Developmental Topographical Disorientation With Concurrent Face Recognition Deficit: A Case Report.

Maria Luisa Rusconi,Chiara Pinardi,Giulia Fusi,Chiara Stampatori,Flavia Mattioli,Tommaso Costa,Angelo Suardi,Claudia Ambrosi

doi:10.3389/fpsyt.2021.654071

Abstract

Developmental topographical disorientation (DTD) has been defined as a developmental deficit in human navigational skills in the absence of congenital or acquired brain damage. We report the case of Lost In Space Again (LISA), a 22-year-old woman with a normal development and no clinical history of neurological or psychiatric diseases, evaluated twice, with an interval of 5 years. The magnetic resonance imaging (MRI) examination did not reveal any morphological alteration, while diffusion tensor imaging (DTI) showed a structural connectivity deficit (a decreased fractional anisotropy—FA) in the parieto–prefrontal and parieto–premotor pathway. The behavioral assessment showed different deficits in spatial and navigational tasks, which seemed to be connected to a poor ability to form a cognitive map of the environment. Moreover, LISA displayed a poor performance in high-level face encoding and retrieval. The aim of this case report is to share new insight about DTD in order to deepen the knowledge of this specific neurodevelopmental disorder. In conclusion, this novel DTD case (1) supports the hypothesis of the existence of different DTD subtypes; (2) sustains the evidence that DTD can co-occur (or not) with deficit in face recognition; and (3) highlights the need for an in-depth examination from both a neurocognitive and behavioral point of view of a possible common developmental defect between the formation of cognitive maps and the recognition of faces that might be in mental imagery skills. Future directions will be also discussed.

Highlights

In the last years, a newly discovered neurodevelopmental disorder identified as “developmental topographical disorientation” (DTD) has been described
Even if the greatest difficulty exhibited by these patients was found in the formation of a cognitive map [2], they have exhibited varying types and degrees of spatial and navigational difficulties [see Fusi et al [10] for a review] leading researchers to hypothesize the existence of different subtypes of DTD [8]
We described a new DTD case, Lost In Space Again (LISA), whose assessments revealed a complex clinical picture and presented some significant elements that may be considered for future studies

Summary

Introduction

A newly discovered neurodevelopmental disorder identified as “developmental topographical disorientation” (DTD) has been described. This disorder seems to be widespread [1, 2]; only few patients affected by DTD have been studied with a comprehensive neuropsychological, behavioral, and neuroimaging assessment. Lost in Space Again environments since childhood [3,4,5,6,7,8,9]. They have no history of neurological or psychiatric disorders and show no brain damage. The authors have already suggested that a possible common developmental defect could be responsible for this comorbidity

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