Developmental Topographical Disorientation With Concurrent Face Recognition Deficit: A Case Report

Abstract

Developmental topographical disorientation (DTD) has been defined as a developmental deficit in human navigational skills in the absence of congenital or acquired brain damage. We report the case of Lost In Space Again (LISA), a 22-year-old woman with a normal development and no clinical history of neurological or psychiatric diseases, evaluated twice, with an interval of 5 years. The magnetic resonance imaging (MRI) examination did not reveal any morphological alteration, while diffusion tensor imaging (DTI) showed a structural connectivity deficit (a decreased fractional anisotropy—FA) in the parieto–prefrontal and parieto–premotor pathway. The behavioral assessment showed different deficits in spatial and navigational tasks, which seemed to be connected to a poor ability to form a cognitive map of the environment. Moreover, LISA displayed a poor performance in high-level face encoding and retrieval. The aim of this case report is to share new insight about DTD in order to deepen the knowledge of this specific neurodevelopmental disorder. In conclusion, this novel DTD case (1) supports the hypothesis of the existence of different DTD subtypes; (2) sustains the evidence that DTD can co-occur (or not) with deficit in face recognition; and (3) highlights the need for an in-depth examination from both a neurocognitive and behavioral point of view of a possible common developmental defect between the formation of cognitive maps and the recognition of faces that might be in mental imagery skills. Future directions will be also discussed.

Where Am I? Searching for the Tangle in the Developmental Topographical Disorientation

“…Differently from Burles and Iaria [ 12 ], we found that males are more affected than females by DTD with a ratio of 4:1. This finding is in line with the single cases described in literature, given that we identified more males [ 3 , 6 , 7 , 9 ] than females [ 1 , 8 , 23 ]. It is worth emphasizing that the two samples are not equivalent.…”

“…In addition, even the case described by Piccardi et al [ 9 ] that had both developmental landmark agnosia and developmental prosopagnosia, the treatment of developmental prosopagnosia had produced positive effects on developmental landmark agnosia by greatly reducing its symptoms. However, with respect to single case studies, just two cases showed the co-occurrence of a landmark agnosia and prosopagnosia [ 9 , 23 ]. This co-occurrence is also reported in acquired deficits [ 24 , 25 ] indicating a general difficulty in accessing similar stored representations.…”

Functional brain networks in Developmental Topographical Disorientation

“…Given the reliable, but slight self-reported impairments in some object, place, and face recognition in individuals with DTD ( Piccardi et al. 2019 ; Burles and Iaria 2020 ; Rusconi et al. 2021 ), these connectivity changes may be representative of weaker functional specialization within visual processing regions for special classes of objects, places in particular, in which individuals with DTD report difficulty processing relative to controls ( Burles and Iaria 2020 ).…”

Study on Brain Structure Network of Individuals with Different Space Navigation Ability

“…A recent case study of developmental topographic disorientation reported no morphological changes in MRI. However, DTI results suggested that etiology is associated with disrupted ber connections and decreased FA values, both of which occur in the prefrontal and prefrontal lobe-motor pathways [11].…”