See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/9044910

Visual agnosia

Article  in  Current Neurology and Neuroscience Reports · December 2003

DOI: 10.1007/s11910-003-0055-4 · Source: PubMed

CITATIONS READS
14 1,494

2 authors:

Iftah Biran H. Branch Coslett

Tel Aviv Sourasky Medical Center University of Pennsylvania
44 PUBLICATIONS   832 CITATIONS    277 PUBLICATIONS   14,262 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Dissociation in awareness of memory and language decline in Alzheimer’s disease View project

Fostering clinical excellence and empowerment to support adults with acquired neurogenic communication challenges View project

All content following this page was uploaded by Iftah Biran on 30 May 2014.

The user has requested enhancement of the downloaded file.

 Visual Agnosia
I. Biran, MD, and H. B. Coslett, MD

Address Clinical Variants

Department of Neurology, University of Pennsylvania School of Medi- Visual agnosia can be specific to certain kinds of objects.
cine, 3400 Spruce Street, Philadelphia, PA 19104, USA. Accordingly, there are agnosias for objects, agnosias for
E-mail: hbc@mail.med.upenn.edu
faces or “prosopagnosia,” agnosias for words or “pure
Current Neurology and Neuroscience Reports 2003, 3:508–512
word blindness,” agnosias for colors, and agnosias for
Current Science Inc. ISSN 1528–4042
Copyright © 2003 by Current Science Inc. the environment, including landmarks. Finally, the dis-
order of simultanagnosia—an inability to “see” more
than one object at a time—is often regarded as a type of
The visual agnosias are an intriguing class of clinical phe-
visual agnosia.
nomena that have important implications for current theo-
ries of high-level vision. Visual agnosia is defined as impaired
Agnosia for objects
object recognition that cannot be attributed to visual loss,
Inability to recognize familiar objects is the most com-
language impairment, or a general mental decline. At least
mon of the agnostic syndromes. Patients are impaired in
in some instances, agnostic patients generate an adequate
naming regular objects and are often unable to describe
internal representation of the stimulus but fail to recognize
them or mimic their use. Object agnosias are further
it. In this review, we begin by describing the classic works
classified as either apperceptive (the percept is not fully
related to the visual agnosias, followed by a description of
constructed and, therefore, patients are unable to copy
the major clinical variants and their occurrence in degener-
drawings) or associative (the percept is relatively intact
ative disorders. In keeping with the theme of this issue, we
and patients are able to copy drawings). As the follow-
then discuss recent contributions to this domain. Finally, we
ing text discusses, the agnosia can be specific to a
present evidence from functional imaging studies to sup-
semantic category, usually living or animate objects;
port the clinical distinction between the various types of
agnosias for nonliving or inanimate objects have also
visual agnosias.
been described [8].

Prosopagnosia
Introduction Prosopagnosic patients are unable to recognize the iden-
The term “agnosia” was coined by Freud [1] in his discus- tity of faces (ie, to whom a face belongs), although they
sion of aphasia and related disorders. Like subsequent are capable of recognizing that a face is a face and, in
investigators, he described a disruption between objects some instances, the gender and age of the person.
and their concepts. However, there are earlier descriptions Prosopagnosia is usually secondary to temporo-occipital
of similar clinical phenomena. Munk [2] described dogs lesions, affecting the fusiform and lingual gyri. Whether
with parieto-occipital lesions that were able to avoid a bilateral or a right unilateral lesion is sufficient to cause
objects in their surroundings but failed to recognize the the deficit has been an issue of debate [9]. There is also
objects. He termed this behavior as “Seelenblindheit” evidence that impaired face recognition could be
(mind-blindness) [2]. An important early theoretical con- encountered with frontal lesions. Rapcsak et al. [10] doc-
tribution was made by Lissauer [3], who offered the dis- umented both anterograde and retrograde face memory
tinction between two clinical forms of impaired object impairment in subjects with frontal lesions.
recognition: “apperceptive” and “associative” agnosias. On
Lissauer’s account, the former reflects a failure to generate a Agnosia for words
fully specified perceptual representation, whereas the latter This is also known as pure alexia, alexia without agraphia,
is attributable to an inability to link an adequate percept to or pure word blindness. Although this phenomenon is
stored knowledge indicating its name, function, size, and usually discussed in the context of language impairments,
so forth [3] (translated into English by Jackson [4]). As it is an agnostic symptom, as subjects who suffer from this
noted by Teuber [5], associative visual agnosia may be deficit show a language impairment limited to visually pre-
regarded as a “normal percept stripped of its meaning.” sented stimuli (eg, reading), but not to auditorily pre-
Earlier descriptions of visual agnosia were provided by sented stimuli. Accordingly, this deficit could be regarded
Finkelnburg’s account [6] of “asymbolia” and Jackson’s as a failure in the visual recognition of words, and thus as
concept [7] of “imperception.” an agnostic deficit [11].
 Visual Agnosia • Biran and Coslett 509

Color agnosia Progressive prosopagnosia

In this rare clinical syndrome, patients fail to name colors. This is a degenerative disorder presenting with progressive
This deficit is not secondary to basic color perception, as impairment in the recognition of faces. This syndrome is
demonstrated by tasks requiring color categorization and part of the fronto-temporal dementias (FTDs), which may
hue perception. The distinction between this syndrome present as focal atrophy in any combination of the right
and color anomia is not clear. Some authors suggest that and left frontal or temporal cortices. Although in the
the two syndromes could be differentiated by tasks prob- semantic dementia variant of the FTDs the atrophy is
ing color information (ie, matching between known prominent in the left temporal lobe, in progressive
objects to colors), which is impaired with agnostic subjects prosopagnosia the atrophy is prominent in the right tem-
and preserved with anomic subjects [12,13]. poral lobe [20–22].

Landmark agnosia Schizophrenia

Landmark agnosia is one of the causes for topographic dis- Although not a classic neurodegenerative disorder,
orientation (the loss of way-finding ability). Patients with schizophrenia is often associated with visual agnosia. In
landmark agnosia are unable to use environmental fea- a recent study of 41 patients with schizophrenia,
tures for orientation. This deficit is usually secondary to Gabrovska et al. [23] reported a high incidence of visual
lesions of the medial aspect of the occipital lobes, either processing deficits that were similar to associative agno-
bilaterally or right-sided. Pallis [14] reported a classic case sia. Schizophrenia patients also demonstrate a specific
of this disorder, and the topic has recently been reviewed impairment to memorizing faces. This deficit is highly
by Aguirre [15]. correlated with a reduction in the volume of the fusiform
gyrus [24]. In conjunction with other reports of discrete
Simultanagnosia cognitive impairments in schizophrenia [25], these con-
Simultanagnosia is the inability to perceive simulta- tributions help to bridge the gap between schizophrenia
neously several items in the visual scene. This piecemeal and behavioral neurology.
perception of the visual environment causes severe dis-
ability and patients often behave as blind subjects.
Simultanagnosia can be part of Balint’s syndrome [16], Mechanisms
which also includes an inability to shift gaze (psychic The visual agnosias can teach us about the way we allocate
paralysis of gaze) and difficulties in reaching visualized attention to the external world and build an internal mental
objects (optic ataxia). This complex syndrome is associ- representation. In the following section, we focus on recent
ated with bilateral lesion of the posterior parietal and work that explores the cognitive deficits underlying visual
occipital lobes [17]. agnosia. These reports not only contribute to our under-
standing of the clinical disorders, but also have implications
for our understanding of perception and cognition.
Visual Agnosia in Degenerative Disorders
The clinical phenomena discussed here were described Attention
mainly through lesion studies. However, the agnosias are Simultanagnosia can teach us about the way we allocate and
also prevalent in degenerative disorders, often at a stage of shift attention. According to Posner et al.’s [26] paradigm,
the illness at which general cognitive abilities are at least shifting attention from a previous to a novel focus is per-
relatively preserved. The following syndromes have been formed in three steps: 1) disengaging from the previous
reported in neurodegenerative disorders. focus, 2) moving attention between the foci, and 3) engaging
attention at the new focus. In a recent report, Pavese et al.
Posterior cortical atrophy [27•] provide compelling evidence that, at least in some
This disorder presents with a progressive decline in com- instances, simultanagnosia is associated with a deficit in dis-
plex visual processing and relative sparing of other cogni- engaging visual attention. They studied a patient with simul-
tive abilities [18]. It is associated with occipito-parietal tanagnosia whose ability to report both items in an array was
atrophy and hypometabolism on single photon emission greatly facilitated by removing the item that he had initially
computed tomography (SPECT) or positron emission reported. Performance was not improved by the sudden
tomography (PET) scans. In most instances, the disorder is onset of a second stimulus, suggesting that once he had
caused by Alzheimer’s disease. However, posterior cortical “locked onto” a stimulus, he was unable to disengage atten-
atrophy differs from typical Alzheimer’s disease in that the tion and shift to a different object or location [27•].
lesions show predilection to the posterior parietal and
occipital areas. Patients with this syndrome show a high Mental representations
rate of alexia without oral language difficulty (80%), Visual agnosia is generally regarded as a deficit in the pro-
Balint’s syndrome (68%), and visual agnosia (44%) that is cessing of information, such that knowledge of the shape,
primarily apperceptive [19•]. form, and other stored knowledge of the physical attributes
510 Behavior

of an object cannot be accessed. In some instances, there is imate dissociation follows from a selective impairment of
strong reason to believe that the mental representations of the sensory or functional attributes that subserve the pro-
that knowledge are preserved. Several investigators have cessing of either of these two categories. On this account,
recently reported data from visual imagery tasks that dem- the identification of animate objects relies more on sen-
onstrate that stored visual knowledge may be at least rela- sory attributes and would be disproportionately impaired
tively preserved in patients with severe visual agnosia. by damage to the processing of sensory features associated
Simultanagnosic patients can be impaired in the allo- with these objects. In contrast, inanimate objects may be
cation of attention not only in the context of a visual scene, known primarily by virtue of their function and the man-
but also in mental imagery. An interesting clinical observa- ner in which they are used or manipulated. As a conse-
tion is that of an artist who, following a stroke in the poste- quence, a deficit in the recognition of inanimate objects
rior circulation, suffered from simultanagnosia. During her would be disrupted by loss of information regarding the
stroke recovery while painting scenes from memory, her function of an object or sensory-motor knowledge regard-
drawings revealed selective attention to the left lower quad- ing the manner in which the object is manipulated. A com-
rant, with important aspects of the whole image “clipped,” peting hypothesis is that the semantic knowledge is
as if missing from her internal representation of the scene organized categorically in the brain [32]. Clearly, teleologic
[28]. Subjects with prosopagnosia can show impaired overt explanations for this organization can be made. Evolution-
recognition of faces with relative preservation of covert rec- ary pressures would favor an animal that could easily rec-
ognition of these stimuli (eg, these patients may fail to ognize and distinguish other animals that are potential
match faces, but event-related potentials could demon- predator or prey or plants that are potential sources of
strate covert matching) [29]. The covert recognition of food. Further, developmental data support the idea that
faces suggests that internal representations of faces can be infants as young as 3 months of age can differentiate living
relatively preserved in prosopagnostic subjects. Barton and from nonliving things [33].
Cherkasova [30] studied nine prosopagnostic patients and There have been several recent contributions to this
assessed their mental imagery for faces by a questionnaire debate. Borgo and Shallice [34] demonstrated that subjects
composed of 37 questions probing facial features (eg, who with specific impairment to animate objects are also
has a bigger moustache—Stalin or Hitler?) and facial shape impaired in the recognition of inanimate materials (eg, liq-
(eg, who has a more pear-shaped face—John F. Kennedy or uids) for which sensory-motor knowledge is lacking and
Nixon?). They demonstrated a dissociation between per- that are distinguished by sensory features such as texture.
formance on tasks assessing facial features as compared They concluded that these data are not consistent with the
with face shape; deficits in the former were associated with proposal that there is a fundamental distinction between
left occipito-temporal damage whereas deficits in the latter items as a function of semantic category [34].
were associated with lesions of the right fusiform face area. The following case study provides data consistent with
Covert face recognition (assessed by sorting famous faces the categorical hypothesis. We recently studied a 50-year-
by occupation and by pointing out a famous face from two old patient who suffered a stroke involving the antero-
faces) correlated with feature imagery. Finally, impaired medial aspect of the right occipital lobe (Coslett and Biran,
mental representation in a visual agnostic-like pattern can unpublished data). Following this insult, he suffered from
also be demonstrated in pure alexic subjects. Bartolomeo et a marked visual recognition deficit and memory loss. Neu-
al. [31] described a patient who was impaired in tasks ropsychologic tests showed normal attention, concentra-
assessing mental imagery of letters (judging whether an tion, and working memory, and impaired immediate and
upper-case letter has curved lines), but had a faultless per- long-term memory. The patient performed normally on
formance when he was allowed to trace the contour of the the Wisconsin Card Sorting Task. Despite good perfor-
letters with his finger. This suggests that his impairment mance on a variety of tests assessing visual processing, he
was isolated to the visual representation of the letters, but performed poorly on the Boston Naming Test and the Ben-
not to their relative motor engrams [31]. ton Facial Recognition Test. He was significantly impaired
naming animate as compared with inanimate items (42%
Semantics vs 75%, chi-squared test P value=0.019).
As briefly noted previously, for some patients the ability to We than evaluated the contribution of various knowl-
recognize visually presented stimuli is significantly influ- edge types (sensory, functional, encyclopedic, and taxo-
enced by the semantic category of the item. Thus, a num- nomic) to the naming performance and the differential
ber of patients have been reported, for example, who are animate/inanimate impairment observed with AD. In a
able to name man-made objects but are severely impaired naming to confrontation task, the subject was presented
in naming naturally occurring items such as animals, fruits, with color pictures of 194 inanimate objects and 150 ani-
and vegetables. A number of competing hypotheses try to mate objects; accuracy and reaction time were recorded.
explain these category-specific deficits. The modality-spe- For each item, 30 control subjects had listed semantic fea-
cific hypothesis [8], later named the Sensory-Functional tures that were further classified into the following catego-
Theory (SFT) [32], postulates that the animate versus inan- ries: sensory (eg, “a lantern is bright”); function (eg, “ovens
 Visual Agnosia • Biran and Coslett 511

are used for broiling”); and encyclopedic/taxonomic (eg, trally than peripherally located faces, and that the place
“dove is a symbol of peace”) [35]. Using a stepwise dis- areas responded more to peripherally than centrally
criminant analysis, we evaluated the predictive value of the located places. They suggested that objects whose recogni-
various factors such as stimulus frequency, familiarity, ani- tion and analysis require fine details (eg, faces) will be
macy, and types of knowledge that defined the object. linked to centrally located activation, whereas large objects
This subject named the inanimate objects significantly (eg, houses) will be linked to peripheral activation.
better and faster than the animate objects (69% accuracy
for inanimate, 37% accuracy for animate, chi-squared test
P value=0.0001; response time of -4633 ms for inanimate Conclusions
objects, response time of -7581 ms for animate objects, t=- In reviewing recent contributions to the understanding of
3.416; P=0.008). In a discriminant function analysis, the the heterogeneous category of visual agnosias, we have
only factor contributing to his performance was animacy attempted to highlight not only the clinical phenomenol-
versus inanimacy. This suggests that in this case, the ani- ogy of these disorders, but also their implications for
mate/inanimate distinction cannot be reduced to different accounts of the manner in which visual information articu-
features, different knowledge types, and other variables lates with other brain faculties. Although the agnosias have
such as frequency or familiarity, and are rather related been investigated for more than 100 years, exploration of
directly to the category itself. these fascinating disorders continues to offer important
insights into brain function and organization.

Functional Imaging of Object Recognition

In the past few years, functional imaging in healthy sub- Acknowledgments
jects has helped to elucidate the anatomy of object recogni- Dr. Biran may be reached at the Agnes Ginges Center for
tion. Malach et al. [36] described the lateral occipital cortex Human Neurogenetics, Hadassah University Medical Cen-
(LOC), which is located at the lateral and ventral aspects of ter in Jerusalem.
the occipito-temporal cortex. This area is activated prefer-
entially by objects compared with scrambled objects or tex-
tures, regardless of the nature of the object (eg, faces, cars, References and Recommended Reading
common objects, and even unfamiliar abstract objects) Papers of particular interest, published recently, have been
[36,37]. Further processing of the visual stimuli occurs in highlighted as:
specific brain areas according to stimulus category. For • Of importance
•• Of major importance
example, faces are processed in the fusiform face area [38]
and in the occipital face area [39]; the former is more selec- 1. Freud S: Zur Aufassung der Aphasien. Wien: Deuticke; 1891.
tive for faces than the latter. Places and/or spatial layouts 2. Munk H. Ueber die functionen der grosshirnrinde. In Gesam-
melte Mittheilungen aus den Jahren 1877–1880. Berlin: Hir-
are processed in the parahippocampal place area [40], schwald; 1881:1877–1880.
whereas objects like animals and tools are processed in 3. Lissauer H: Ein fall von seelenblindheit nebst einem beitrag
specific loci in the fusiform and the superior and middle zur theorie derselben. Arch fur Psychiatrie 1890, 21:222–270.
temporal gyri [41]. Orthographic stimuli are processed in 4. Lissauer H: A case of visual agnosia with a contribution to
theory (translation from German by Jackson, M). Cogn Neu-
the left inferior occipito-temporal cortex on or near the left ropsychol 1988, 5:153–192.
fusiform gyrus [42,43], although this localization is highly 5. Teuber HL: Alteration of perception and memory in man. In
debated [44]. Thus, the specific perceptual categories of Analysis of Behavioral Change. Edited by Weiskrantz L. New York:
Harper and Row; 1968.
visual stimuli dictate very different ways of their processing 6. Finkelnburg FC: Niederrheinische Gesellscahft in Bonn. Medici-
in the brain and might give an anatomic basis for the dif- nische Section. Berl Klin Wochenschr 1870, 7:449–450, 460–461.
ferent agnostic syndromes. 7. Jackson JH: Case of large cerebral tumour without optic neu-
The allocation of the different brain areas to specific ritis and with left hemiplegia and imperception. In Selected
Writings of John Hughlings Jackson. Edited by Taylor J. New York:
object categories could be explained in part by the eccen- Basic Books; 1958.
tricity bias (a preferential response to stimuli based on 8. Warrington EK, Shallice T: Category specific semantic impair-
their location in the visual field, either in the center or in ments. Brain 1984, 107:829–854.
9. De Renzi E, Perani D, Carlesimo GA, et al.: Prosopagnosia can
the periphery). This is one of the dimensions of organiza- be associated with damage confined to the right hemisphere:
tion of the visual cortex, especially the low-level areas. In a an MRI and PET study and a review of the literature. Neuropsy-
recent study, Levy et al. [45••] demonstrated a relationship chologia 1994, 32:893–892.
between category specificity and retinal eccentricity. They 10. Rapcsak SZ, Nielsen L, Littrell LD, et al.: Face memory impair-
ments in patients with frontal lobe damage. Neurology
scanned subjects while they viewed either faces or houses; 2001, 57:1168–1175.
in different trials, both types of stimuli were presented in 11. Geschwind N: Disconnexion syndromes in animals and man.
either the center or periphery of the visual fields. They Brain 1965, 88:237–294, 585–644.
12. Kinsbourne M, Warrington EK: Observations on colour agno-
demonstrated that the face areas responded more to cen- sia. J Neurol Neurosurg Psychiatry 1964, 27:296–299.
 512 Behavior

13. Coslett HB, Saffran E: Disorders of higher visual processing: 28. Smith WS, Mindelzun RE, Miller B: Simultanagnosia through
theoretical and clinical perspectives. In Cognitive Neuropsychol- the eyes of an artist. Neurology 2003, 60:1832–1834.
ogy in Clinical Practice. Edited by Margolin D. Oxford: Oxford 29. Bobes MA, Lopera F, Garcia M, et al.: Covert matching of unfa-
University Press; 1991:353–404. miliar faces in a case of prosopagnosia: an ERP study. Cortex
14. Pallis CA: Impaired identification of locus and places 2003, 39:41–56.
with agnosia for colours. J Neurol Neurosurg Psychiatry 30. Barton JJ, Cherkasova M: Face imagery and its relation to per-
1955, 18:218–224. ception and covert recognition in prosopagnosia. Neurology
15. Aguirre GK. Topographical disorientation: a disorder of way- 2003, 61:220–225.
finding ability. In Neurological Foundations of Cognitive Neuro- 31. Bartolomeo P, Bachoud-Levi AC, Chokron S, Dogos JD: Visu-
science, edn 1. Edited by D'Esposito M. Cambridge, MA: MIT ally- and motor-based knowledge of letters: evidence from a
Press; 2003. pure alexic patient. Neuropsychologia 2003, 40:1363–1371.
16. Balint R: Seelenlahmung des "Schauens", Optische Ataxie, 32. Caramazza A, Shelton JR: Domain-specific knowledge systems
raumliche Storung der Aufmerksamkeit. Monatschrift fur Psy- in the brain the animate-inanimate distinction. J Cogn Neuro-
chiatrie und Neurologie 1909, 25:51–81. sci 1998, 10:1–34.
17. Rizzo M, Vecera SP: Psychoanatomical substrates of Balint's 33. Bertenthal BI, Proffitt DR, Cutting JE: Infant sensitivity to fig-
syndrome. J Neurol Neurosurg Psychiatry 2002, 72:162–178. ural coherence in biomechanical motions. J Exp Child Psychol
18. Goethals M, Santens P: Posterior cortical atrophy. Two case 1984, 37:213–230.
reports and a review of the literature. Clin Neurol Neurosurg 34. Borgo F, Shallice T: When living things and other 'sensory
2001, 103:115–119. quality' categories behave in the same fashion: a novel cate-
19.• Mendez MF, Ghajarania M, Perryman KM: Posterior cortical atro- gory specificity effect. Neurocase 2001, 7:201–220.
phy: clinical characteristics and differences compared to Alzhe- 35. McRae K, Cree GS: Factors underlying category-specific
imer's disease. Dement Geriatr Cogn Disord 2002, 14:33–40. semantic deficits. In Category-Specificity in Brain and Mind.
A comparison of the clinical presentation, the cognitive deficit pat- Edited by Forde EM, Humphreys GW. East Sussex, UK: Psychol-
tern, and brain imaging of patients with posterior cortical atrophy ogy Press; 2002.
and typical Alzheimer’s disease. 36. Malach R, Reppas JB, Benson RR, et al.: Object-related activity
20. Evans JJ, Heggs AJ, Hodges NA Jr: Progressive prosopagnosia revealed by functional magnetic resonance imaging in
associated with selective right temporal lobe atrophy. A new human occipital cortex. Proc Natl Acad Sci U S A
syndrome? Brain 1995, 118:1–13. 1995, 92:8135–8139.
21. Hodges JR: Frontotemporal dementia (Pick's disease): clini- 37. Malach R, Levy I, Hasson U: The topography of high-order
cal features and assessment. Neurology 2001, 56(11 suppl human object areas. Trends Cogn Sci 2002, 6:176–184.
4):S6–S10. 38. Kanwisher N, McDermott J, Chun MM: The fusiform face area:
22. Mendez MF, Ghajarnia M: Agnosia for familiar faces and a module in human extrastriate cortex specialized for face
odors in a patient with right temporal lobe dysfunction. Neu- perception. J Neurosci 1997, 17:4302–4311.
rology 2001, 57:519–521. 39. Gauthier I, Tarr MJ, Moylan J, et al.: The fusiform "face area" is
23. Gabrovska VS, Laws KR, Sinclair J, McKenna PJ: Visual object part of a network that processes faces at the individual level.
processing in schizophrenia: evidence for an associative J Cogn Neurosci 2000, 12:495–504.
agnosic deficit. Schizophr Res 2003, 59:277–286. 40. Epstein R, Kanwisher N: A cortical representation of the local
24. Onitsuka T, Shenton ME, Kasai K, et al.: Fusiform gyrus volume visual environment. Nature 1998, 392:598–601.
reduction and facial recognition in chronic schizophrenia. 41. Chao LL, Haxby JV, Martin A: Attribute-based neural sub-
Arch Gen Psychiatry 2003, 60:349–355. strates in temporal cortex for perceiving and knowing about
25. McKenna PJ, Laws K: Schizophrenic amnesia. In Neuropsychol- objects. Nat Neurosci 1999, 2:913–919.
ogy of Memory. Edited by Parkin AJ. Hove, UK: Psychology Press; 42. Polk TA, Stallcup M, Aguirre GK, et al.: Neural specialization
1997. for letter recognition. J Cogn Neurosci 2002, 14:145–159.
26. Posner MI, Walker JA, Friedrich FJ, Rafal RD: Effects of 43. Allison T, McCarthy G, Nobre A, et al.: Human extrastriate
parietal injury on covert orienting of attention. J Neurosci visual cortex and the perception of faces, words, numbers,
1984, 4:1863–1874. and colors. Cereb Cortex 1994, 4:544–554.
27.• Pavese A, Coslett HB, Saffran E, Buxbaum L: Limitations of 44. Price CJ, Devlin JT: The myth of the visual word form area.
attentional orienting. Effects of abrupt visual onsets and off- Neuroimage 2003, 19:473–481.
sets on naming two objects in a patient with simultanagno- 45.•• Levy I, Hasson U, Avidan G, et al.: Center-periphery organiza-
sia. Neuropsychologia 2002, 40:1097–1103. tion of human object areas. Nat Neurosci 2001, 4:533–539.
A case study of a patient with simultanagnosia, demonstrating a defi- A functional magnetic resonance imaging study looking at the associ-
cit in disengaging from a target in the visual environment, which is ation between category specificity and retinotopic organization.
the first step in reallocating attention according to the Posner para-
digm.

View publication stats