RESUMEN
We present the results of 51 stroke patients with free central visual fields of which about half suffer from clear deficits of midlevel vision undetected by standard clinical tests. These patients yield significantly elevated thresholds for detection and/or discrimination between forms defined by motion, colour, or line orientation ('texture'). As demonstrated by voxel-based lesion-symptom mapping (VLSM) the underlying lesions involve mainly area human V4 (hV4) located in the posterior third of the fusiform gyrus and extending into the lingual gyrus. Patient's detection thresholds correlate only very weakly between the submodalities tested, indicating partly separate neural networks on mid-level vision for colour, motion, and texture detection. Correlations are far stronger for form discrimination tasks, indicating partly shared mechanisms for even simple form discrimination of distinct visual submodalities. We conclude that deficits of visual perception are far more common after strokes in visual brain areas than is apparent in clinical practice. Our results further clarify the functional organization of midlevel visual cortical areas.
Asunto(s)
Accidente Cerebrovascular , Corteza Visual , Mapeo Encefálico , Humanos , Orientación , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico por imagen , Corteza Visual/diagnóstico por imagen , Campos Visuales , Percepción VisualRESUMEN
The existing literature suggests a critical role for both the right intraparietal sulcus (IPS) and the right temporo-parietal junction (TPJ) in our ability to attend to multiple simultaneously-presented lateralized targets (multi-target attention), and the failure of this ability in extinction patients. Currently, however, the precise role of each of these areas in multi-target attention is unclear. In this study, we combined the theory of visual attention (TVA) with functional magnetic resonance imaging (fMRI) guided continuous theta burst stimulation (cTBS) in neurologically healthy subjects to directly investigate the role of the right IPS and TPJ in multi-target attention. Our results show that cTBS at an area of the right IPS associated with multi-target attention elicits a reduction of visual short-term memory capacity. This suggests that the right IPS is associated with a general capacity-limited encoding mechanism that is engaged regardless of whether targets have to be attended or remembered. Curiously, however, cTBS to the right IPS failed to elicit extinction-like behavior in our study, supporting previous suggestions that different areas of the right IPS may provide different contributions to multi-target attention. CTBS to the right TPJ failed to induce a change in either TVA parameters or extinction-like behavior.
Asunto(s)
Atención/fisiología , Memoria a Corto Plazo/fisiología , Lóbulo Parietal/diagnóstico por imagen , Lóbulo Parietal/fisiología , Tiempo de Reacción/fisiología , Percepción Visual/fisiología , Adolescente , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Estimulación Luminosa/métodos , Adulto JovenRESUMEN
Object agnosia is a rare symptom, occurring mainly after bilateral damage of the ventral visual cortex. Most patients suffering from unilateral ventral lesions are clinically non-agnosic. Here, we studied the effect of unilateral occipito-temporal lesions on object categorization and its underlying neural correlates in visual areas. Thirteen non-agnosic stroke patients and twelve control subjects performed an event-related rapid object categorization task in the fMRI scanner where images were presented either to the left or to the right of a fixed point. Eight patients had intact central visual fields within at least 10° eccentricity while five patients showed an incomplete hemianopia. Patients made more errors than controls for both contra- and ipsilesional presentation, meaning that object categorization was impaired bilaterally in both patient groups. The activity in cortical visual areas is usually higher when a stimulus is presented contralaterally compared to presented ipsilaterally (contralateral bias). A region of interest analysis of early visual (V1-V4) and object-selective areas (lateral occipital complex, LOC; fusiform face area, FFA; and parahippocampal place area, PPA) revealed that the lesioned-hemisphere of patients showed reduced contralateral bias in early visual areas and LOC. In contrast, literally no contralateral bias in FFA and PPA was found. These findings indicate disturbed processing in the lesioned hemisphere, which might be related to the processing of visually presented objects. Thus, unilateral occipito-temporal damage leads to altered contralateral bias in the lesioned hemisphere, which might be the cause of impaired categorization performance in both visual hemifields in clinically non-agnosic patients. We conclude that both hemispheres need to be functionally intact for unimpaired object processing.
Asunto(s)
Lateralidad Funcional/fisiología , Lóbulo Occipital/fisiopatología , Reconocimiento Visual de Modelos/fisiología , Accidente Cerebrovascular/fisiopatología , Adulto , Anciano , Mapeo Encefálico , Medidas del Movimiento Ocular , Humanos , Juicio/fisiología , Imagen por Resonancia Magnética , Persona de Mediana Edad , Pruebas Neuropsicológicas , Lóbulo Occipital/diagnóstico por imagen , Accidente Cerebrovascular/diagnóstico por imagen , Pruebas del Campo VisualRESUMEN
Neuropsychological deficits after occipital infarction are most often described in case studies and only a small sample of studies has attempted to exactly correlate the anatomical localization of lesions with associated neuropsychological symptoms. The present study investigated a large number of patients (N = 128) in order to provide an overview of neurological and neuropsychological deficits after occipital, occipito-temporal and occipito-parietal infarction. A particular approach of the study was to define exact anatomical correlates of neuropsychological dysfunction by using voxel-based lesion-symptom mapping (VLSM) in 61 patients. In addition to a visual field defect and phosphenes, patients often reported anomia, difficulties in reading and memory deficits. Visual disorders, such as achromatopsia, akinetopsia or prosopagnosia, were rarely reported by the patients. Memory and visual disorders were diagnosed efficiently using simple clinical screening tests, such as the Rey-Osterrieth Complex Figure Test for immediate recall, the Demtect and the Lang Stereo Test. Visual field defects, reading disorders and the perception of phosphenes were associated primarily with lesions of the calcarine sulcus. Anomia and memory deficits were related to lesions of the occipital inferior gyrus, the lingual gyrus and hippocampus, as well as to lesions of principal white matter tracts.
Asunto(s)
Infarto Cerebral/fisiopatología , Trastornos de la Memoria/fisiopatología , Lóbulo Occipital/patología , Lóbulo Parietal/patología , Lóbulo Temporal/patología , Trastornos de la Visión/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Infarto Cerebral/complicaciones , Infarto Cerebral/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Trastornos de la Memoria/etiología , Trastornos de la Memoria/patología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Lóbulo Occipital/fisiopatología , Lóbulo Parietal/fisiopatología , Lóbulo Temporal/fisiopatología , Trastornos de la Visión/etiología , Trastornos de la Visión/patología , Campos Visuales/fisiología , Adulto JovenRESUMEN
It is widely agreed that in object categorization bottom-up and top-down influences interact. How top-down processes affect categorization has been primarily investigated in isolation, with only one higher level process at a time being manipulated. Here, we investigate the combination of different top-down influences (by varying the level of category, the animacy and the background of the object) and their effect on rapid object categorization. Subjects participated in a two-alternative forced choice rapid categorization task, while we measured accuracy and reaction times. Subjects had to categorize objects on the superordinate, basic or subordinate level. Objects belonged to the category animal or vehicle and each object was presented on a gray, congruent (upright) or incongruent (inverted) background. The results show that each top-down manipulation impacts object categorization and that they interact strongly. The best categorization was achieved on the superordinate level, providing no advantage for basic level in rapid categorization. Categorization between vehicles was faster than between animals on the basic level and vice versa on the subordinate level. Objects in homogenous gray background (context) yielded better overall performance than objects embedded in complex scenes, an effect most prominent on the subordinate level. An inverted background had no negative effect on object categorization compared to upright scenes. These results show how different top-down manipulations, such as category level, category type and background information, are related. We discuss the implications of top-down interactions on the interpretation of categorization results.