Topographical disorientation in patients with brain impairment

Abstract

Topographical disorientation refers to inability to recognize the environment, as well as to orient, to find the right way into a familiar or new environment and to use a map for the orientation. These functions are based on neuronal activity of posterior parietal cortex, retrosplenial cortex and the posterior part of cingular gyrus, medial temporal lobe, lingual gyrus and prefrontal cortex and are considered within egocentric or allocentric (exocentric) reference systems. Object locations in the egocentric system are evaluated with respect to the subject's body position while object locations in the allocentric reference frame are evaluated with respect to the object-to-object relations in the external environment. Topographical orientation disorders are observed in local lesions of the brain and in neurodegenerative diseases. The topographical disorientation may be due to landmark аgnosia, egocentric disorientation, heading disorientation and anterograde disorientation. Clinical tests for the diagnosis of topographical disorientation include blanket methods and navigation tasks in real or virtual space. The restorative and compensatory strategies are used in rehabilitation of patients with topographical disorientation. Clarification of the general strategy and selection of the optimal neurorehabilitation methods depend on the causes and severity of brain lesions.