Facial neglect

Face-Specific Perceptual Distortions Reveal A View- and Orientation-Independent Face Template

The spatial coordinate system in which a stimulus representation is embedded is known as its reference frame. Every visual representation has a reference frame [1], and the visual system uses a variety of reference frames to efficiently code visual information [e.g., 1-5]. The representation of faces in early stages of visual processing depends on retino-centered reference frames, but little is known about the reference frames that code the high-level representations used to make judgements about faces. Here, we focus on a rare and striking disorder of face perception-hemi-prosopometamorphopsia (hemi-PMO)-to investigate these reference frames. After a left splenium lesion, Patient A.D. perceives features on the right side of faces as if they had melted. The same features were distorted when faces were presented in either visual field, at different in-depth rotations, and at different picture-plane orientations including upside-down. A.D.'s results indicate faces are aligned to a view- and orientation-independent face template encoded in a face-centered reference frame, that these face-centered representations are present in both the left and right hemisphere, and that the representations of the left and right halves of a face are dissociable.

A shrunken world - micropsia after a right occipito-parietal ischemic stroke

Micropsia is a rare condition in which patients perceive the outside world smaller in size than it actually is. We examined a patient who, after a right occipito-parietal stroke, subjectively reported perceiving everything at seventy percent of the actual size. Using experimental tasks, we confirmed the extent of his micropsia at 70%. Visual half-field tests showed an impaired perception of shape, location and motion in the left visual field. As his micropsia concerns the complete visual field, we suggest that it is caused by a higher-order compensation process in order to reconcile the conflicting information from the two hemifields.

Unilateral spatial neglect after posterior parietal damage

Unilateral spatial neglect is a disabling neurologic deficit, most frequent and severe after right-hemispheric lesions. In most patients neglect involves the left side of space, contralateral to a right-hemispheric lesion. About 50% of stroke patients exhibit neglect in the acute phase. Patients fail to orient, respond to, and report sensory events occurring in the contralateral sides of space and of the body, to explore these portions of space through movements by action effectors (eye, limbs), and to move the contralateral limbs. Neglect is a multicomponent higher-level disorder of spatial awareness, cognition, and attention. Spatial neglect may occur independently of elementary sensory and motor neurologic deficits, but it can mimic and make them more severe. Diagnostic tests include: motor exploratory target cancellation; setting the midpoint of a horizontal line (bisection), that requires the estimation of lateral extent; drawing by copy and from memory; reading, assessing neglect dyslexia; and exploring the side of the body contralateral to the lesion. Activities of daily living scales are also used. Patients are typically not aware of neglect, although they may exhibit varying degrees of awareness toward different components of the deficit. The neural correlates include lesions to the inferior parietal lobule of the posterior parietal cortex, which was long considered the unique neuropathologic correlate of neglect, to the premotor and to the dorsolateral prefrontal cortices, to the posterior superior temporal gyrus, at the temporoparietal junction, to subcortical gray nuclei (thalamus, basal ganglia), and to parietofrontal white-matter fiber tracts, such as the superior longitudinal fascicle. Damage to the inferior parietal lobule of the posterior parietal cortex is specifically associated with the mainly egocentric, perceptual, and exploratory extrapersonal, and with the personal, bodily components of neglect. Productive manifestations, such as perseveration, are not a correlate of posterior parietal cortex damage.

Précis of From neuropsychology to mental structure

Neuropsychological results are increasingly cited in cognitive theories although their methodology has been severely criticised. The book argues for an eclectic approach but particularly stresses the use of single-case studies. A range of potential artifacts exists when inferences are made from such studies to the organisation of normal function – for example, resource differences among tasks, premorbid individual differences, and reorganisation of function. The use of “strong” and “classical” dissociations minimises potential artifacts. The theoretical convergence between findings from fields where cognitive neuropsychology is well developed and those from the normal literature strongly suggests that the potential artifacts are not critical. The fields examined in detail in this respect are short-term memory, reading, writing, the organisation of input and output speech systems, and visual perception. Functional dissociation data suggest that not only are input systems organised modularly, but so are central systems. This conclusion is supported by findings on impairment of knowledge, visual attention, supervisory functions, memory, and consciousness.

The frequency, clinical correlates, and mechanism of anosognosia after stroke

OBJECTIVE

To review the frequency, clinical correlates, and mechanism of anosognosia after stroke.

METHODS

We searched the most recent relevant literature on anosognosia after stroke and carried out a critical analysis of the main findings.

RESULTS

Anosognosia is present in about 10% of acute stroke patients and its diagnosis is relatively simple. Nevertheless, a valid and reliable standardization of diagnostic instruments and criteria for research purposes is more difficult to achieve. This limitation may partially account for various instruments available to assess anosognosia and the different strategies used to diagnose this phenomenon. Anosognosia is a fleeting phenomenon and chronic cases are infrequent. There is a robust association between anosognosia and right-hemisphere lesions involving cortical (insular, temporal, and parietal lobes) and subcortical structures (thalamus and basal ganglia). The main clinical correlates of anosognosia are the presence of neglect, cognitive deficits, previous strokes, and older age. Anosognosia has a negative impact on the rehabilitation of stroke patients. The mechanism of anosognosia remains unknown but was explained as owing to psychological denial, disconnection between left and right hemispheres, and dysfunction of a system that monitors the intention to move and actual movements.

CONCLUSION

Anosognosia is a relatively frequent complication of acute stroke and may become an excellent model to understand the mechanism of human awareness.

Neuropsychological inference with an interactive brain: A critique of the “locality” assumption

When cognitive neuropsychologists make inferences about the functional architecture of the normal mind from selective cognitive impairments they generally assume that the effects of brain damage are local, that is, that the nondamaged components of the architecture continue to function as they did before the damage. This assumption follows from the view that the components of the functional architecture are modular, in the sense of being informationally encapsulated. In this target article it is argued that this “locality” assumption is probably not correct in general. Inferences about the functional architecture can nevertheless be made from neuropsychological data with an alternative set of assumptions, according to which human information processing is graded, distributed, and interactive. These claims are supported by three examples of neuropsychological dissociations and a comparison of the inferences obtained from these impairments with and without the locality assumption. The three dissociations are: selective impairments in knowledge of living things, disengagment of visual attention, and overt face recognition. In all three cases, the neuropsychological phenomena lead to more plausible inferences about the normal functional architecture when the locality assumption is abandoned. Also discussed are the relations between the locality assumption in neuropsychology and broader issues, including Fodor's modularity hypothesis and the choice between top-down and bottom-up research approaches.

Are you always on my mind? A review of how face perception and attention interact

In this review we examine how attention is involved in detecting faces, recognizing facial identity and registering and discriminating between facial expressions of emotion. The first section examines whether these aspects of face perception are "automatic", in that they are especially rapid, non-conscious, mandatory and capacity-free. The second section discusses whether limited-capacity selective attention mechanisms are preferentially recruited by faces and facial expressions. Evidence from behavioral, neuropsychological, neuroimaging and psychophysiological studies from humans and single-unit recordings from primates is examined and the neural systems involved in processing faces, emotion and attention are highlighted. Avenues for further research are identified.

Revisiting unilateral neglect

Unilateral neglect, a neurological disorder in which patients fail to detect or respond to contralesional stimuli, has long been considered a failure of attentional orienting mechanisms. This review provides a selective overview of the prominent biases in spatial orienting and exploratory motor behaviour observed in these patients before considering the impact of other factors on the presentation of the disorder and how those factors might inform current neurological models of neglect. In the latter part of the review, we intend to suggest that neglect is likely to be a combination of distinct but interacting impairments including biases in attentional orienting, exploratory motor behaviours and a deficit of spatial working memory. That is, we suggest that the cardinal symptom of neglect - a loss of awareness for contralesional stimuli and events - arises as a result of a combination of these impairments rather than being associated solely with the more dramatic and immediately evident biases in spatial attention.

Hemispheric metacontrol and cerebral dominance in healthy individuals investigated by means of chimeric faces

Cerebral dominance and hemispheric metacontrol were investigated by testing the ability of healthy participants to match chimeric, entire, or half faces presented tachistoscopically. The two hemi-faces compounding chimeric or entire stimuli were presented simultaneously or asynchronously at different exposure times. Participants did not consciously detect chimeric faces for simultaneous presentations lasting up to 40 ms. Interestingly, a 20 ms separation between each half-chimera was sufficient to induce detection of conflicts at a conscious level. Although the presence of chimeric faces was not consciously perceived, performance on chimeric faces was poorer than on entire- and half-faces stimuli, thus indicating an implicit processing of perceptual conflicts. Moreover, the precedence of hemispheric stimulation over-ruled the right hemisphere dominance for face processing, insofar as the hemisphere stimulated last appeared to influence the response. This dynamic reversal of cerebral dominance, however, was not caused by a shift in hemispheric specialization, since the level of performance always reflected the right hemisphere specialization for face recognition. Thus, the dissociation between hemispheric dominance and specialization found in the present study hints at the existence of hemispheric metacontrol in healthy individuals.

The influence of divided attention on holistic face perception

There is evidence that upright, but not inverted, faces are encoded holistically. The holistic coding of faces was examined in four experiments by manipulating the attention allocated to target faces. In Experiment 1, participants in a divided attention condition were asked to match two upright flanker faces while encoding a centrally presented upright target face. Although holistic coding was evident in the full attention conditions, dividing attention disrupted holistic coding of target faces. In Experiment 2, we found that while matching upright flanker faces disrupted holistic coding, matching inverted flanker faces did not. Experiment 3 demonstrated that the differential effects of flanker orientation were not due to participants taking longer to match upright, than inverted, flanker faces. In Experiment 4, we found that matching fractured faces had an intermediate effect to that of matching upright and inverted flankers, on the holistic coding of the target faces. The findings emphasize the differences in processing of upright, fractured and inverted faces and suggest that there are limitations in the number of faces that can be holistically coded in a brief time.

Two eyes make a pair: facial organization and perceptual learning reduce visual extinction

We examined a patient with left spatial neglect and visual extinction due to right parietal damage in tasks where identical stimuli were presented before and after they were primed so as to be perceived as the eyes of schematic faces. In a first block, we presented alphanumeric stimuli (+, o, T, 6) on the right, left, or both sides of fixation on a blank background, and established that the patient could perceive unilateral stimuli on either side but extinguished most of the left-sided ones in the bilateral trials. In a second block, some of these stimuli (+, o) were presented again, but now in the position of eyes within the context of an oval frame which created the impression of a schematic face. Other stimuli (T, 6) were presented as previously on a blank background for an equal number of trials. In the third critical block, all stimuli were presented once again on a blank background, as in the first block. Now the patient extinguished very few of those left-sided stimuli primed to be seen as a pair of eyes in face configuration (+, o), but still extinguished most of the other stimuli (T, 6). A second control experiment showed no effect of repeatedly exposing stimuli in a common region of space defined by meaningless shape boundaries. These results suggest that facial organization can group eye features before the level where attentional selection or extinction occurs, and that such grouping may be influenced by rapid perceptual learning.

Pseudoneglect: a review and meta-analysis of performance factors in line bisection tasks

An exhaustive qualitative (vote-counting) review is conducted of the literature concerning visual and non-visual line bisection in neurologically normal subject populations. Although most of these studies report a leftward bisection error (i.e., pseudoneglect), considerable between-study variability and inconsistency characterize this literature. A meta-analysis of this same literature is performed in which the total quantitative data set, comprising 73 studies (or sub-studies) and 2191 subjects, is analyzed with respect to 26 performance factors. The meta-analytic results indicate a significant leftward bisection error in neurologically normal subjects, with an overall effect size of between -0.37 and -0.44 (depending on integration method), which is significantly modulated to varying degrees by a number of additional task or subject variables. For example, visual bisection tasks, midsagittal-pointing tasks and tactile bisection tasks all lead to leftward errors, while kinesthetic tasks result in rightward errors. Tachistoscopic forced-choice testing methods reveal much greater estimates of bisection error (effect size = -1.32) than do manual method-of-adjustment procedures (effect size= -0.40). Subject age significantly modulates line bisection performance such that older subjects err significantly rightward compared to younger subjects, and to veridical line midpoint. Male subjects make slightly larger leftward errors than do female subjects. Handedness has a small effect on bisection errors, with dextrals erring slightly further to the left than sinistral subjects. The hand used to perform manual bisection tasks modulated performance, where use of the left hand lead to greater leftward errors than those obtained using the right hand. One of the most significant factors modulating bisection error is the direction in which subjects initiate motor scanning (with either eye or hand), where a left-to-right scan pattern leads to large leftward errors while a right-to-left scan pattern leads to rightward errors.

Face recognition impairments

Face recognition impairments are often found in the context of brain injury involving the right cerebral hemisphere. Recognition impairments can be dissociated from impairments affecting the processing of other types of information carried by the face, such as expression. The face recognition impairments themselves take different forms, corresponding to idealized stages or levels of recognition. These types of error can also arise as transitory phenomena in normal everyday life. From these observations, psychologists have proposed functional models that characterize the organization of the face processing system in schematic form. Such models provide useful ways of summarizing what is known. More importantly, they also allow new findings to act as tests of each model’s usefulness by the extent to which they can be readily accommodated or force revision. Examples of this are briefly considered, including delusional misidentification, impaired learning of new faces, disordered attention to faces, ‘covert’ recognition in prosopagnosia, and unawareness of impaired face recognition.

Overt and covert processing of left-side information in unilateral neglect investigated with chimeric drawings

Overt and covert processing of contralesional information was investigated in 6 right-brain-damaged (RBD) patients with or without left hemispatial neglect by using three bedside tests that require the analysis of whole, half, and chimeric drawings. In the first task, patients named these stimuli. In the second task, patients designated as "same" or "different" drawings in a pair where one drawing was always whole and the other could be whole, half, or chimeric. In the third task, patients pointed to the more veridical, complete drawing that was presented with one half drawing, and two chimeric drawings. Although patients with no neglect performed without error in all conditions, patients with severe neglect based their performance on the analysis of the right side of the stimuli. In patients with mild neglect, not only did performance rely upon the right side of stimuli but it was also modulated by left-side information acquired either overtly or unconsciously.

Endogenous visuospatial precuing effects as a function of age and task demands

This experiment examined the effects of age on processing resource capacity using an endogenous visuospatial precuing task and four levels of resource demands. Younger and older adults made speeded two-choice responses to dim and bright targets that required a line-orientation or a lexical decision. An arrow preceding target onset served as an attentional cue to affect the spatial distribution of resources. It provided accurate information about the target's location on most trials and inaccurate or neutral information on the remaining trials. Although older adults were slower than younger adults under all conditions and were more affected by the resource demand manipulations, they exhibited a pattern of precuing effects across conditions that was similar to that of the younger adults. Results are consistent with the idea that the visuospatial attention system remains relatively unaffected by aging. However, the data speak against the idea that capacity reduction is the primary contributor to age-related slowing.

Cerebral correlates of visual awareness

While it may be a long time before we can specify the mechanisms through which a brain process achieves awareness, it may be possible to determine as a first step whether awareness is limited to the products of certain kinds of processing. In the domain of vision, for example, perceptual awareness might only be attainable in association with object-centred coding, configural representations of space, and other such forms of abstracted (non-retinocentric) coding. It appears that these forms of visual coding are anatomically restricted to telencephalic structures, and indeed it has been argued that they may be peculiar to, or at least visually dependent upon, the 'ventral stream' of visual areas with the cortex. It is suggested here that such a brain process would still not be able to enter visual awareness unless it was selectively amplified through neuronal gating of the kind that has been shown to be correlated with selective spatial attention. The present paper explores the extent to which this putative dual requirement for visual consciousness might form a basis for understanding the various phenomena of "covert vision" seen in patients suffering from hemianopia, apperceptive agnosia, and unilateral spatial neglect.

Evidence of altered dominance in children with congenital spastic hemiplegia

The study aimed at investigating lateralization effects and signs of transfer and crowding in children with congenital lateralized brain damage with the aid of a dichotic listening test, a chimeric test, and verbal and nonverbal neuropsychological tests. Thirty-three children with spastic hemiplegia and 86 control children (age 5.0-12.0 yr) were assessed. Children with left-hemisphere damage (n = 17) were found to have a pathological left-ear advantage for verbal material, and children with right-hemisphere damage (n = 16) were found to have a pathological right visual half-field advantage for visual material. Children with left-hemisphere damage and a left-ear advantage on the dichotic test were also found to have a right visual half-field advantage on the chimeric test, which was regarded as a sign of reversed dominance. No verbal or nonverbal differences emerged between the left-hemisphere and the right-hemisphere damage groups, nor did differences emerge when the children were reclassified by considering children with left hemisphere damage and signs of reversed dominance as having damage to the nondominant hemisphere. It was concluded that although lateralized brain damage may alter the dominance for verbal and visual functions, there is still considerable inter-individual variability with respect to inter- and intrahemispheric neural adjustment to damage. The dichotic and the chimeric tests did not indicate the presence of brain damage accurately, but they indicated the lateralization of damage in children with stated abnormality with a high degree (91.3%) of accuracy.

Spatial attention in the mental architecture: evidence from neuropsychology

Using neuropsychological evidence, this paper examines whether spatial attention functions as a domain-specific module or as a more general-purpose central processor. Data are presented from two spatial attention cuing tasks completed by subjects, with an acquired attentional deficit, and control subjects. In both tasks, an arrow indicated with high probability the side of response (response task) or the side of space on which the stimulus would appear (visuospatial task). In the response task, the stimuli appeared foveally and the response component was lateralized, and in the visuospatial task, the stimuli were lateralized and the response component remained constant in the midline. Only the neglect subjects showed a disproportionate increase in reaction time on both the response and visuospatial tasks when the arrow cued the subject to the ipsilateral side and the stimulus or response was on the side of space contralateral to the lesion. The substantial association across the two tasks suggests that a common underlying internal spatial representation subserves perception and action. While this finding is consistent with Fodor's view of a cross-domain processor, it does not meet all of his criteria of a central processor. We conclude, therefore, that the posterior attentional mechanism is strictly neither a module nor a central processor. Rather, these results suggest that a common attentional mechanism may subserve behavior in domains that are tightly coupled.

Domain-specific forms of neglect

In this paper, it is assumed that domain specificity is one of the crucial criteria of modularity. It is also assumed that hemispatial neglect is basically a spatial attention deficit. Then, the literature that has shown, on the basis of either single or double dissociations, that neglect can be confined to very specific representational domains is reviewed. In particular, two recent studies are summarized that reported dissociations between perceptual and motor neglect and between visual and tactile neglect. It is suggested that disorders of spatial attention can affect just one spatial representational domain. This satisfies the domain specificity criterion of modularity and suggests that spatial attention mechanisms may be modular.

Prosopagnosia can be associated with damage confined to the right hemisphere--an MRI and PET study and a review of the literature

The early position that prosopagnosia is predominantly associated with right hemisphere (RH) injury was challenged by the finding that in practically all cases that come to autopsy pathological data point to bilateral damage. Yet the rejection of the RH hypothesis may have been too hasty. We report three prosopagnosic patients in whom MRI and CT documented a lesion confined to the right occipito-temporal areas and PET confirmed that hypometabolism involved the RH only. A review of the literature brought out 27 cases with neuroimaging evidence that prosopagnosia was associated with RH damage plus four cases with surgical evidence. It remains, however, that the inability to recognize familiar faces is a rare disorder, not manifested by the majority of patients with right temporo-occipital injury. We submit that right-handers differ in the degree of their RH specialization in processing faces and that in only a minority of them is it so marked that it cannot be compensated for by the healthy left hemisphere.

Can task specific perceptual bias be distinguished from unilateral neglect?

The present study examined visuoperceptual bias in 12 right hemisphere damaged patients, eight of whom showed left unilateral neglect on standard clinical tests, and in 30 normal controls. In the chimeric faces task, subjects were required to judge which of a pair of faces appeared happier. Stimuli comprising each pair were mirror images, with the smiling half on the left of one face and on the right of the other. In the grey scales task, subjects were required to indicate which of two shaded rectangles appeared to be darker overall. Again, stimuli were mirror images, with the darker end appearing either on the left or on the right. Patients exhibited a significant rightward bias on both experimental tasks, in contrast to the significant leftward bias exhibited by controls. There was no significant correlation between patients' performances on standard clinical tests and the extent of bias on the two experimental tasks, suggesting that such patients exhibit distinct impairments of spatial cognition which are differentially indexed by the two types of task. Moreover, for both patients and controls, scores obtained on the two perceptual bias tasks were unrelated, suggesting that they may engage stimulus-specific processes which have different underlying patterns of asymmetrical processing. These data provide further support for models which propose that the heterogeneity of disorders of spatial cognition arise from disruption of distinct neural mechanisms.