Cases reported "Perceptual Disorders"

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1/12. attention-referenced visual representations: evidence from impaired visual localization.

    Spatial representations in the visual system were probed in 4 experiments involving A. H., a woman with a developmental deficit in localizing visual stimuli. Previous research (M. McCloskey et al., 1995) has shown that A. H.'s localization errors take the form of reflections across a central vertical or horizontal axis (e.g., a stimulus 30 degrees to her left localized to a position 30 degrees to her right). The present experiments demonstrate that A. H.'s errors vary systematically as a function of where her attention is focused, independent of how her eyes, head, or body are oriented, or what potential reference points are present in the visual field. These results suggest that the normal visual system constructs attention-referenced spatial representations, in which the focus of attention defines the origin of a spatial coordinate system. A more general implication is that some of the brain's spatial representations take the form of coordinate systems.
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2/12. Retinotopic modulation of space misrepresentation in unilateral neglect: evidence from quadrantanopia.

    A patient with right sided brain damage suffered contralesional neglect, inferior quadrantanopia (with 0 degrees sparing in the left eye and 13 degrees sparing in the right), and a visual field restriction (to 15 degrees ) in the upper contralesional quadrant of the left eye. In binocular vision, the patient showed underestimation of the horizontal size of contralesional line segments unless cued to localise their end points. When asked to reproduce, in monocular vision, 10 degrees and 20 degrees distances between two attentionally cued end points lying on the frontal vertical plane, the patient showed relative contralesional overextension and ipselesional underextension along the directions falling within the blind sectors of the neglected space. No asymmetry was present along the directions falling within the seeing sectors of the same space. These findings suggest precise retinotopic modulation of space misrepresentation in unilateral neglect.
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3/12. Object-based versus object-centred neglect in reading words.

    Neglect dyslexia is a reading disorder which affects the identification of portions of words or sentences and is typically due to right-brain damage. Caramazza and Hillis (1990a, b) proposed a model of representation of words whereby various patterns of neglect dyslexia are attributed to selective impairment to the different forms of representation. According to the model, patients with first and second level deficits will "neglect" those parts of horizontally presented words that fall on one side of the retina, or on one side of the string centre, respectively, but will read vertically presented words without errors. A patient with a third level deficit will neglect letters at the beginning of the word irrespective of whether they fall on the right or left half of the retina, or on the right or the left of the word centre. In the present paper I describe an atypical pattern of neglect errors that is not easily explicable by this model and is better interpreted as an object-based neglect within an ego-centred frame of reference.
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4/12. Developmental neglect dyslexia in a Hebrew-reading child.

    This paper describes for the first time a detailed study of a child with neglect dyslexia. NT is 10-year-old child, with left word-based neglect dyslexia, without clinical signs of visuo-spatial neglect. Since he is a native speaker of Hebrew, which is read from right to left, his neglect dyslexia manifests in omissions and substitutions of final letters. He is severely impaired in single words, with 96% of his errors being omissions and substitutions of final letters. When presented with more than one word, in word pairs, sentences or text, he neglects the left part of each word, but never omit whole words on the left side of the page. His reading improves considerably when the same word is presented vertically or when manipulations are done to shift his attention to the left--with coloured final letters, flashing light, or tapping his finger to the left of each word. NT's neglect dyslexia is very selective, with good reading of numbers and symbols, and even good performance on letter sequences when no reading is required. A dissociation is also detected between his impaired reading due to neglect dyslexia and his normal performance on conventional clinical tests of general visual neglect visual of line, object and letter cancellation, line bisection, object drawing and copying. His neglect dyslexia seems to be developmental as no abrupt onset is reported.
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5/12. Spatial-temporal anisometries following right parietal damage.

    patients with right parietal damage often have a lateralized deficit of spatial attention. In addition to a spatial deficit, such patients have also been reported to have a non-spatial deficit in temporal processing. Here, we tested the hypothesis that these spatial and temporal deficits might be linked if the right temporal-parietal cortex is important in integrating spatial and temporal attention. In AF, a patient with an acute right temporal-parietal stroke, we replicated previous observations showing that he was biased to judge ipsilesional stimuli as occurring before contralesional stimuli. More importantly, for vertically aligned stimuli, AF more accurately judged the temporal order of successive ipsilesional than contralesional stimuli. Furthermore, his contralesional performance improved with stimuli with larger vertical separations. Taken together, these findings provide additional evidence that right temporal-parietal damage produces a processing refractory period for stimuli in contralesional space that extends in both space and time. These findings are in agreement with other studies that suggest that the right temporal-parietal cortex is important in integrating the where and when of stimuli.
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6/12. Impaired spatial working memory: one component of the visual neglect syndrome?

    Both impaired spatial working memory (SWM) and unilateral neglect may follow damage to the right parietal lobe. We propose that impaired SWM can exacerbate visual neglect, due to failures in remembering locations that have already been searched. When combined with an attentional bias to the ipsilesional right side, such a SWM impairment should induce recursive search of ipsilesional locations. Here we studied a left neglect patient with a right temporoparietal haemorrhage. On a nonlateralised, purely vertical SWM task, he was impaired in retaining spatial locations. In a visual search task, his eye position was monitored while his spatial memory was probed. He recursively searched through right stimuli, re-fixating previously inspected items, and critically treated them as if they were new discoveries, consistent with the SWM deficit. When his recovery was tracked over several months, his SWM deficit and left neglect showed concurrent improvements. We argue that impaired SWM may be one important component of the visual neglect syndrome.
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7/12. Spatial representations and multiple-visual-systems hypotheses: evidence from a developmental deficit in visual location and orientation processing.

    AH, a young, well-educated woman, has a developmental deficit in processing visual location and orientation information. Her deficit manifests itself in a wide range of visual tasks, including visually-guided reaching, copying pictures and words, and responding verbally to the location or orientation of visual stimuli; however, her performance in non-visual localization tasks is intact. AH's visual location and orientation errors are systematic left-right or up-down reflections (e.g., reaching to the far right for an object on the far left). More specifically, the errors involve reflection across the point where AH's attention is focused, regardless of where her eyes are fixated. These results imply that at some level(s) of the visual system, locations and orientations of visual stimuli are represented in a spatial coordinate system with an origin defined by the focus of attention. In these attention-centered representations location is specified in terms of distance and direction of displacement from the attentional focus along horizontal and vertical reference axes. AH's errors, I argue, result from misrepresentation of displacement direction (e.g., left rather than right, down rather than up) along a reference axis. Several visual variables dramatically affected AH's performance in visual location and orientation tasks: She was much more accurate for stimuli that were brief, moving, flickering, low in contrast, or high in eccentricity, than for those that were long in duration, stationary, continuous, high in contrast, and low in eccentricity. These results suggest that location and orientation are computed in each of two visual subsystems, which I call transient and sustained, and that AH's deficit affects only the sustained subsystem. I argue that AH's performance poses challenges to multiple-visual-subsystems hypotheses proposed by Ungerleider and Mishkin (1982) and by Milner and Goodale (1995).
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8/12. Crossing the midline: reducing attentional deficits via interhemispheric interactions.

    patients with unilateral neglect and extinction show a profound lack of awareness of stimuli presented contralateral to their lesion. However, many processes of perception are intact and contralesional stimuli seem to reach a high level of representation, perceptual and semantic. Some of these processes can work to decrease the magnitude of the attentional deficit. Here, we examine two of these intact processes, feature detection and perceptual grouping. First, we demonstrate that feature detection occurs in parallel in the contralesional visual fields of neglect and extinction patients. Second, we attempt to dissociate the influence of perceptual contours across the vertical meridian from the presence of an object or higher-level perceptual unit (or group) that may be created by these contours. We find that connections across the midline affect attentional deficits independently of the objects they may create. This suggests that several effects of grouping on neglect and extinction may be mediated by long-range cortical interactions that arise from connections across the vertical meridian.
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9/12. Spatial compression in visual neglect: a case study.

    In the standard account of left neglect, some manner of attentional boundary is postulated such that elements to the left of that boundary are cognitively neglected. We propose an alternative model in which space is distorted ('compressed') in neglect. A new task is devised whereby the subject must follow 'in imagination' the direction of an arrowhead across 'empty' space to its corresponding position in a numerical target array. The two-dimensional array is Euclidian and all four arrow/array relationships are incorporated (arrow to the left/right of a vertical array, arrow to the top/bottom of a horizontal array). Normal subjects perform at ceiling, with excellent accuracy in all orientations and positions. A patient with severe left neglect (consequent upon lesion of the right temporo-parietal region) shows systematic deflections in her judgement of target positions. These distortions are fully consistent with a model whereby points in 'left space' are compressed rightwards; the compression function is linearly proportional to the coordinates of Euclidian space.
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10/12. Spatial representation of words in the brain implied by studies of a unilateral neglect patient.

    reading and writing require access to stored knowledge about the spelling of words. Presumably, we recognize chair but not chare or chiar as a word of English, and similarly would write 'chair' but not 'chare' or 'chiar', because we access orthographic representations that specify the identity and the order of the graphemes (abstract letter representations) that comprise the spelling of words. Thus, a fundamental problem concerns the content and structure of the hypothesized orthographic representations, and how information about grapheme order is represented and processed. We present evidence from a brain-damaged patient (N.G.) with unilateral neglect that this information is coded spatially. Unilateral neglect is a disorder clinically characterized by the inability to perceive or respond to stimuli presented to the side contralateral to the site of lesion, despite the absence of significant sensory or motor deficits. The patient made reading and spelling errors only on the right half of words, regardless of length. Furthermore, she produced the same pattern of errors in reading and spelling, irrespective of the topographic arrangement of stimuli in reading (horizontal, vertical or mirror-reversed words) and of the type of response in spelling (written, oral or backward oral spelling). This pattern of performance suggests that order information in orthographic representations is coded spatially in a word-centred coordinate system; that is, in a spatially defined coordinate frame whose centre corresponds to the midpoint of a canonical, orientation-invariant representation of the word and not the midpoint of the word stimulus.
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