Visuospatial memory in apraxia: Exploring quantitative drawing metrics to assess the representation of local and global information

Neuropsychological evidence suggests that visuospatial memory is subserved by two separable processing systems, with dorsal underpinnings for global form and ventral underpinnings for the integration of part elements. Previous drawing studies have explored the effects of Gestalt organisation upon memory for hierarchical stimuli, and we here present an exploratory study of an apraxic dorsal stream patient's (MH) performance. We presented MH with a stimulus set (previously reported by Riddoch et al., Cognitive Neuropsychology, 20(7), 641-671, 2003) and devised a novel quantitative scoring system to obtain a finer grain of insight into performance. Stimuli possessed either good or poor Gestalt qualities and were reproduced in a copy condition and two visual memory conditions (with unlimited viewing before the model was removed, or with 3 s viewing). MH's copying performance was impaired in comparison to younger adult and age-matched older adult controls, with a variety of errors at the local level but relatively few at the global level. However, his performance in the visual memory conditions revealed impairments at the global level. For all participants, drawing errors were modulated by the Gestalt qualities of the stimuli, with accuracy at the global and local levels being lesser for poor global stimuli in all conditions. These data extend previous observations of this patient, and support theories that posit interaction between dorsal and ventral streams in the representation of hierarchical stimuli. We discuss the implications of these findings for our understanding of visuospatial memory in neurological patients, and also evaluate the application of quantitative metrics to the interpretation of drawings.

Recovery of Visuospatial Neglect Subtypes and Relationship to Functional Outcome Six Months After Stroke

Background/Objective. This study aims to investigate how complex visuospatial neglect behavioural phenotypes predict long-term outcomes, both in terms of neglect recovery and broader functional outcomes after 6 months post-stroke. Methods. This study presents a secondary cohort study of acute and 6-month follow-up data from 400 stroke survivors who completed the Oxford Cognitive Screen's Cancellation Task. At follow-up, patients also completed the Stroke Impact Scale questionnaire. These data were analysed to identify whether any specific combination of neglect symptoms is more likely to result in long-lasting neglect or higher levels of functional impairment, therefore warranting more targeted rehabilitation. Results. Overall, 98/142 (69%) neglect cases recovered by follow-up, and there was no significant difference in the persistence of egocentric/allocentric (X2 [1] = .66 and P = .418) or left/right neglect (X2 [2] = .781 and P = .677). Egocentric neglect was found to follow a proportional recovery pattern with all patients demonstrating a similar level of improvement over time. Conversely, allocentric neglect followed a non-proportional recovery pattern with chronic neglect patients exhibiting a slower rate of improvement than those who recovered. A multiple regression analysis revealed that the initial severity of acute allocentric, but not egocentric, neglect impairment acted as a significant predictor of poor long-term functional outcomes (F [9,300] = 4.742, P < .001 and adjusted R2 = .098). Conclusions. Our findings call for systematic neuropsychological assessment of both egocentric and allocentric neglect following stroke, as the occurrence and severity of these conditions may help predict recovery outcomes over and above stroke severity alone.

Handgrip Based Action Information Modulates Attentional Selection: An ERP Study

Prior work shows that the possibility of action to an object (visual affordance) facilitates attentional deployment. We sought to investigate the neural mechanisms underlying this modulation of attention by examining ERPs to target objects that were either congruently or incongruently gripped for their use in the presence of a congruently or incongruently gripped distractor. Participants responded to the presence or absence of a target object matching a preceding action word with a distractor object presented in the opposite location. Participants were faster in responding to congruently gripped targets compared to incongruently gripped targets. There was a reduced N2pc potential when the target was congruently gripped, and the distractor was incongruently gripped compared to the conditions where targets were incongruently gripped or when the distractor, as well as target, was congruently gripped. The N2pc results indicate that target selection is easier when action information is congruent with an object’s use.

Preliminary validation study of the Russian Birmingham Cognitive Screen

INTRODUCTION

The Birmingham Cognitive Screen (BCoS) is designed for use with individuals who have acquired language impairment following stroke. Our goal was to develop a Russian version of the BCoS (Rus-BCoS) by translating the battery following cultural and linguistic adaptations and establishing preliminary data on its psychometric properties.

METHOD

Fifty patients with left-hemisphere stroke were recruited, of whom 98% were diagnosed with mild to moderate aphasia. To check whether the Rus-BCoS provides stable and consistent scores, internal consistency, test-retest, and interrater types of reliability were determined. Eight participants with stroke and 20 neurologically intact participants were assessed twice. To inspect the discriminative power of the battery, 63 participants without brain impairment were tested with the Rus-BCoS. Additionally, the Russian version of the Montreal Cognitive Assessment (MoCA), Quantitative Assessment of Speech in Aphasia, and Luria's Neuropsychological Assessment Battery were used to examine convergent validity, sensitivity, and specificity of the Rus-BCoS.

RESULTS

The internal consistency as well as test-retest and interrater reliability of the Rus-BCoS satisfied criteria for the research use. Performance on a majority of tasks in the battery correlated significantly with independently validated tests that putatively measure similar cognitive processes. Critically, all patients with aphasia returned nonzero scores in at least one task in all the Rus-BCoS sections, with the exception of the Controlled Attention section where two patients with severe executive control deficits could not perform.

CONCLUSIONS

The Rus-BCoS shows promise as a comprehensive cognitive screening tool that can be used by clinicians working with Russian-speaking persons experiencing poststroke aphasia after much further validation and development of reliable normative standards. Given a lack of quantitative neuropsychological assessment tools in Russia, however, we contend the Rus-BCoS offers potential benefits to clinicians and patients. However, data from research studies with a broader sample of Russian speakers are needed.

Unconscious Familiarity-based Color-Form Binding: Evidence from Visual Extinction

There is good evidence that early visual processing involves the coding of different features in independent brain regions. A major question, then, is how we see the world in an integrated manner, in which the different features are "bound" together. A standard account of this has been that feature binding depends on attention to the stimulus, which enables only the relevant features to be linked together [Treisman, A., & Gelade, G. A feature-integration theory of attention. Cognitive Psychology, 12, 97-136, 1980]. Here we test this influential idea by examining whether, in patients showing visual extinction, the processing of otherwise unconscious (extinguished) stimuli is modulated by presenting objects in their correct (familiar) color. Correctly colored objects showed reduced extinction when they had a learned color, and this color matched across the ipsi- and contralesional items (red strawberry + red tomato). In contrast, there was no reduction in extinction under the same conditions when the stimuli were colored incorrectly (blue strawberry + blue tomato; Experiment 1). The result was not due to the speeded identification of a correctly colored ipsilesional item, as there was no benefit from having correctly colored objects in different colors (red strawberry + yellow lemon; Experiment 2). There was also no benefit to extinction from presenting the correct colors in the background of each item (Experiment 3). The data suggest that learned color-form binding can reduce extinction even when color is irrelevant for the task. The result is consistent with preattentive binding of color and shape for familiar stimuli.

Domain-specific versus generalized cognitive screening in acute stroke

Cognitive assessments after stroke are typically short form tests developed for dementia that generates pass/fail classifications (e.g. the MoCA). The Oxford Cognitive Screen (OCS) provides a domain-specific cognitive profile designed for stroke survivors. This study compared the use of the MoCA and the OCS in acute stroke with respect to symptom specificity and aspects of clinical utility. A cross-sectional study with a consecutive sample of 200 stroke patients within 3 weeks of stroke completing MoCA and OCS. Demographic data, lesion side and Barthel scores were recorded. Inclusivity was assessed in terms of completion rates and reasons for non-completion were evaluated. The incidence of cognitive impairments on both the MoCA and OCS sub-domains was calculated and differences in stroke specificity, cognitive profiles and independence of the measures were addressed. The incidence of acute cognitive impairment was high: 76 % of patients were impaired on MoCA, and 86 % demonstrated at least one impairment on the cognitive domains assessed in the OCS. OCS was more sensitive than MoCA overall (87 vs 78 % sensitivity) and OCS alone provided domain-specific information on prevalent post-stroke cognitive impairments (neglect, apraxia and reading/writing ability). Unlike the MOCA, the OCS was not dominated by left hemisphere impairments but gave differentiated profiles across the contrasting domains. The OCS detects important cognitive deficits after stroke not assessed in the MoCA, it is inclusive for patients with aphasia and neglect and it is less confounded by co-occurring difficulties in these domains.

On the importance of cognitive profiling: A graphical modelling analysis of domain-specific and domain-general deficits after stroke

Cognitive problems following stroke are typically analysed using either short but relatively uninformative general tests or through detailed but time consuming tests of domain specific deficits (e.g., in language, memory, praxis). Here we present an analysis of neuropsychological deficits detected using a screen designed to fall between other screens by being 'broad' (testing multiple cognitive abilities) but 'shallow' (sampling the abilities briefly, to be time efficient) - the BCoS. Assessment using the Birmingham Cognitive Screen (BCoS) enables the relations between 'domain specific' and 'domain general' cognitive deficits to be evaluated as the test generates an overall cognitive profile for individual patients. We analysed data from 287 patients tested at a sub-acute stage of stroke (<3 months). Graphical modelling techniques were used to investigate the associative structure and conditional independence between deficits within and across the domains sampled by BCoS (attention and executive functions, language, memory, praxis and number processing). The patterns of deficit within each domain conformed to existing cognitive models. However, these within-domain patterns underwent substantial change when the whole dataset was modelled, indicating that domain-specific deficits can only be understood in relation to linked changes in domain-general processes. The data point to the importance of using over-arching cognitive screens, measuring domain-general as well as domain-specific processes, in order to account for neuropsychological deficits after stroke. The paper also highlights the utility of using graphical modelling to understand the relations between cognitive components in complex datasets.

Hierarchical processing in Balint's syndrome: a failure of flexible top-down attention

Patients with Balint’ s syndrome are typically impaired at perceiving multiple objects simultaneously, and at evaluating the relationship between multiple objects in a scene (simultanagnosia). These deficits may not only be observed in complex scenes, but also when local elements of individual objects must be integrated into a perceptual global whole. Thus, unlike normal observers, patients with simultanagnosia typically show a bias towards the local forms, even to the extent that they cannot identify the global stimuli. However, we have previously shown that global processing is still attainable in Balint patients in certain scenarios (e.g., when local elements are unfamiliar). This suggests that in addition to a possible perceptual deficit that favors the local elements in these patients, impaired attentional control may be at the core of their unique performance. To test this hypothesis we manipulated the perceptual saliency of the local and global elements in a compound letter task so that it included global-more-salient or local-more-salient displays. We show that a Balint patient was able to accurately identify both global and local targets as long as they were the salient aspect of the compound letter. However, substantial impairment was evident when either the global or local elements were the less salient aspect of the compound letter. We conclude that in Balint’ s syndrome there is a failure of flexible top-down attention both in biasing attention away from salient irrelevant aspects of the display (salience-based-selection) and in impaired disengagement from irrelevant but salient items once they have been selected.

Attending to the possibilities of action

Actions taking place in the environment are critical for our survival. We review evidence on attention to action, drawing on sets of converging evidence from neuropsychological patients through to studies of the time course and neural locus of action-based cueing of attention in normal observers. We show that the presence of action relations between stimuli helps reduce visual extinction in patients with limited attention to the contralesional side of space, while the first saccades made by normal observers and early perceptual and attentional responses measured using electroencephalography/event-related potentials are modulated by preparation of action and by seeing objects being grasped correctly or incorrectly for action. With both normal observers and patients, there is evidence for two components to these effects based on both visual perceptual and motor-based responses. While the perceptual responses reflect factors such as the visual familiarity of the action-related information, the motor response component is determined by factors such as the alignment of the objects with the observer's effectors and not by the visual familiarity of the stimuli. In addition to this, we suggest that action relations between stimuli can be coded pre-attentively, in the absence of attention to the stimulus, and action relations cue perceptual and motor responses rapidly and automatically. At present, formal theories of visual attention are not set up to account for these action-related effects; we suggest ways that theories could be expected to enable action effects to be incorporated.

Motor extinction: a deficit of attention or intention?

Motor extinction refers to a deficit of motor production on the side opposite a brain lesion that either only becomes apparent or disproportionately worsens during bilateral motor activity. It may arise due either to a contralesional deficit in setting the motor activation level (an intentional deficit) or a deficit in contralesional awareness of the sensory consequences of movement (an attentional deficit). In this study, we investigate the nature of motor extinction in a patient (LR) with a right fronto-temporal lesion through the kinematic analysis of unimanual and bimanual circle-drawing movements. While the ipsi- and contralesional limbs performed comparably for unimanual movements, the contralesional limb demonstrated marked bradykinesia and hypometria during bimanual movements. Furthermore, these deficits were not overcome when visual feedback of the contralesional limb was provided (Experiment 1). However, when performing bimanual movements in the presence of a visual template (Experiment 2), LR was able to overcome the contralesional hypometria but not the bradykinesia which proved intractable across both experiments. Both the bradykinesia and hypometria could result from an intentional deficit of motor production. However, in Experiment 2, LR also demonstrated an abnormal level of positional drift in the contralesional limb for bimanual movements indicative of an additional attentional deficit. We conclude that LR’s presentation of motor extinction is the result of a primary intentional deficit and a secondary attentional deficit.

Mu rhythm desynchronization reveals motoric influences of hand action on object recognition

We examined the effect of hand grip on object recognition by studying the modulation of the mu rhythm when participants made object decisions to objects and non-objects shown with congruent or incongruent hand-grip actions. Despite the grip responses being irrelevant to the task, mu rhythm activity on the scalp over motor and pre-motor cortex was sensitive to the congruency of the hand grip-in particular the event-related desynchronization of the mu rhythm was more pronounced for familiar objects grasped with an appropriate grip than for objects given an inappropriate grasp. Also the power of mu activity correlated with RTs to congruently gripped objects. The results suggest that familiar motor responses evoked by the appropriateness of a hand grip facilitate recognition responses to objects.

I can see what you are doing: Action familiarity and affordance promote recovery from extinction

We assessed the effects of three factors on recovery from extinction in patients with lesions including the posterior parietal lobe: (a) whether objects were frequently used together in action versus whether they could be used in action together; (b) whether there was an effect of positioning objects for action; and (c) whether the surface properties of objects mediated performance. There was greater recovery from extinction for objects used frequently together, along with effects produced by objects that could be used together. There were also positive effects of correctly positioning objects for action. There were no effects of surface information on the benefit of reporting both members of a pair, though there were some effects on error trials. The results provide positive evidence for an effect on attention of affordances based on objects falling in plausible co-locations for action. Such affordances may also be influenced by the frequency with which objects are used together and can be generated from edge-based representations of objects (surface colour and depth are not necessary). However, surface-based representations may influence the speed with which action-related properties of objects engage attention.

Long-term effects of prism adaptation in chronic visual neglect: A single case study

We investigated the effects of long-term training using prism adaptation on a patient with chronic neglect. A positive effect of prism adaptation was apparent on tests of visuo-spatial processing (cancellation, bisection, and grasping), but there was no benefit for neglect on the detection of errors on the contralesional side of words or on the detection the left side of chimeric faces. Across training sessions, the benefit of adaptation on immediate performance decreased, but it increased across sessions and within sessions when performance was tested up to 90 minutes after adaptation. The beneficial effect was maintained up to 1 year posttraining. In later sessions there were also increased negative after-effects following prism adaptation, as training progressed. There was no improvement on tests of mathematical cognition, which comprised an independent deficit in this patient. The data suggest that prolonged prism training can induce long-term adaptive spatial realignment of visuo-motor mappings, ameliorating some aspects of neglect. We discuss the implications for the rehabilitation of neglect and for understanding the neglect syndrome more generally.

Systematic assessment of apraxia and functional predictions from the Birmingham Cognitive Screen

OBJECTIVE

The validity and functional predictive values of the apraxia tests in the Birmingham Cognitive Screen (BCoS) were evaluated. BCoS was developed to identify patients with different forms of praxic deficit using procedures designed to be inclusive for patients with aphasia and/or spatial neglect.

METHOD

Observational studies were conducted from a university neuropsychological assessment centre and from acute and rehabilitation stroke care hospitals throughout an English region. Volunteers from referred patients with chronic acquired brain injuries, a consecutive hospital sample of patients within 3 months of stroke (n=635) and a population based healthy control sample (n=100) were recruited. The main outcome measures used were the Barthel Index, the Nottingham Extended Activities of Daily Living Scale as well as recovery from apraxia.

RESULTS

There were high inter-rater reliabilities and correlations between the BCoS apraxia tasks and counterpart tests from the literature. The vast majority (88.3%) of the stroke survivors were able to complete the screen. Pantomime and gesture recognition tasks were more sensitive in differentiating between individuals with left hemisphere damage and right hemisphere damage whereas the Multistep Object Use test and the imitation task had higher functional correlates over and above effects of hemiplegia. Together, the initial scores of the four tasks enabled predictions with 75% accuracy, the recovery of apraxia and independence level at 9 months.

CONCLUSIONS

As a model based assessment, BCoS offers a quick and valid way to detect apraxia and predict functional recovery. It enables early and informative assessment of most stroke patients for rehabilitation planning.

When connectedness increases hemispatial neglect

Patients with left neglect were tested with “chimeric” figures composed of the right and left halves of two different objects. The connectivity relation was modulated between the two half figures. For some displays, the two chimeric halves were separated by a small gap, while in others, the separate halves were connected by a line segment. In line with previous reports, performance on reporting the left half improved when the chimera were separated; but when a line connected the two separated halves the advantage was lost. If the connecting line was broken, the performance was again enhanced. The results suggest an important role for connectedness in the representation of perceptual objects and in the distribution of attention in neglect.

Functional relations trump implied motion in recovery from extinction: evidence from the effects of animacy on extinction

Patients with extinction show a characteristic impairment in the identification of objects when two items are presented simultaneously, typically reporting the ipsilesional item only. The effect is thought to be due to a spatial bias advantaging the ipsilesional item under conditions of competing concurrent stimulation. Action relations between objects can result in recovery from extinction as the object pair may be perceived as a single group rather than competing perceptual units. However, objects interacting together can also have implied motion. Here we test whether implied motion is necessary to generate recovery from extinction. We varied orthogonally whether animate and inanimate objects were paired together in positions related or unrelated to action. Implied motion was greater when an animate object was present than when both stimuli were inanimate. Despite this, recovery from extinction was greater when actions were shown between inanimate objects. We suggest that actions between inanimate objects are perceived more easily due to the surfaces of these stimuli being designed for functional goals (e.g., the flat surface of a hammer head is designed to hit the flattened head of a nail). Attention is sensitive to the fit between potential action and the functional properties of objects, and not just to implied motion between stimuli.

The paired-object affordance effect

We demonstrate that right-handed participants make speeded classification responses to pairs of objects that appear in standard co-locations for right-handed actions relative to when they appear in reflected locations. These effects are greater when participants "weight" information for action when deciding if 2 objects are typically used together, compared with deciding if objects typically occur in a given context. The effects are enhanced, and affect both types of decision, when an agent is shown holding the objects. However, the effects are eliminated when the objects are not viewed from the first-person perspective and when words are presented rather than objects. The data suggest that (a) participants are sensitive to whether objects are positioned correctly for their own actions, (b) the position information is coded within an egocentric reference frame, (c) the critical representation involved is visual and not semantic, and (d) the effects are enhanced by a sense of agency. The results can be interpreted within a dual-route framework for action retrieval in which a direct visual route is influenced by affordances for action.

Neuropsychological evidence for visual- and motor-based affordance: effects of reference frame and object-hand congruence

Two experiments are reported that use patients with visual extinction to examine how visual attention is influenced by action information in images. In Experiment 1 patients saw images of objects that were either correctly or incorrectly colocated for action, with the objects held by hands that were congruent or incongruent with those used premorbidly by the patients. The images were also shown from a 1st- and 3rd-person perspective. There was an overall reduction in extinction for objects colocated for action. In addition, there was an extra benefit when the objects were held in hands congruent with those used by the patients and when the objects were seen from a 1st-person perspective. This last result fits with an effect of motor simulation, over and above a purely visual effect based on positioning objects correctly for action. Experiment 2 showed that effects of hand congruence could emerge with images depicted from a 3rd-person perspective when patients saw themselves holding the objects. The data indicate 2 effects of action information on extinction: (a) an effect of colocating objects for action, which does not depend on a self-reference frame (a visual effect), and (b) an effect sensitive to object-hand congruence, which does depend on a self-reference frame (a motor-based effect). The self-reference frame is induced when stimuli are viewed from a 1st-person perspective and when an image of the self is seen from a 3rd-person perspective. Both visual and motor-based effects of action information facilitate the spread of attention across objects.

Attention and its coupling to action

We discuss two commentaries that we have received on our target article (Humphreys et al., 2010). We elaborate on the evidence for action effects on extinction and discuss whether these effects occur pre or post the selection of a response. In addition, we discuss the neural basis of the effects of action relations on extinction and on the generalization of results on action relations to real-world examples.

The neural mechanisms of visual selection: the view from neuropsychology

In this review, we discuss how neuropsychological impairments in visual selection can inform us about how selection normally operates. Using neuroanatomical and behavioral evidence on the disorders of neglect, extinction, and simultanagnosia, we propose functional and anatomical links between different aspects of visual selection and distinct sites in the posterior parietal cortex (PPC). This includes linking: (i) bottom-up attentional capture and the right temporo-parietal junction (TPJ); (ii) top-down segmentation of displays and the medial PPC; (iii) grouping, individuation and identification, and the inferior intra-parietal sulcus (IPS) bilaterally; and (iv) the suppression of saliency and the left IPS. In addition, when neuropsychological studies are combined with fMRI, there is evidence that these regions of the PPC interact with striate and extra-striate cortical areas, which respond to specific properties of stimuli. Selection should be viewed as an emergent property of a network of areas involving both ventral and dorsal cortex.

Motor neglect: Implications for movement and rehabilitation following stroke

PURPOSE

The syndrome of unilateral neglect following stroke is associated with poor outcome and presents significant challenges to those providing therapy for affected individuals. In contrast to a number of reviews which have recently appeared in therapy and rehabilitation journals relating to sensory aspects of neglect, this review focuses on 'motor neglect'.

SEARCH STRATEGY

We searched the clinical and scientific literature for papers concerning motor neglect. The search included the databases Web of Science, Pubmed and Cinahl, primarily using the term 'motor neglect'. There was also a large degree of secondary searching involved.

DISCUSSION

Motor neglect refers to the under-utilization of a limb opposite a brain lesion that cannot be fully explained by primary sensory and motor deficits. The paper discusses classical descriptions of motor neglect and highlights the difficulties in disentangling motor neglect from hemiparesis. The related problem of motor extinction is introduced as a useful clinical measure of neglect-related movement difficulties and a significant clinical problem in its own right.

CONCLUSION

Motor neglect is a relatively under-recognized deficit which may have a significant impact on patient performance and recovery following stroke. We conclude with a discussion of the implications of motor neglect for rehabilitation, including the relative contributions that may be made by Constraint-induced movement therapy and Bilateral movement therapy in managing patients with neglect-related movement problems.

Are faces special? A case of pure prosopagnosia

The ability to recognize individual faces is of crucial social importance for humans and evolutionarily necessary for survival. Consequently, faces may be "special" stimuli, for which we have developed unique modular perceptual and recognition processes. Some of the strongest evidence for face processing being modular comes from cases of prosopagnosia, where patients are unable to recognize faces whilst retaining the ability to recognize other objects. Here we present the case of an acquired prosopagnosic whose poor recognition was linked to a perceptual impairment in face processing. Despite this, she had intact object recognition, even at a subordinate level. She also showed a normal ability to learn and to generalize learning of nonfacial exemplars differing in the nature and arrangement of their parts, along with impaired learning and generalization of facial exemplars. The case provides evidence for modular perceptual processes for faces.

From both sides now: crossover effects influence navigation in patients with unilateral neglect

Unilateral neglect is a challenging disorder that pervades a range of behaviours following stroke and hampers recovery. Although a preponderance of clinical studies measure performance on a range of bedside assessments, including line bisection and cancellation tasks, there have been calls for studies to embrace more relevant functional measures. Here, for the first time, we present data from two separate tasks that characterise the performance of seven patients with unilateral neglect when navigating a power wheelchair. The tasks involved negotiating an obstacle course and steering a central path between gaps of different sizes. Results from the obstacle course confirmed the clinical observation and predicted bias of contralesional errors. However, the second task revealed a robust "crossover" effect. Patients deviated to the ipsilesional side for large gaps but deviated increasingly contralesionally when steering through small gaps in behaviour that was analogous to that previously shown on line bisection tasks. Contrary to being seen as an unintuitive finding, further analysis of these errors suggests that patients are giving disproportionate weight to the location of the ipsilesional object when plotting a midline course between two objects. Our results provide a platform for further studies to investigate the modulation and rehabilitation of this important skill.

Action relations, semantic relations, and familiarity of spatial position in Balint's syndrome: Crossover effects on perceptual report and on localization

We contrasted effects of the action relationship between objects, relative to effects of semantic relation and familiarity of spatial location, in a patient with Balint's syndrome. We found enhanced perceptual report of objects placed in the correct colocations for action in comparison with when the objects (1) were placed in incorrect locations for action (Experiment 1), (2) were associatively related (Experiment 2), or (3) fell in familiar locations but were not action related (Experiment 4). In contrast, the ability to localize the objects was affected by whether the objects were in familiar as opposed to unfamiliar locations with respect to one another. Action relations between objects facilitate joint attention to both objects but do not facilitate binding to location. Familiar spatial relations facilitate spatial binding, but do not cue joint attention to the stimuli. Effects of action relation on attention and localization can be dissociated from effects of semantic relationship and familiarity of spatial location on attention and localization.

How to Make the Word-Length Effect Disappear in Letter-by-Letter Dyslexia: Implications for an Account of the Disorder

The diagnosis of letter-by-letter (LBL) dyslexia is based on the observation of a substantial and monotonic increase of word naming latencies as the number of letters in the stimulus increases. This pattern of performance is typically interpreted as indicating that word recognition in LBL dyslexia depends on the sequential identification of individual letters. We show, in 7 LBL patients, that the word-length effect can be eliminated if words of different lengths are matched on the sum of the confusability (visual similarity between a letter and the remainder of the alphabet) of their constituent letters. Additional experiments demonstrate that this result is mediated by parallel letter processing and not by any compensatory serial processing strategy. These findings indicate that parallel processing contributes significantly to explicit word recognition in LBL dyslexia and that a letter-processing impairment is fundamental in causing the disorder.

Don’t think twice, it's all right—contralesional dependency for bimanual prehension movements

In bimanual coordination when moving the hands to two separate objects, subjects tend to initiate and terminate the movements together, even when the targets are at different distances or are of a different size. Additionally, each hand tends to scale its grasp independently to the object to be grasped. Here, we report the performance of a patient, who had previously shown signs of motor neglect, on two experiments investigating coupling and independence in bimanual coordination. The patient showed relatively normal bimanual behaviour for the transport phase of prehension when objects were placed at different distances (Experiment 1), but abnormal behaviour for the grasp component when objects were of different sizes (Experiment 2). Moreover, the contralesional limb demonstrated a dependency of grasp that was related to the object grasped by the ipsilesional limb. We discuss the possible underlying mechanisms of this dependency in relation to competitive motor programming and attentional bias. The results also reinforce the view that the transport and grasp components of prehension are distinct processes.

On having royal relatives: Interpreting misidentifications in a case of impaired person recognition

We report data from a patient, NE, who after surviving encephalitis made misidentification responses to faces known to her premorbidly. NE frequently mistook one famous person for another, one relative for another, and, under some conditions, believed that a picture of a famous person actually depicted one of her relatives. Unlike previously reported patients who have misidentified faces, NE (1) performed reasonably well on tests of facial perception, (2) showed no obvious executive deficits in tests of frontal lobe function, and (3) showed an ability to constrain her misidentification responses in certain situations. A cognitive neuropsychological investigation revealed that NE was able to judge misidentified faces as familiar but failed to access precise semantic information. There were also semantic deficits when knowledge of people was probed through nonvisual modalities-for example, when naming people from definition. We argue that a semantic, as opposed to executive, deficit plays the major (though probably not sole) role in NE's misidentification responses, and we consider how the inter-active activation model of face recognition (Burton, Bruce, & Johnston, 1990) can account for such disorders of person recognition more comprehensively than the Bruce and Young (1986) model.