Accurate distance perception depends on the processing and integration of a variety of monocular and binocular cues. Dorsal stream lesions can impair this process, but details of this neurocognitive relationship remain unclear. Here, we tested a patient with bilateral occipitoparietal damage and severely impaired stereopsis. We addressed four related questions: 1) Can distance and size perception survive limitations in perceiving monocular and binocular cues? 2) Are egocentric (selfreferential) and allocentric (object-referential) distance judgments similarly impaired? 3) Are distance measurements equally impaired in peripersonal and extrapersonal space? 4) Are size judgments possible when distance processing is impaired? The results demonstrate that the patient's lesions impaired both her distance and size perception, but not uniformly. Her performance when using an egocentric reference frame was more impaired than her performance when using an allocentric reference frame. Likewise, her distance judgments in peripersonal space were more impaired than those in extrapersonal space. The patient showed partial preservation in size processing of novel objects even when familiar size cues were removed. Keywords distance; depth; parietal; stereopsis; simultanagnosia; Balint's syndrome
Impaired Distance Perception and Size Constancy Following Bilateral Occipitoparietal DamageA veridical representation of the three-dimensional world requires accurate perception of object distance and object size. Distance perception requires the integration of diverse cues; size perception is determined by size constancy, the scaling of an object's retinal subtense by estimated distance (Emmert, 1881). The neural correlates of these processes have long been linked to dorsal stream function. Ninety years ago, Holmes and Horrax reported the case study of a soldier with bilateral parietal lobe lesions who exhibited extensive distance perception deficits (Holmes & Horrax, 1919). This patient could not determine the closer of two objects even though he possessed normal visual acuity. He had also lost stereopsis, a binocular distance cue. Additional reports have linked distance perception deficits with dorsal stream damage (Critchley, 1953;Holmes, 1918;Riddoch, 1917). Other reports have related dorsal stream damage to deficits in size constancy (Ferber & Danckert, 2006;Rode, Michel, Rossetti, Boisson, & Vallar, 2006;Wyke, 1960). In such classic neuropsychological reports lesion location is roughly estimated and deficits are based on bedside clinical evaluations.More recently, a number of fMRI studies have investigated stereopsis and have identified a number of dorsal stream areas associated with stereopsis, such as retinotopic area V3A and caudal intraparietal sulcus (Backus, Fleet, Parker, and Heeger, 2001;Brouwer, van Ee, and Schwarzbach, 2005;Inui et al., 2000;Iwami et al., 2002;Kwee, Fujii, Matsuzawa, and Nakada, 1999;Naganuma et al., 2005;Neri, Bridge, and Heeger, 2004;Nishida et al., 2001;Rutschmann and Greenlee, 2004;Rutschmann...