Astereognosis

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Astereognosis
Specialty Neurology

Astereognosis (or tactile agnosia if only one hand is affected) is the inability to identify an object by active touch of the hands without other sensory input, such as visual or sensory information. An individual with astereognosis is unable to identify objects by handling them, despite intact elementary tactile, proprioceptive, and thermal sensation. [1] With the absence of vision (i.e. eyes closed), an individual with astereognosis is unable to identify what is placed in their hand based on cues such as texture, size, spatial properties, and temperature. [1] As opposed to agnosia, when the object is observed visually, one should be able to successfully identify the object.

Individuals with tactile agnosia may be able to identify the name, purpose, or origin of an object with their left hand but not their right, or vice versa, or both hands. Astereognosis refers specifically to those who lack tactile recognition in both hands. In the affected hand(s) they may be able to identify basic shapes such as pyramids and spheres (with abnormally high difficulty) but still not tactilely recognize common objects by easily recognizable and unique features such as a fork by its prongs (though the individual may report feeling a long, metal rod with multiple, pointy rods stemming off in uniform direction). [2] These symptoms suggest that a very specific part of the brain is responsible for making the connections between tactile stimuli and functions/relationships of those stimuli, which, along with the relatively low impact this disorder has on a person's quality of life, helps explain the rarity of reports and research of individuals with tactile agnosia. [2] However in some cases, those persons with tactile agnosia may have many challenges in daily life and occupation. An example is a task that requires typing quickly, as this agnosia type prevents the recognition of keys without looking at a keyboard.[ citation needed ]

Astereognosis is associated with lesions of the parietal lobe or dorsal column or parieto-temporo-occipital lobe (posterior association areas) of either the right or left hemisphere of the cerebral cortex. [1] [2] Despite cross-talk between the dorsal and ventral cortices, fMRI results suggest that those with ventral cortex damage are less sensitive to object 3D structure than those with dorsal cortex damage. Unlike the ventral cortex, the dorsal cortex can compute object representations. Thus, those with object recognition impairments are more likely to have acquired damage to the dorsal cortex. [3] Those suffering from Alzheimer’s disease show a reduction in stereognosis, the ability to perceive and recognize the form of an object in the absence of visual and auditory information. This supports the notion that astereognosis appears to be an associative disorder in which the connections between tactile information and memory is disturbed.[ citation needed ]

While astereognosis is characterized by the lack of tactile recognition in both hands, it seems to be closely related to tactile agnosia (impairment connected to one hand). Tactile agnosia observations are rare and case-specific. Josef Gerstmann recounts his experience with patient JH, a 34-year-old infantryman who suffered a lesion to the posterior parietal lobe due to a gunshot. Following the injury, JH was unable to recognize or identify everyday objects by their meaning, origin, purpose and use with his left hand using tactile sensation alone. His motility performance, elementary sensitivity, and speech were intact, and he lacked abnormalities in brain nerves. [2]

The majority of all objects JH touched with his left hand went unrecognized, but very simple objects (i.e. globes, pyramids, cube, etc.) were regularly recognized based on form alone. For more complex objects, his behavior and recognition varied daily based on his tactile resources that changed over time and depended on his fatigue. That is, JH’s ability to recognize depended on his concentration and ability to recognize simple forms and single qualities like size, shape, etc. With further interrogation and greater effort, he was able to correctly identify more specific features of an object (i.e. softness, rounded or cornered, broad or narrow) and could even draw a copy of it, but he was often left unable to identify the object by name, use, or origin. This behavioral deficit occurred even if JH had handled the object in his fully intact right hand. [2]

Interventions tend to focus on helping these patients and their family and caregivers cope and adapt to the condition, and furthermore, to help patients function independently within their context. [4]

Related Research Articles

Agnosia Medical condition

Agnosia is the inability to process sensory information. Often there is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss. It is usually associated with brain injury or neurological illness, particularly after damage to the occipitotemporal border, which is part of the ventral stream. Agnosia only affects a single modality, such as vision or hearing. More recently, a top-down interruption is considered to cause the disturbance of handling perceptual information.

Parietal lobe

The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus.

Temporal lobe One of the four lobes of the mammalian brain

The temporal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain.

Occipital lobe

The occipital lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The name derives from its position at the back of the head, from the Latin ob, behind, and caput, the head.

Simultanagnosia is a rare neurological disorder characterized by the inability of an individual to perceive more than a single object at a time. This type of visual attention problem is one of three major components of Bálint's syndrome, an uncommon and incompletely understood variety of severe neuropsychological impairments involving space representation. The term "simultanagnosia" was first coined in 1924 by Wolpert to describe a condition where the affected individual could see individual details of a complex scene but failed to grasp the overall meaning of the image.

Stereognosis is the ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spatial properties, and temperature, etc. In humans, this sense, along with tactile spatial acuity, vibration perception, texture discrimination and proprioception, is mediated by the dorsal column-medial lemniscus pathway of the central nervous system. Stereognosis tests determine whether or not the parietal lobe of the brain is intact. Typically, these tests involved having the patient identify common objects placed in their hand without any visual cues. Stereognosis is a higher cerebral associative cortical function.

Associative visual agnosia Medical condition

Associative visual agnosia is a form of visual agnosia. It is an impairment in recognition or assigning meaning to a stimulus that is accurately perceived and not associated with a generalized deficit in intelligence, memory, language or attention. The disorder appears to be very uncommon in a "pure" or uncomplicated form and is usually accompanied by other complex neuropsychological problems due to the nature of the etiology. Afflicted individuals can accurately distinguish the object, as demonstrated by the ability to draw a picture of it or categorize accurately, yet they are unable to identify the object, its features or its functions.

Acalculia is an acquired impairment in which people have difficulty performing simple mathematical tasks, such as adding, subtracting, multiplying and even simply stating which of two numbers is larger. Acalculia is distinguished from dyscalculia in that acalculia is acquired late in life due to neurological injury such as stroke, while dyscalculia is a specific developmental disorder first observed during the acquisition of mathematical knowledge. The name comes from the Greek "a" meaning "not" and Latin "calculare", which means "to count".

Visual agnosia is an impairment in recognition of visually presented objects. It is not due to a deficit in vision, language, memory, or intellect. While cortical blindness results from lesions to primary visual cortex, visual agnosia is often due to damage to more anterior cortex such as the posterior occipital and/or temporal lobe(s) in the brain.[2] There are two types of visual agnosia: apperceptive agnosia and associative agnosia.

Inferior temporal gyrus One of three gyri of the temporal lobe of the brain

The inferior temporal gyrus is one of three gyri of the temporal lobe and is located below the middle temporal gyrus, connected behind with the inferior occipital gyrus; it also extends around the infero-lateral border on to the inferior surface of the temporal lobe, where it is limited by the inferior sulcus. This region is one of the higher levels of the ventral stream of visual processing, associated with the representation of objects, places, faces, and colors. It may also be involved in face perception, and in the recognition of numbers.

Autotopagnosia from the Greek a and gnosis, meaning "without knowledge", topos meaning "place", and auto meaning "oneself", autotopagnosia virtually translates to the "lack of knowledge about one's own space," and is clinically described as such.

Graphesthesia is the ability to recognize writing on the skin purely by the sensation of touch. Its name derives from Greek graphē ("writing") and aisthēsis ("perception"). Graphesthesia tests combined cortical sensation; therefore, it is necessary that primary sensation be intact.

Apperceptive agnosia is a failure in recognition that is due to a failure of perception. In contrast, associative agnosia is a type of agnosia where perception occurs but recognition still does not occur. When referring to apperceptive agnosia, visual and object agnosia are most commonly discussed; this occurs because apperceptive agnosia is most likely to present visual impairments. However, in addition to visual apperceptive agnosia there are also cases of apperceptive agnosia in other sensory areas.

Recognition memory, a subcategory of declarative memory, is the ability to recognize previously encountered events, objects, or people. When the previously experienced event is reexperienced, this environmental content is matched to stored memory representations, eliciting matching signals. As first established by psychology experiments in the 1970s, recognition memory for pictures is quite remarkable: humans can remember thousands of images at high accuracy after seeing each only once and only for a few seconds.

Extinction is a neurological disorder that impairs the ability to perceive multiple stimuli of the same type simultaneously. Extinction is usually caused by damage resulting in lesions on one side of the brain. Those who are affected by extinction have a lack of awareness in the contralesional side of space and a loss of exploratory search and other actions normally directed toward that side.

Visual object recognition refers to the ability to identify the objects in view based on visual input. One important signature of visual object recognition is "object invariance", or the ability to identify objects across changes in the detailed context in which objects are viewed, including changes in illumination, object pose, and background context.

Amorphosynthesis, also called a hemi-sensory deficit, is a neuropsychological condition in which a patient experiences unilateral inattention to sensory input. This phenomenon is frequently associated with damage to the right cerebral hemisphere resulting in severe sensory deficits that are observed on the contralesional (left) side of the body. A right-sided deficit is less commonly observed and the effects are reported to be temporary and minor. Evidence suggests that the right cerebral hemisphere has a dominant role in attention and awareness to somatic sensations through ipsilateral and contralateral stimulation. In contrast, the left cerebral hemisphere is activated only by contralateral stimuli. Thus, the left and right cerebral hemispheres exhibit redundant processing to the right-side of the body and a lesion to the left cerebral hemisphere can be compensated by the ipsiversive processes of the right cerebral hemisphere. For this reason, right-sided amorphosynthesis is less often observed and is generally associated with bilateral lesions.

Topographical disorientation is the inability to orient oneself in one's surroundings, sometimes as a result of focal brain damage. This disability may result from the inability to make use of selective spatial information or to orient by means of specific cognitive strategies such as the ability to form a mental representation of the environment, also known as a cognitive map. It may be part of a syndrome known as visuospatial dysgnosia.

Haptic memory is the form of sensory memory specific to touch stimuli. Haptic memory is used regularly when assessing the necessary forces for gripping and interacting with familiar objects. It may also influence one's interactions with novel objects of an apparently similar size and density. Similar to visual iconic memory, traces of haptically acquired information are short lived and prone to decay after approximately two seconds. Haptic memory is best for stimuli applied to areas of the skin that are more sensitive to touch. Haptics involves at least two subsystems; cutaneous, or everything skin related, and kinesthetic, or joint angle and the relative location of body. Haptics generally involves active, manual examination and is quite capable of processing physical traits of objects and surfaces.

Form perception is the recognition of visual elements of objects, specifically those to do with shapes, patterns and previously identified important characteristics. An object is perceived by the retina as a two-dimensional image,[1] but the image can vary for the same object in terms of the context with which it is viewed, the apparent size of the object, the angle from which it is viewed, how illuminated it is, as well as where it resides in the field of vision.[2] Despite the fact that each instance of observing an object leads to a unique retinal response pattern, the visual processing in the brain is capable of recognizing these experiences as analogous, allowing invariant object recognition. recognition|object recognition]]. Visual processing occurs in a hierarchy with the lowest levels recognizing lines and contours, and slightly higher levels performing tasks such as completing boundaries and recognizing contour combinations. The highest levels integrate the perceived information to recognize an entire object. Essentially object recognition is the ability to assign labels to objects in order to categorize and identify them, thus distinguishing one object from another. During visual processing information is not created, but rather reformatted in a way that draws out the most detailed information of the stimulus.

References

  1. 1 2 3 O'Sullivan, S.B.; Schmitz, T.J. (2007). Physical Rehabilitation (5th ed.). Philadelphia: F.A. Davis Company. pp.  1180–1181. ISBN   9780803612471.
  2. 1 2 3 4 5 Gerstmann, J. (2001). Translated by T. Benke. "Pure Tactile Agnosia". Cognitive Neuropsychology . 18 (3): 267–274. doi:10.1080/02643290042000116. PMID   20945214. S2CID   30352886.
  3. Freud, E.; Ganel, T.; Shelef, I.; Hammer, M.; Avidan, G.; Behrmann, M. (2015). "Three-Dimensional Representations of Objects in Dorsal Cortex are Dissociable from Those in Ventral Cortex". Cerebral Cortex. 27 (1): 422–434. doi: 10.1093/cercor/bhv229 . PMID   26483400.
  4. Kumar, A.; Wroten, M. (2019). "Agnosia". StatPearls. PMID   29630208 . Retrieved 2020-01-21.