Category-selective deficits are the exception and not the rule: Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage
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Category-selective deficits are the exception and not the rule : Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage. / Rice, Grace E.; Kerry, Sheila J.; Robotham, Ro J.; Leff, Alex P.; Lambon Ralph, Matthew A.; Starrfelt, Randi.
In: Cortex, Vol. 138, 05.2021, p. 266-281.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Category-selective deficits are the exception and not the rule
T2 - Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage
AU - Rice, Grace E.
AU - Kerry, Sheila J.
AU - Robotham, Ro J.
AU - Leff, Alex P.
AU - Lambon Ralph, Matthew A.
AU - Starrfelt, Randi
PY - 2021/5
Y1 - 2021/5
N2 - The organisational principles of the visual ventral stream are still highly debated, particularly the relative association/dissociation between word and face recognition and the degree of lateralisation of the underlying processes. Reports of dissociations between word and face recognition stem from single case-studies of category selective impairments, and neuroimaging investigations of healthy participants. Despite the historical reliance on single case-studies, more recent group studies have highlighted a greater commonality between word and face recognition. Studying individual patients with rare selective deficits misses (a) important variability between patients, (b) systematic associations between task performance, and (c) patients with mild, severe and/or non-selective impairments; meaning that the full spectrum of deficits is unknown. The Back of the Brain project assessed the range and specificity of visual perceptual impairment in 64 patients with posterior cerebral artery stroke recruited based on lesion localization and not behavioural performance. Word, object, and face processing were measured with comparable tests across different levels of processing to investigate associations and dissociations across domains. We present two complementary analyses of the extensive behavioural battery: (1) a data-driven analysis of the whole patient group, and (2) a single-subject case-series analysis testing for deficits and dissociations in each individual patient. In both analyses, the general organisational principle was of associations between words, objects, and faces even following unilateral lesions. The majority of patients either showed deficits across all domains or in no domain, suggesting a spectrum of visuo-perceptual deficits post stroke. Dissociations were observed, but they were the exception and not the rule: Category-selective impairments were found in only a minority of patients, all of whom showed disproportionate deficits for words. Interestingly, such selective word impairments were found following both left and right hemisphere lesions. This large-scale investigation of posterior cerebral artery stroke patients highlights the bilateral representation of visual perceptual function.
AB - The organisational principles of the visual ventral stream are still highly debated, particularly the relative association/dissociation between word and face recognition and the degree of lateralisation of the underlying processes. Reports of dissociations between word and face recognition stem from single case-studies of category selective impairments, and neuroimaging investigations of healthy participants. Despite the historical reliance on single case-studies, more recent group studies have highlighted a greater commonality between word and face recognition. Studying individual patients with rare selective deficits misses (a) important variability between patients, (b) systematic associations between task performance, and (c) patients with mild, severe and/or non-selective impairments; meaning that the full spectrum of deficits is unknown. The Back of the Brain project assessed the range and specificity of visual perceptual impairment in 64 patients with posterior cerebral artery stroke recruited based on lesion localization and not behavioural performance. Word, object, and face processing were measured with comparable tests across different levels of processing to investigate associations and dissociations across domains. We present two complementary analyses of the extensive behavioural battery: (1) a data-driven analysis of the whole patient group, and (2) a single-subject case-series analysis testing for deficits and dissociations in each individual patient. In both analyses, the general organisational principle was of associations between words, objects, and faces even following unilateral lesions. The majority of patients either showed deficits across all domains or in no domain, suggesting a spectrum of visuo-perceptual deficits post stroke. Dissociations were observed, but they were the exception and not the rule: Category-selective impairments were found in only a minority of patients, all of whom showed disproportionate deficits for words. Interestingly, such selective word impairments were found following both left and right hemisphere lesions. This large-scale investigation of posterior cerebral artery stroke patients highlights the bilateral representation of visual perceptual function.
KW - Face recognition
KW - Prosopagnosia
KW - Pure alexia
KW - Stroke
KW - Visual agnosia
KW - Visual perception
KW - Word recognition
U2 - 10.1016/j.cortex.2021.01.021
DO - 10.1016/j.cortex.2021.01.021
M3 - Journal article
C2 - 33770511
AN - SCOPUS:85102852925
VL - 138
SP - 266
EP - 281
JO - Cortex
JF - Cortex
SN - 0010-9452
ER -
ID: 259641550