Disorders of tactile object recognition (TOR) may result from primary motor or sensory deficits or higher cognitive impairment of tactile shape representations or semantic memory. Studies with healthy participants suggest the existence of exploratory motor procedures directly linked to the extraction of specific properties of objects. A pure deficit of these procedures without concomitant gnostic disorders has never been described in a brain-damaged patient. Here, we present a patient with a right hemispheric infarction who, in spite of intact sensorimotor functions, had impaired TOR with the left hand. Recognition of 2D shapes and objects was severely deficient under the condition of spontaneous exploration. Tactile exploration of shapes was disorganized and exploratory procedures, such as the contour-following strategy, which is necessary to identify the precise shape of an object, were severely disturbed. However, recognition of 2D shapes under manually or verbally guided exploration and the recognition of shapes traced on the skin were intact, indicating a dissociation in shape recognition between active and passive touch. Functional MRI during sensory stimulation of the left hand showed preserved activation of the spared primary sensory cortex in the right hemisphere. We interpret the deficit of our patient as a pure tactile apraxia without tactile agnosia, i.e. a specific inability to use tactile feedback to generate the exploratory procedures necessary for tactile shape recognition.
This study addresses the limits of haptic orientation deficit observed in patients with left visuo-spatial neglect (VSN) in the fronto-parallel plane. We concentrated on two aspects of the haptic perception of vertical, horizontal and oblique orientations: first, the global level of performances compared with normal subjects and, second, the occurrence of the oblique effect (i.e. lower performances in oblique orientations than in vertical-horizontal orientations). Subjects were asked to position a rod, presented in the fronto-parallel plane, to one of four orientations: vertical, horizontal, left 45 degrees oblique and right 45 degrees oblique. First, we found a haptic orientation deficit in neglect patients: The precision was lower in the neglect patients than in the normal (young adults and seniors) subjects. Second, we observed in both neglect patients and control subjects the occurrence of a similar haptic oblique effect and there were no differences between the results in the left and right hemispaces. Taken together, this means that, in spite of the global haptic orientation production deficit observed in VSN patients, no specific pattern was observed in the haptic production of different orientations in these subjects as compared to the two other groups. The haptic orientation deficit of neglect patients seems to affect in the same way all values and spatial positions of orientations.
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