Category-specific versus modality-specific aphasia for colours: a review of the pioneer case studies

Visual objects and their colors

The ventral temporal cortex hosts key regions for the high-level visual processing of object shape and color. These areas represent nodes of large-scale neural circuits dedicated to object recognition. In the language-dominant hemisphere, some of these regions communicate with the language systems; by assigning verbal labels to percepts, these circuits speedup stimulus categorization, and permit fast and accurate interindividual communication. By impairing the functioning of these circuits, neurological damage may provoke disabling disorders of the processing of visual objects and of their colors. Brain damage of vascular, degenerative, toxic, or traumatic origin can induce deficits at different levels of visual processing, from the building of shape- or wavelength-invariant percepts, to their connections with semantic knowledge and with the appropriate lexical entry. After an overview of the neuroimaging of domain-preferring regions for object shape and color in the ventral temporal cortex, this chapter reviews evidence from historical and recent cases of acquired visual agnosia and color processing deficits. A recurrent motif emerging from patients' patterns of performance and lesion locations is the existence of caudo-rostral gradients in the ventral occipito-temporal cortex, spanning from more perceptual to more cognitive stages of processing.

Color Vision Deficits

PURPOSE OF REVIEW

Color provides important information about the identity of the objects we encounter. After early processing stages in the retinal cones, thalamus, and occipital cortex, retinal signals reach the ventral temporal cortex for high-level color and object processing, which links color perception with top-down expectations and knowledge. In the language-dominant hemisphere, some of these regions communicate with the language systems; by assigning verbal labels to percepts, these circuits speed up stimulus categorization, and permit fast and accurate inter-individual communication. This paper provides a review of color processing deficits, from dysfunction of wavelength discrimination in the retinal photoreceptors to deficits of high-level processing in the ventral temporal cortex.

RECENT FINDINGS

Neuroimaging evidence defined the existence and localization of color-preferring domains in the ventral occipito-temporal cortex. Evidence from the performance of a brain-damaged patient with color anomia but preserved color categorization demonstrated the independence of color categorization from color naming in the adult brain. Evidence from patients with brain damage suggests that high-level color processing may be divided into at least three functional domains: perceptual color experience, color naming, and color knowledge.

What Cognitive Neurology Teaches Us about Our Experience of Color

Color provides valuable information about the environment, yet the exact mechanisms explaining how colors appear to us remain poorly understood. Retinal signals are processed in the visual cortex through high-level mechanisms that link color perception with top-down expectations and knowledge. Here, we review the neuroimaging evidence about color processing in the brain, and how it is affected by acquired brain lesions in humans. Evidence from patients with brain-damage suggests that high-level color processing may be divided into at least three modules: perceptual color experience, color naming, and color knowledge. These modules appear to be functionally independent but richly interconnected, and serve as cortical relays linking sensory and semantic information, with the final goal of directing object-related behavior. We argue that the relations between colors and their objects are key mechanisms to understand high-level color processing.

Category-specific cortical mapping: color-naming areas

OBJECT

It has been hypothesized that a certain degree of specialization exists within language areas, depending on some specific lexical repertories or categories. To spare hypothetical category-specific cortical areas and to gain a better understanding of their organization, the authors studied patients who had undergone electrical stimulation mapping for brain tumors and they compared an object-naming task with a category-specific task (color naming).

METHODS

Thirty-six patients with no significant preoperative language deficit were prospectively studied during a 2-year period. Along with a reading task, both object- and color-naming tasks were used in brain mapping. During color naming, patients were asked to identify 11 visually presented basic colors. The modality specificity of the color-naming sites found was subsequently tested by asking patients to retrieve the color attributes of objects. High individual variability was observed in language organization among patients and in the tasks performed. Significant interferences in color naming were found in traditional language regions-that is, Broca (p < 0.003) and Wernicke centers (p = 0.05)--although some color-naming areas were occasionally situated outside of these regions. Color-naming interferences were exclusively localized in small cortical areas (< 1 cm2). Anatomical segregation of the different naming categories was apparent in 10 patients; in all, 13 color-specific naming areas (that is, sites evoking no object-naming interference) were detected in the dominant-hemisphere F3 and the supramarginal, angular, and posterior parts of the temporal gyri. Nevertheless, no specific brain region was found to be consistently involved in color naming (p > 0.05). At five sites, although visually presented color-naming tasks were impaired by stimulation, auditory color naming (for example, "What color is grass?") was performed with no difficulty, showing that modality-specific areas can be found during naming.

CONCLUSIONS

Within language areas, a relative specialization of cortical language areas for color naming can be found during electrical stimulation mapping.

A progressive category-specific semantic deficit for non-living things

We report a longitudinal study of a patient, ES, with a progressive degenerative disorder resulting from generalised cerebral atrophy. Across a range of tasks, ES showed a greater difficulty in recognising and naming artifacts than living things. This deficit for artifacts emerged over time, as she became more severely impaired. In one task, picture naming, there was a crossover from an initial deficit for living things to the later artifact deficit. All materials were carefully controlled to rule out potential confounding factors such as concept familiarity or age of acquisition. There was no evidence that ES's deficit for artifacts was associated with a greater loss of functional than visual information. The pattern of results are consistent with a recently proposed distributed connectionist model, in which a deficit for artifact concepts can emerge as the result of severe, general damage to semantic memory.

Preserved imagery for colours in a patient with cerebral achromatopsia

We report the case of a patient who, after sequential bilateral strokes in the occipital regions sparing the primary visual cortex, developed a severe deficit of colour perception. At variance with other reports of acquired achromatopsic patients, she showed a perfectly vivid visual imagery for colours. These findings, together with similar data in domains other than colour processing, challenge the theories which posit that the same cognitive processes are involved in both the perception and the retrieval from memory of a given stimulus.

The colour cognition of children

It is well known that young children have great difficulty in stating the appropriate colour name when presented with a colour stimulus, even though they may be effective at matching one colour stimulus with another and possess a good vocabulary of colour terms. The present studies demonstrate a further, but distinct, impairment in dealing with coloured stimuli. Three- to four-year-old children were given the task of distinguishing an appropriately coloured option from one with an inappropriate colour. Despite displaying a preference for the appropriate colour over the inappropriate one, children found the task very difficult. In contrast, they succeeded on the task more frequently when the alternatives were presented verbally, rather than in terms of two pictures. We discuss the results within a theoretical framework which distinguishes the access to object-colour knowledge from colour naming. The model makes divisions within the mental templates required for object matching. In particular, colour detail is functionally separated from shape detail and appears to be represented in more than one code.

Two systems for colour-naming defects: verbal disconnection vs colour imagery disorder

Two subjects affected by pure alexia and showing no central dyschromatopsia or generalized aphasia, performed poorly on traditional tasks with visually-presented colour stimuli and on tasks with objects presented verbally. Three experiments were conducted to evaluate the possible role of mental colour imagery in recalling the colours of objects from memory. It was concluded that Case I, with left occipital lobe softening, had preserved imagery systems, but failed to recode the colours of mentally generated colour images, just as he failed to name visually presented colours, suggesting a language-imagery disconnection. In contrast, Case II, with a bilateral occipital lesion, had sustained damage to her long-term visual memories for colours as chromatic attributes of objects. This content-specific imagery deficit was concomitant with colour agnosia. The present findings are discussed in terms of current cognitive theories on imagery deficits.