any change in H.J.A.'s basic perceptual abilities which were stable over a 16-year period. The improvement in object naming was attributed to better use of non-contour-based visual information (such as surface detail and depth cues). In addition, we demonstrate a deterioration in H.J.A.'s long-term memory for the visual properties of objects, and argue that this has occurred as a result of his having impaired perceptual input. The deterioration was only apparent in drawing from memory and in the verbal descriptions of items; with forced-choice testing, H.J.A. operated at ceiling; we propose that current tests of visual imagery may not be sufficiently sensitive to detect subtle impairments of visual memory. Our findings can be taken to indicate that perceptual and memorial processes are not functionally independent, but are linked in an interactive manner. ( info)

3/359. On some neurobiological and cultural-anthropological aspects of the contralateral-neglect syndrome.

    Contralateral neglect is a frequent clinical syndrome which can be provoked by lesions in several brain areas (primarily inferior parietal and frontal) and includes symptoms of motor and perceptual negligence of both real and imaginative contralateral hemi-space. Attentional and representative theories attempting to explain neglect are presently the most popular. This paper analyzes two cases of neglect patients. Paying attention especially to their reading defects, a possible role of the persons with contralateral neglect is proposed in the development of script. Other neurobiological and cultural-anthropological questions arising from the analysis of these cases are also discussed. ( info)

4/359. prosopagnosia and structural encoding of faces: evidence from event-related potentials.

    Event-related brain potentials (ERPs) were recorded in response to unfamiliar faces and to houses from a severely prosopagnosic patient (PHD) and 24 control subjects. For all control subjects, faces elicited an enhanced negativity at lateral temporal electrodes (N170). This component was absent for PHD. Comparable results were obtained in response to inverted faces and houses. A selective deficit in face recognition is therefore reflected by abnormalities in ERP components specific to faces. As PHD was shown to have substantial deficits on tasks requiring the structural analysis of faces, these findings are consistent with the view that the N170 reflects processes involved in the structural encoding of faces, and may be a measure of selective impairments in the analysis of face components. ( info)

5/359. A case of verbal auditory agnosia: missing the word ... missing the sound....

    The neuropsychological nature of verbal auditory agnosia is not fully understood. This study aims to describe the language deficits and the remediation strategies used in a person with verbal auditory agnosia. In addition, it will address the theoretical issues concerning the nature of the phenomenon and the clinical implications in the management of people with this disorder. ( info)

6/359. Tactile morphagnosia secondary to spatial deficits.

    A 73-year old man showed visual and tactile agnosia following bilateral haemorrhagic stroke. Tactile agnosia was present in both hands, as shown by his impaired recognition of objects, geometrical shapes, letters and nonsense shapes. Basic somatosensory functions and the appreciation of substance qualities (hylognosis) were preserved. The patient's inability to identify the stimulus shape (morphagnosia) was associated with a striking impairment in detecting the orientation of a line or a rod in two- and three-dimensional space. This spatial deficit was thought to underlie morphagnosia, since in the tactile modality form recognition is built upon the integration of the successive changes of orientation in space made by the hand as it explores the stimulus. Indirect support for this hypothesis was provided by the location of the lesions, which could not account for the severe impairment of both hands. Only those located in the right hemisphere encroached upon the posterior parietal cortex, which is the region assumed to be specialised in shape recognition. The left hemisphere damage spared the corresponding area and could not, therefore, be held responsible for the right hand tactile agnosia. We submit that tactile agnosia can result from the disruption of two discrete mechanisms and has different features. It may arise from a parietal lesion damaging the high level processing of somatosensory information that culminates in the structured description of the object. In this case, tactile recognition is impaired in the hand contralateral to the side of the lesion. Alternatively, it may be caused by a profound derangement of spatial skills, particularly those involved in detecting the orientation in space of lines, segments and complex patterns. This deficit results in morphagnosia, which affects both hands to the same degree. ( info)

7/359. Can face recognition really be dissociated from object recognition?

    We argue that the current literature on prosopagnosia fails to demonstrate unequivocal evidence for a disproportionate impairment for faces as compared to nonface objects. Two prosopagnosic subjects were tested for the discrimination of objects from several categories (face as well as nonface) at different levels of categorization (basic, subordinate, and exemplar levels). Several dependent measures were obtained including accuracy, signal detection measures, and response times. The results from Experiments 1 to 4 demonstrate that, in simultaneous-matching tasks, response times may reveal impairments with nonface objects in subjects whose error rates only indicate a face deficit. The results from Experiments 5 and 6 show that, given limited stimulus presentation times for face and nonface objects, the same subjects may demonstrate a deficit for both stimulus categories in sensitivity. In Experiments 7, 8 and 9, a match-to-sample task that places greater demands on memory led to comparable recognition sensitivity with both face and nonface objects. Regardless of object category, the prosopagnosic subjects were more affected by manipulations of the level of categorization than normal controls. This result raises questions regarding neuropsychological evidence for the modularity of face recognition, as well as its theoretical and methodological foundations. ( info)

8/359. Unconscious letter discrimination is enhanced by association with conscious color perception in visual form agnosia.

    Adaptive behavior guided by unconscious visual cues occurs in patients with various kinds of brain damage as well as in normal observers, all of whom can process visual information of which they are fully unaware [1] [2] [3] [4] [5] [6] [7] [8]. Little is known on the possibility that unconscious vision is influenced by visual cues that have access to consciousness [9]. Here we report a 'blind' letter discrimination induced through a semantic interaction with conscious color processing in a patient who is agnosic for visual shapes, but has normal color vision and visual imagery. In seeing the initial letters of color names printed in different colors, it is normally easier to name the print color when it is congruent with the initial letter of the color name than when it is not [10]. The patient could discriminate the initial letters of the words 'red' and 'green' printed in the corresponding colors significantly above chance but without any conscious accompaniment, whereas he performed at chance with the reverse color-letter mapping as well as in standard tests of letter reading. We suggest that the consciously perceived colors activated a representation of the corresponding word names and their component letters, which in turn brought out a partially successful, unconscious processing of visual inputs corresponding to the activated letter representations. ( info)

9/359. Coding space within but not between objects: evidence from Balint's syndrome.

    The ability to make spatial judgements was examined in a patient demonstrating poor perception of multiple objects following bilateral parietal lesions, under conditions in which the presence of the stimuli to which judgements were made could be detected. The tasks required judgements of spatial length or the position of coloured parts of stimuli. We manipulated the degree to which two uprights in a display could be encoded into a single perceptual object using either stored knowledge or bottom-up cues based on 2D or 3D image relations. Performance was dependent on the presence of both bottom-up grouping and familiarity. However, connectedness in the image was not sufficient to benefit performance, when stimuli were separate objects in 3D space. This deficit in spatial judgements, arising following detection of the relevant stimulus elements, is attributed to an impairment in coding the spatial relations between separate perceptual objects. This deficit could be overcome if stimuli could be grouped in 3D, using bottom-up cues and top-down knowledge. ( info)

10/359. Auditory agnosia and auditory spatial deficits following left hemispheric lesions: evidence for distinct processing pathways.

    Auditory recognition and auditory spatial functions were studied in four patients with circumscribed left hemispheric lesions. Patient FD was severely deficient in recognition of environmental sounds but normal in auditory localisation and auditory motion perception. The lesion included the left superior, middle and inferior temporal gyri and lateral auditory areas (as identified in previous anatomical studies), but spared Heschl's gyrus, the acoustic radiation and the thalamus. Patient SD had the same profile as FD, with deficient recognition of environmental sounds but normal auditory localisation and motion perception. The lesion comprised the postero-inferior part of the frontal convexity and the anterior third of the temporal lobe; data from non-human primates indicate that the latter are interconnected with lateral auditory areas. Patient MA was deficient in recognition of environmental sounds, auditory localisation and auditory motion perception, confirming that auditory spatial functions can be disturbed by left unilateral damage; the lesion involved the supratemporal region as well as the temporal, postero-inferior frontal and antero-inferior parietal convexities. Patient CZ was severely deficient in auditory motion perception and partially deficient in auditory localisation, but normal in recognition of environmental sounds; the lesion involved large parts of the parieto-frontal convexity and the supratemporal region. We propose that auditory information is processed in the human auditory cortex along two distinct pathways, one lateral devoted to auditory recognition and one medial and posterior devoted to auditory spatial functions. ( info)
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