The nature and limits of orientation and pattern processing supporting visuomotor control in a visual form agnosic

We have previously reported that a patient (DF) with visual form agnosia shows accurate guidance of hand and finger movements with respect to the size, orientation, and shape of the objects to which her movements are directed. Despite this, she is unable to indicate any knowledge about these object properties. In the present study, we investigated the extent to which DF is able to use visual shape or pattern to guide her hand movements. In the first experiment, we found that when presented with a stimulus aperture cut in the shape of the letter T, DF was able to guide a T-shaped form into it on about half of the trials, across a range of different stimulus orientations. On the remaining trials, her responses were almost always perpendicular to the correct orientation. Thus, the visual information guiding the rotation of DFs hand appears to be limited to a single orientation. In other words, the visuomotor transformations mediating her hand rotation appear to be unable to combine the orientations of the stem and the top of the T, although they are sensitive to the orientation of the element(s) that comprise the T. In a second experiment, we examined her ability to use different sources of visual information to guide her hand rotation. In this experiment, DF was required to guide the leading edge of a hand-held card onto a rectangular target positioned at different orientations on a flat surface. Here the orientation of her hand was determined primarily by the predominant orientation of the luminance edge elements present in the stimulus, rather than by information about orientation that was conveyed by nonluminance boundaries. Little evidence was found for an ability to use contour boundaries defined by Gestalt principles of grouping (good continuation or similarity) or 'nonaccidental' image properties (colinearity) to guide her movements. We have argued elsewhere that the dorsal visual pathway from occipital to parietal cortex may underlie these preserved visuomotor skills in DF. If so, the limitations in her ability to use different kinds of 'pattern' information to guide her hand rotation suggest that such information may need to be transmitted from the ventral visual stream to these parietal areas to enable the full range of prehensive acts in the intact individual.