Complementary deficits in perceptual classification in pure alexia and acquired prosopagnosia - New insights from two classic cases.

Pure alexia and prosopagnosia traditionally have been seen as prime examples of dissociated, category-specific agnosias affecting reading and face recognition, respectively. More recent accounts have moved towards domain-independent explanations that postulate potential cross-links between different types of visual agnosia. According to one proposal, abnormal crowding, i.e. the impairment of recognition when features of adjacent objects are positioned too closely to each other, might provide a unified account for the perceptual deficits experienced by an agnosic patient. An alternative approach is based on the notion of complementary visual subsystems favouring the processing of abstract categories and specific exemplars, respectively. To test predictions of these two approaches with regard to pure alexia and prosopagnosia, we present previously unpublished data on digit recognition and visual crowding from two in the neuropsychological literature extensively studied patients, KD and MT (e.g., Campbell et al., 1986; Landis and Regard, 1988; Rentschler et al., 1994). Patient MT, diagnosed with pure alexia, showed pronounced abnormal foveal crowding, whereas KD, diagnosed with prosopagnosia, did not. These results form a distinct double dissociation with the performance of the two patients in other perceptual classification tasks involving Gabor micropatterns and textures, as well as Glass patterns, which revealed a significantly greater impairment in KD relative to MT. Based on an analysis of the specific task demands we argue that prosopagnosia and pure alexia may involve complementary deficits in instantiation and abstraction, respectively, during perceptual classification, beyond any category specificity. Such an explanation appears in line with previous distinctions between a predominantly left-hemispheric, abstract-category and a predominantly right-hemispheric, specific-exemplar subsystem underlying object recognition.

A matter of time: improvement of visual temporal processing during training-induced restoration of light detection performance.

The issue of how basic sensory and temporal processing are related is still unresolved. We studied temporal processing, as assessed by simple visual reaction times (RT) and double-pulse resolution (DPR), in patients with partial vision loss after visual pathway lesions and investigated whether vision restoration training (VRT), a training program designed to improve light detection performance, would also affect temporal processing. Perimetric and campimetric visual field tests as well as maps of DPR thresholds and RT were acquired before and after a 3 months training period with VRT. Patient performance was compared to that of age-matched healthy subjects. Intact visual field size increased during training. Averaged across the entire visual field, DPR remained constant while RT improved slightly. However, in transition zones between the blind and intact areas (areas of residual vision) where patients had shown between 20 and 80% of stimulus detection probability in pre-training visual field tests, both DPR and RT improved markedly. The magnitude of improvement depended on the defect depth (or degree of intactness) of the respective region at baseline. Inter-individual training outcome variability was very high, with some patients showing little change and others showing performance approaching that of healthy controls. Training-induced improvement of light detection in patients with visual field loss thus generalized to dynamic visual functions. The findings suggest that similar neural mechanisms may underlie the impairment and subsequent training-induced functional recovery of both light detection and temporal processing.

The Tölz Temporal Topography Study: mapping the visual field across the life span. Part II: cognitive factors shaping visual field maps.

Part I described the topography of visual performance over the life span. Performance decline was explained only partly by deterioration of the optical apparatus. Part II therefore examines the influence of higher visual and cognitive functions. Visual field maps for 95 healthy observers of static perimetry, double-pulse resolution (DPR), reaction times, and contrast thresholds, were correlated with measures of visual attention (alertness, divided attention, spatial cueing), visual search, and the size of the attention focus. Correlations with the attentional variables were substantial, particularly for variables of temporal processing. DPR thresholds depended on the size of the attention focus. The extraction of cognitive variables from the correlations between topographical variables and participant age substantially reduced those correlations. There is a systematic top-down influence on the aging of visual functions, particularly of temporal variables, that largely explains performance decline and the change of the topography over the life span.

The Tölz Temporal Topography Study: mapping the visual field across the life span. Part I: the topography of light detection and temporal-information processing.

Temporal performance parameters vary across the visual field. Their topographical distributions relative to each other and relative to basic visual performance measures and their relative change over the life span are unknown. Our goal was to characterize the topography and age-related change of temporal performance. We acquired visual field maps in 95 healthy participants (age: 10-90 years): perimetric thresholds, double-pulse resolution (DPR), reaction times (RTs), and letter contrast thresholds. DPR and perimetric thresholds increased with eccentricity and age; the periphery showed a more pronounced age-related increase than the center. RT increased only slightly and uniformly with eccentricity. It remained almost constant up to the age of 60, a marked change occurring only above 80. Overall, age was a poor predictor of functionality. Performance decline could be explained only in part by the aging of the retina and optic media. In Part II, we therefore examine higher visual and cognitive functions.

Time will tell: deficits of temporal information processing in patients with visual field loss.

Visual field loss after brain lesions is commonly determined using perimetric tests of light detection (perimetry). Many patients with visual field defects complain about perceptual difficulties in areas that are perimetrically normal. To look at a potential cause for such difficulties, we topographically determined temporal characteristics of visual information processing in those patients and compared them to those of healthy subjects. In nine patients with visual field loss we measured thresholds of double-pulse resolution (DPR), i.e., the minimum perceivable duration of a temporal gap between two light pulses, at eccentricities up to 20°. Furthermore, high-resolution maps of visual reaction times (RT) were obtained in a computer-based campimetric test. Performance was compared to healthy controls from a cross-sectional study of temporal perception across the life span (Toelz Temporal Topography Study). Compared to healthy subjects, DPR thresholds and RTs in patients are elevated in the entire visual field, including areas that are perimetrically intact. Performance on temporal variables depends on the degree of intactness of the respective visual field position. DPR thresholds correlate considerably with RTs, and both parameters increase with eccentricity. However, whereas DPR thresholds are increased around blind regions relative to the intact field, this is not the case for RTs. Temporal processing in patients with cerebral vision loss is impaired to a certain extent independently from perimetric light detection performance. This may partly explain reported subjective perceptual problems. The findings may have important implications for visual rehabilitation, i.e., the potential generalization of light detection training to temporal processing performance.

Increasing the temporal g(r)ain: double-pulse resolution is affected by the size of the attention focus.

Spatial cueing of transient attention has recently been shown to reduce temporal sensitivity. We investigated how the size of the sustained attentional focus influences double-pulse resolution (DPR) thresholds mapped across the visual field in a sample of 95 healthy subjects using a 9-fold interleaved adaptive algorithm (YAAP). Peripheral DPR thresholds increased for measurements between 2.5 degrees and 20 degrees eccentricity. Additionally, central DPR thresholds increased at a similar rate when measured with increasingly larger stimulus displays for peripheral measurements. This latter effect suggests that temporal resolution decreases with a larger sustained attention focus and cannot be explained by retinal characteristics only.