Mid-range visual functions in relation to higher-order visual functions after stroke

• Published in: Journal of clinical and experimental neuropsychology 2022-10, Vol.44 (8), p.580-591
• Main Authors: van den Berg, Nils S., Lammers, Nikki A., Smits, Anouk R., Lugtmeijer, Selma, Pinto, Yair, De Haan, Edward H.F.
• Format: Article
• Language: English
• Subjects: Brain; Cognition; Cognitive ability; Emotions; higher-order cognitive functions; Humans; Ischemia; Memory; mid-range visual functions; Orientation behavior; patchwork model; Perception; Stroke; Stroke - complications; Two-visual pathway model; Visual functions
• ISSN: 1380-3395; 1744-411X
• DOI: 10.1080/13803395.2022.2147487

We aimed to investigate whether associations between deficits in "mid-range" visual functions and deficits in higher-order visual cognitive functions in stroke patients are more in line with a hierarchical, two-pathway model of the visual brain, or with a patchwork model, which assumes a parallel organization with many processing routes and cross-talk. A group of 182 ischemic stroke patients was assessed with a new diagnostic set-up for the investigation of a comprehensive range of visuosensory mid-range functions: color, shape, location, orientation, correlated motion, contrast and texture. With logistic regression analyses we investigated the predictive value of these mid-range functions for deficits in visuoconstruction (Copy of the Rey-Complex Figure Test), visual emotion recognition (Ekman 60 Faces Test of the FEEST) and visual memory (computerized Doors-test). Results showed that performance on most mid-range visual tasks could not predict performance on higher-order visual cognitive tasks. Correlations were low to weak. Impaired visuoconstruction and visual memory were only modestly predicted by a worse location perception. Impaired emotion perception was modestly predicted by a worse orientation perception. In addition, double dissociations were found: there were patients with selective deficits in mid-range visual functions without higher-order visual deficits and vice versa. Our findings are not in line with the hierarchical, two-pathway model. Instead, the findings are more in line with alternative "patchwork" models, arguing for a parallel organization with many processing routes and cross-talk. However, future studies are needed to test these alternative models.