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Recognition without awareness in a patient with simultanagnosia
Journal article   Open access   Peer reviewed

Recognition without awareness in a patient with simultanagnosia

Natalie L Denburg, Robert D Jones and Daniel Tranel
International journal of psychophysiology, Vol.72(1), pp.5-12
2009
DOI: 10.1016/j.ijpsycho.2008.02.012
PMCID: PMC2688652
PMID: 18824046
url
http://doi.org/10.1016/j.ijpsycho.2008.02.012View
Open Access

Abstract

We report a psychophysiological study of “recognition without awareness” in patient 2354, who had severe but circumscribed atrophy in the occipitoparietal region bilaterally (caused by visual-variant Alzheimer's disease, documented by structural and functional neuroimaging) and an accompanying Balint syndrome that prevented her from recognizing the emotional valence of many highly charged negative visual scenes (e.g., a burned body). Despite this lack of overt recognition, patient 2354 nonetheless generated large amplitude skin conductance responses to highly charged negative pictures, demonstrating the same kind of recognition without awareness that has been reported previously in patients with bilateral occipitotemporal dysfunction and prosopagnosia [e.g., Tranel, D., & Damasio, A. R. (1985). Knowledge without awareness: an autonomic index of facial recognition by prosopagnosics. Science, 228, 1453–1454.]. Our case complements both previous evidence of covert, nonconscious recognition in patients with prosopagnosia, and previous behavioral studies of patients with Balint syndrome that have shown evidence of “preattentive” visual processing. The findings add to the small but important set of empirical observations regarding nonconscious visual processing in neurological patients, and indicate that recognition without awareness can occur in the setting of dorsal visual stream dysfunction and Balint syndrome. The findings in our patient suggest that she has patent pathways from higher-order visual cortices to autonomic effectors in the amygdala or hypothalamus, even though the results of such information processing are not made available to conscious awareness.
Simultanagnosia Balint syndrome Prosopagnosia Covert

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