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BCS 242:Neuropsychology Clinical Assessment of Visual Perception,Visuospatial, and Visuoconstruction Ability. Outline. Neuroanatomy Review retina, LGN, unimodal cortex, multimodal association cortex, parallel processing, What/Where Disorders of Higher-Order Visual Function

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Outline

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  1. BCS 242:NeuropsychologyClinicalAssessment of Visual Perception,Visuospatial, and Visuoconstruction Ability

  2. Outline • Neuroanatomy Review • retina, LGN, unimodal cortex, multimodal association cortex, parallel processing, What/Where • Disorders of Higher-Order Visual Function • Striate-Peristriate Syndromes • Ventral Stream Syndromes • Dorsal Stream Syndromes • Assessment of Higher-Order Visual Function • Visuoperception • Visuospatial • Visuoconstructive • Examples

  3. Neuroanatomy Review

  4. Cortical Brain Regions Involved in Visual Processing Parietal Lobe Temporal Lobe Occipital Lobe

  5. 1 4 2 5 3 6 Central Visual Pathways Adapted from http://thalamus.wustl.edu/course/

  6. Segregation of Dorsal and Ventral Processing Streams Where Pathway What Pathway

  7. Disorders of Higher Order Visual Abilities

  8. Classification of Visuoperceptual, Visuospatial, and Visuoconstructive Disorders • Visuoperceptual • Visual Object Agnosia • Defective visual analysis and synthesis • Impariment of facial recognition • Impairment in color recognition • Visuospatial • Defective localization of points in space • Defective judgement of direction and distance • Defective topographical orientation • Unilateral visual neglect • Visuoconstructive • Defective assembling performance • Defective graphomotor performance

  9. Disruption of Visual Information Processing • Vascular lesions • Neoplasm • Trauma • Dementias • Toxic/Metabolic Encephalopathy

  10. Disorder Area of Damage Symptoms Balint’s Syndrome Bilateral lesions involving cortex and white matter of dorsal O-P areas Ischemic event in posterior watershed areas Simultanagnosia- disruption of visuospatial synthesis of complex scenes Optic Ataxia-difficulty with visually guided movements. Ocular Apraxia- erratic pattern of occulomotor scanning and unpredictable paralysis of fixation during visual search Hemispatial Neglect Usually after R hemisphere lesion to posterior parietal, frontal eye field, or cingulate cortex Disruption of spatial representation of contralesional side of space, exploratory scanning, visual extinction, anosagnosia Dorsal (“Where”) Syndromes

  11. Disorder Area of Damage Symptoms Color Anomia L Occipital lesion w/ R Hemianopia Can match, but cannot name colors. Color words retain semantic meanings, but cannot be matched to appropriate visual stimulus Pure Alexia Periventricular white matter. L hemisphere lesion interferes w/ fibers from R O-T areas Can write, speak, and understand speech, but profound inability to read, even words patient just wrote Object anomia L O-T region Inability to name objects by sight, can name if other modalities are used. Prosop-agnosia Bilat infarcts to medial O-T region Cannot recognize familiar faces or learn to recognize new ones. Also cannot recognize objects within a specific class (animals, cars, houses, etc) Ventral (“What”) Syndromes

  12. Disorder Area of Damage Symptoms Associative Visual Object Agnosia Medial O-T Visual info cannot activate either verbal of nonverbal associative linkages. Visually inspected objets cannot be named or recognizd by pt with otherwise intact language and perceptual functions Visual integration deficits Parietal lobe Disruption of complex perceptual tasks and maintenance of spatial relationships Peduncular hallucinosis Central lesion-esp in distribution of basilar artery Formed hallucinations often taking the shape of small animals or people. Ventral (“What”) Syndromes

  13. Assessment of Higher-Order Visual Function

  14. Why is it important? • Help give information about localization • Disruption of visuoperception can influence "downstream" abilities • Give recommendations about how to cope with deficits in this area.

  15. Selected Measures of Higher- Order Visual Abilities • Visuoperceptual • Ishihara Color Vision Plates • Benton Facial Recognition • Hooper Visual Organization Test • Visuospatial • Benton Judgement of Line Orientation • Cancellation Tests • Line Bisection Tests • Money Road Map • Visuoconstructive • Rey-Osterieth Complex Figure Copy • WAIS-III Block Design • Clock Drawing • Figure Drawing

  16. Raven's Progressive Matrices

  17. Benton Facial Recognition

  18. Gollin Incomplete Figures Test

  19. Hooper Visual Organization Test

  20. Line BisectionTest

  21. Visual Search Tasks

  22. Copy Tasks

  23. Mental Rotation Tasks

  24. Right Left Orientation

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