Abstract

Observations of the visual form agnosic patient DF have been highly influential in establishing the hypothesis that separate processing streams deal with vision for perception (ventral stream) and vision for action (dorsal stream). In this context, DF's preserved ability to perform visually-guided actions has been contrasted with the selective impairment of visuomotor performance in optic ataxia patients suffering from damage to dorsal stream areas. However, the recent finding that DF shows a thinning of the grey matter in the dorsal stream regions of both hemispheres in combination with the observation that her right-handed movements are impaired when they are performed in visual periphery has opened up the possibility that patient DF may potentially also be suffering from optic ataxia. If lesions to the posterior parietal cortex (dorsal stream) are bilateral, pointing and reaching deficits should be observed in both visual hemifields and for both hands when targets are viewed in visual periphery. Here, we tested DF's visuomotor performance when pointing with her left and her right hand toward targets presented in the left and the right visual field at three different visual eccentricities. Our results indicate that DF shows large and consistent impairments in all conditions. These findings imply that DF's dorsal stream atrophies are functionally relevant and hence challenge the idea that patient DF's seemingly normal visuomotor behaviour can be attributed to her intact dorsal stream. Instead, DF seems to be a patient who suffers from combined ventral and dorsal stream damage meaning that a new account is needed to explain why she shows such remarkably normal visuomotor behaviour in a number of tasks and conditions.

Highlights

  • More than 20 years ago in a seminal paper, Milner et al [1] described a severe case of visual-form agnosia

  • The model suggests that visual information is processed in different brain areas depending on the purpose for which the information is acquired: while visual information needed for the identification and recognition of objects is assumed to be primarily processed in ventral stream areas, visual information for the control of actions is supposed to be primarily processed in dorsal stream areas of the brain

  • The finding that patients with dorsal stream damage show the complementary pattern of deficits and retained functions with compromised visuomotor behaviour but intact perceptual performance [9,10,11,12] has strengthened the view that there is a double-dissociation in function between the dorsal and the ventral streams [2,4]

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Summary

Introduction

More than 20 years ago in a seminal paper, Milner et al [1] described a severe case of visual-form agnosia (patient DF). Their observation that this patient (who suffers from bilateral damage to the ventral cortical stream) was unable to identify and recognise visually presented objects, but was able to use visual information to accurately control hand movements during reaching and grasping, contributed significantly to the development of a new model on how the brain processes visual information: the perception-action model [2,3,4]. The finding that patients with dorsal stream damage (who suffer from optic ataxia) show the complementary pattern of deficits and retained functions with compromised visuomotor behaviour but intact perceptual performance [9,10,11,12] has strengthened the view that there is a double-dissociation in function between the dorsal and the ventral streams [2,4]

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