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The Journal of Neuroscience, May 6, 2009, 29(18):5854-5862; doi:10.1523/JNEUROSCI.5192-08.2009

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Behavioral/Systems/Cognitive
The Anatomy of Object Recognition—Visual Form Agnosia Caused by Medial Occipitotemporal Stroke

Hans-Otto Karnath, Johannes Rüter, André Mandler, and Marc Himmelbach

Section of Neuropsychology, Center of Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, D-72076 Tübingen, Germany

Correspondence should be addressed to Prof. Hans-Otto Karnath, Center of Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. Email: karnath{at}uni-tuebingen.de

The influential model on visual information processing by Milner and Goodale (1995) has suggested a dissociation between action- and perception-related processing in a dorsal versus ventral stream projection. It was inspired substantially by the observation of a double dissociation of disturbed visual action versus perception in patients with optic ataxia on the one hand and patients with visual form agnosia (VFA) on the other. Unfortunately, almost all cases with VFA reported so far suffered from inhalational intoxication, the majority with carbon monoxide (CO). Since CO induces a diffuse and widespread pattern of neuronal and white matter damage throughout the whole brain, precise conclusions from these patients with VFA on the selective role of ventral stream structures for shape and orientation perception were difficult. Here, we report patient J.S., who demonstrated VFA after a well circumscribed brain lesion due to stroke etiology. Like the famous patient D.F. with VFA after CO intoxication studied by Milner, Goodale, and coworkers (Goodale et al., 1991, 1994; Milner et al., 1991; Servos et al., 1995; Mon-Williams et al., 2001a,b; Wann et al., 2001; Westwood et al., 2002; McIntosh et al., 2004; Schenk and Milner, 2006), J.S. showed an obvious dissociation between disturbed visual perception of shape and orientation information on the one side and preserved visuomotor abilities based on the same information on the other. In both hemispheres, damage primarily affected the fusiform and the lingual gyri as well as the adjacent posterior cingulate gyrus. We conclude that these medial structures of the ventral occipitotemporal cortex are integral for the normal flow of shape and of contour information into the ventral stream system allowing to recognize objects.

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Received Oct. 28, 2008; revised Feb. 24, 2009; accepted March 18, 2009.

Correspondence should be addressed to Prof. Hans-Otto Karnath, Center of Neurology, University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. Email: karnath{at}uni-tuebingen.de

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				J. C. Goll Novel Hypotheses from a Neuropsychological Case Study: Is the Visual Ventral Cortex Critical for Both Category-Generic and Category-Specific Form Perception? J. Neurosci., September 16, 2009; 29(37): 11421 - 11423. [Full Text] [PDF]

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