Journal of Neuro-Ophthalmology, December 2007, Volume 27, Issue 4

Spatial Processing in Balint Syndrome and Prosopagnosia

BACKGROUND: Spatial analysis may be subdivided into between-object and within-object spatial coding. We investigated the contribution of various visual cues to grouping processes that might determine whether single or multiple objects were perceived and therefore which type of spatial coding would be used for a stimulus. METHODS: We asked three patients to make shape judgments with a series of displays showing triangular arrangements, moving from more implicit triangles defined by separate objects at the apices (between-object spatial coding) to more explicit triangles with line edges or surface texture (within-object spatial coding). RESULTS: In two patients with prosopagnosia, within-object spatial judgments were impaired, whereas between-object spatial judgments were normal. In a patient with Bálint syndrome, the reverse pattern was obtained. Surface texture but not outline closure led to mandatory within-object coding in the prosopagnosic patients, whereas outline or surface texture was sufficient to support intact within-object spatial judgments in the patient with Bálint syndrome. Illusory contours were ineffective in promoting within-object coding in either condition. CONCLUSIONS: These findings support the existence of parallel representations of space for within-object and between-object processing and reveal the efficacy of different cues in determining which representation is potentially accessible.