This article was downloaded by: [UQ Library]

On: 01 November 2014, At: 20:46

Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer
House, 37-41 Mortimer Street, London W1T 3JH, UK

Neurocase: The Neural Basis of Cognition

Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/nncs20

Topographical disorientation
a
Martin J. Farrell
a
Medical Research Council Applied Psychology Unit , Cambridge, UK
Published online: 17 Jan 2008.

To cite this article: Martin J. Farrell (1996) Topographical disorientation, Neurocase: The Neural Basis of Cognition,
2:6, 509-520, DOI: 10.1080/13554799608402427

To link to this article: http://dx.doi.org/10.1080/13554799608402427

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”)
contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors
make no representations or warranties whatsoever as to the accuracy, completeness, or suitability
for any purpose of the Content. Any opinions and views expressed in this publication are the opinions
and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of
the Content should not be relied upon and should be independently verified with primary sources of
information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands,
costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or
indirectly in connection with, in relation to or arising out of the use of the Content.

This article may be used for research, teaching, and private study purposes. Any substantial or
systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in
any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://
www.tandfonline.com/page/terms-and-conditions
 Neurocase (1996) Vol. 2, pp. 509-520 C Oxford Universify Press I996

REVIEW

Topographical Disorientation

Martin J. Farrell
Medical Research Council Applied Psychology Unit, Cambridge, UK

Abstract

The literature on topographical disorientation is reviewed with respect to different types of spatial
representation and modes of navigation. It is argued that there is not a strong case for the existence of
separate representationsfor, on the one hand, the identity of environmental features, and, on the other hand,
the location of environmental features relative to other landmarks. Identity and location may be considered
Downloaded by [UQ Library] at 20:46 01 November 2014

more profitably as two aspects of one spatial mapping system, which encodes allocentric spatial
relationships and permits landmark-based navigation. Egocentric spatial relationships, however, may also be
important in navigation. It is argued that damage to the dorsal areas that are implicated in the updating and
manipulation of egocentric reference frames, as well as damage to the allocentric system, may result in
topographical disorientation.

Introduction
Topographical disorientation is a general term that refers
to the inability of patients to navigate through their
environments. Navigation through novel environments
tends to be more frequently and more seriously affected
than navigation in familiar surroundings, but this too can
be impaired. The impairment, though it is often associated
with visual field defects, is not sensory in nature and it
must also be distinguished from orientation difficulties due
to factors such as impaired distance perception, defective
localization of objects in space, or hemispatial neglect.
There are several ways in which topographical disorienta-
tion can be manifested, and these have been known for
some time: an inability to find one’s way in previously
familiar surroundings (e.g. Jackson, 1876) and/or an
inability to learn the layout of novel environments, such
as the hospital in which the patient is treated (e.g. Meyer,
1900). Sometimes patients cannot describe familiar
environments (e.g. Badal, 1888), though in other cases
the patient can give descriptions of the spatial relationships
between known locations, but cannot actually use this
knowledge to navigate in the real world (Wilbrand, 1892).
The patient may be unable to recognize places by overall
impression, but be able to recognize them via small
distinctive features (Meyer, 1900).
It is only since the 1940s, however, that a relatively clear
theoretical approach to topographical disorientation has
been formulated. In particular, discussions of topographical
disorientation have, on the one hand, tended to focus on
defects in the underlying representations of buildings and
landmarks and matching incoming perceptual information
to these representations and, on the other hand, on loss of
knowledge of the spatial relationships between landmarks.
In the following review these issues will be examined but,
in addition, it will be argued that, though such representa-
tions are important, little attention has been given to the
ways in which such information is used and manipulated in
navigating through the environment. Thus, discussion of
the characteristics of topographical disorientation will be
made both with reference to the types of spatial repre-
sentations underlying wayfinding abilities and to the
different types of navigational process that can be used in
conjunction with these representations. The following
section will briefly outline the different types of spatial
representation that have been put forward and then the
subsequent section will deal with navigational processes.
The rest of the article will then examine how topographical
disorientation can be interpreted within such a theoretical
framework.

Correspondence to: Martin Farrell, MRC Applied Psychology Unit, Rehabilitation Research Group, Box 58, Addenbrooke’s Hospital, Hills Road,
Cambridge CB2 2QQ, UK. e-mail: martin.farrell@mrc-apu.cam.ac.uk
 510 M. J. Farrell
Types of spatial representation
Spatial relationships between locations can be encoded in
terms of the movements or turning responses needed to get
to one from the other. Such ‘route maps’ (Siege1 and White,
1975) or ‘taxon’ representations (O’Keefe and Nadel, 1978)
typically consist of a series of pairings of an environmental
stimulus with an appropriate orientating response, e.g. ‘turn
left at the garage’. Route representations are relatively
simple and easy to use, but they are extremely inflexible:
they are only useful for allowing one to get to a particular
goal location from a particular starting point. If it is not
possible to follow the prescribed series of responses, e.g. if
an environmental stimulus is now missing or the route is
blocked, the subject will be unable to devise a novel route
and will fail to reach the goal.
The simplicity of such representations is consistent with
the frequent ability of topographically disorientated patients
Downloaded by [UQ Library] at 20:46 01 November 2014
to use them successfully in everyday navigation. Whiteley
and Warrington (1978) say of their patient: ‘. . . he knows
that to get to the shops he has to turn right at the traffic
lights and then left at the Odeon Cinema’ (p. 576). They go
on to add, however, that if he fails to see one of these
landmarks it is very likely that he will become lost. Landis
et d.(1986, Case 1) report a similar case: ‘To go to the
hospital store, he memorized the floor number and the right
and left turns from the elevator. If he missed a turn, he had
to ask the other patients for directions’ (p. 133). However,
this type of representation could not be used to work out
novel routes: ‘Two months after admission he was blind-
folded and taken to an unfamiliar part of the hospital. It
took him 30 min of trial and error to find his bed, a task that
could have been accomplished in 30 s’ (p. 133).
More flexible spatial behaviour, such as inferring novel
routes, requires representations of spatial relationships
per se rather than stimulus-response chains indicating how
to get from one particular location to another. The repre-
sentation of spatial relationships may be egocentric or
allocentric in nature. An allocentric representation locates
objects within an external framework, such as the room or
neighbourhood, whereas egocentric encoding is centred on
the subject and is concerned with the positions of objects
relative to himher. Egocentric representations are there-
fore relative: as soon as the subject moves, all the spatial
relationships change. When, on the other hand, location is
encoded allocentrically, such changes in spatial relation-
ships do not take place as a result of subject movement,
because the objects’ positions are represented in terms of
an external frame of reference.
Cognitive map theorists tend for just this reason to
envisage the map as an allocentric representation. O’Keefe
and Nadel (1978), for example, while admitting the exist-
ence and importance of relative and egocentric encoding,
assert the primary role of the cognitive map, which is
‘a non-centred stationary framework through which the
organism and its egocentric spaces move’ (p. 2). No one
place, or set of places, can be regarded as a ‘goal’ relative
to which other locations are encoded. Instead, by virtue of
their placement within the map’s framework, the spatial
relationship between one point and any other is repre-
sented. Maps of this type, which are usually what are meant
by the term ‘cognitive map’, are not as easy and quick to
use as route representations: more cognitive resources are
required to ‘read’ and manipulate the spatial information
contained in the map, but flexible behaviours, such as the
inferring of novel routes, become possible.
Others (e.g. McNaughton et al., 1995) have argued
against the idea that objects are located within a spatial
framework in which every point is automatically related to
every other point, and instead have postulated spatial
representations consisting of a series of vectors linking
salient locations, such as the organism’s home base or an
important food source. Though this sort of representation
implies that certain locations are encoded as goals, flexible
behaviour is nevertheless possible. If an organism encodes
the distance and direction of its home relative to a land-
mark, then, keeping track of its distance and bearing from
the landmark, it can use vector subtraction to find the
vector directly relating it to its home (i.e. subtraction of the
‘perceptual’ vector relating it to the landmark from the
stored vector relating the landmark to home).
Types of navigation
Gallistel ( 1990) considered navigational processes to be
split into two broad types: those that are carried out contin-
uously and those that are carried out intermittently. The
continuous processes may be referred to generally as dead
reckoning. Dead reckoning refers to the calculation of
one’s change in position or directional heading, and it can
be done either by integrating velocity with respect to time
(Gallistel, 1990; see also Loomis et al., 1992) or on the
basis of acceleration, a process sometimes referred to as
inertial navigation. The distance travelled in a particular
direction can then be conjoined with a map representing the
environment to yield one’s current position.
When there are few features to guide the traveller, dead
reckoning plays an important part in navigation. In the
presence of discernible landmarks, however, another mode
of navigation, called piloting, can be used. Piloting refers to
the computation of one’s position and direction, or head-
ing, relative to visible features of the environment. There
are two ways in which position and heading can be deter-
mined. One method involves exclusive reference to visible
landmarks, and requires at least two such features in order
to determine position and heading unequivocally. When
position and heading are determined on the map, one can
then navigate, via the map and the visible features, with
respect to features and locations that are not currently
visible. Of course, if the goal location is itself visible (or if
there is some other form of sensory output directly linked
to the goal), direct homing to the goal is possible. Situating

oneself can, however, also be done with reference to only
one landmark, but this method requires some sort of
compass mechanism to provide directional information,
otherwise one’s position could be anywhere on the circum-
ference of a circle surrounding the landmark. This method,
therefore, has aspects of both intermittent and continuous
navigation, as heading has to be updated continuously if
one is not to become lost.
Continuous and intermittent navigational processes are,
of course, not mutually exclusive; they tend to be used in
conjunction with one another. The precise balance between
these two broad types of navigation will depend on the
particular circumstances: if there are few salient environ-
mental features, piloting will prove difficult and dead
reckoning will assume priority; if navigation requires
greater precision rather than knowledge of which general
area one is in, piloting will tend to prove more effective
than dead reckoning. Both piloting and dead reckoning,
Downloaded by [UQ Library] at 20:46 01 November 2014
however, can only be successfully performed in con-
junction with an accurate spatial representation of the
environment.
Some (e.g. De Renzi, 1982) have argued that both dead
reckoning and internal compass-based navigation are only
used in new environments and that navigation in familiar
environments is likely to be purely landmark-based. Others
have argued against the use of dead reckoning on the
grounds that it is ‘extremely computationally demanding’
(Milner and Goodale, 1995, p. 90). This, however, is not
necessarily the case. Gallistel (1990) points out that:
‘Symbolic manipulations that seem complex, hard to
learn, and difficult to carry out by human beings often
have simple physical realizations. Integrating a variable
with respect to time sounds like an impressive operation,
yet a bucket receiving a flow of water integrates that
flow with respect to time. The filling of a bucket strikes
most people as a simple physical operation. A symbolic
(mathematical) presentation of the trigonometric and
integrative operations involved in dead reckoning com-
putations makes them sound forbidding, but the dead
reckoning device on a ship is not complex. The trigono-
metric decomposition operations it performs are easily
simulated with plausible neural circuits.’ (pp. 38-39).
The fact that insect species, such as the desert ant, seem
to make use of dead reckoning (see Wehner and Srinivasan,
198 1 ) suggests that complex computational machinery is
not necessary to carry it out and that such operations may
be carried out by ‘smart’ perceptual mechanisms (Runeson,
1977) that are directly sensitive to higher-order variables
without having to calculate them on the basis of putatively
‘simpler’ variables.
The spatial representations that are used in conjunction
with piloting and dead reckoning are allocentric in
nature - they provide stable information on the spatial
relationships between locations, which do not change as
the subject’s position changes. What piloting and dead
Topographical disorientation 51 1
reckoning enable the subject to do is to relate the allo-
centric and egocentric spatial coordinates to one another.
As was noted by Gallistel (1990): ‘Navigation can be
thought of as the process of relating one’s egocentric
system of coordinates to a system in which points anchored
to the earth are fixed points’ (p. 43).
Topographical agnosia and topographical
amnesia
Paterson and Zangwill (1945) describe a patient who was
unable to find his way around previously familiar environ-
ments as a result of a penetrating missile wound in the right
temporal lobe. This patient had great difficulty in recog-
nizing buildings and features, even very distinctive ones, in
his home city. Of this failure to recognize familiar places
Paterson and Zangwill say:
‘. . . the patient was unable to bring the perceived material
into proper relation with those experience-schemes or
memory-dispositions which normally render place recog-
nition immediate, automatic and correct. This failure, in
sharp contrast to the patient’s invariably accurate recog-
nition (gnosis) of objects, colours and written symbols,
appears to warrant treatment as a specific topographical
agnosia’ (p. 208, italics in original).
This patient, however, also had difficulties in describing
routes and in drawing maps and plans. Paterson and
Zangwill (1945) claimed that ‘the patient’s inability to
formulate correct topographical relationships . . . would
rather suggest an additional disorder in the field of spatial
memory’ (p. 208, italics in original).
Since the publication of Paterson and Zangwill’s (1945)
paper, it has been common to describe topographical
disorientation in terms of either agnosia or amnesia
(e.g. Vighetto and Aimard, 1981; De Renzi, 1982), and
there have been discussions as to whether topographical
agnosia or topographical amnesia can be said to account for
the main characteristics of topographical disorientation
(e.g. Landis er al., 1986). It is important to recognize,
however, that a hard and fast distinction between agnosia
and amnesia is nowhere to be found in Paterson and
Zangwill’s original paper. Rather, the patient’s difficulties
with place recognition and route description are seen as two
facets of disruption to stored topographical representations
built up over experience: an inability to use representations
to recognize buildings and an inability to use representa-
tions to revisualize routes.
The somewhat unclear distinction between topo-
graphical amnesia and topographical agnosia may have
contributed to the inconsistent way in which different
authors have labelled the topographical difficulties of the
patients that they have studied. Some (e.g. Assal, 1969;
Whiteley and Warrington, 1978) describe their patients’
inability to recognize landmarks as ‘topographical memory
loss’, though Whiteley and Warrington go on to qualify
 512 M. J. Farrell
their description by distinguishing between memory for
‘topographical feature information’ and ‘topographical
spatial information’. According to Aimard et al. (1981)
the failure of subjects to recognize landmarks produces a
feeling of strangeness and unfamiliarity in the subject,
whereas Habib and Sirigu (1987) seem to make a distinc-
tion between the recognition of landmarks on the one hand
and their familiarity and use for orientation on the other.
For them, topographical agnosia is when ‘patients are no
longer able to recognize well-known places and buildings’
(p. 80), but topographical amnesia is when ‘environmental
landmarks fail to evoke a sense of familiarity to the
patient’ (p. 80).
A clearer definition of the problem came from Levine
et al. (1985), who distinguished between topographical
disorientation due to damaged ‘visual-object’ representa-
tions and topographical disorientation due to damaged
‘visual-spatial’ representations. The former was thought to
Downloaded by [UQ Library] at 20:46 01 November 2014
be associated with the ventral (‘what’) cortical visual
system and the latter with damage to the dorsal (‘where’)
cortical visual system (Ungerleider and Mishkin, 1982).
The ventral visual system, it has been argued, is primarily
concerned with object recognition, and damage to it is thus
often associated with visual object agnosias and proso-
pagnosia. The dorsal system, on the other hand, is thought
to be concerned with object localization in space. Accord-
ing to Levine et al. (1983, ‘[p]rosopagnosic patients lose
their way because they cannot recognize landmarks, which
appear strange even though they know the layout of the
route . . . In contrast, patients with visual disorientation
recognize landmarks, but cannot find their way because
they do not know how to orientate the body with respect to
these landmarks, when to turn and in what direction’
(p. 1016). In addition, Levine et al. believe that the
prevalence of topographical disorientation due to impaired
object recognition is underestimated due to uncritical
acceptance of patients’ statements that they can form
images of places, thus suggesting that their visual repre-
sentations of these environmental objects are intact. The
patient reported by Levine et al. claimed to be able to form
images of places, but when he was tested more thoroughly,
his images were found to be only very sketchy indeed.
This distinction between the identity of an object and its
spatial location provides a clearer framework for discussion
than the traditional agnosidamnesia distinction because,
unlike that dichotomy, it provides relatively clear predic-
tions about the extent to which different aspects of topo-
graphical disorientation should be dissociable, as well as
indicating a possible way in which neural mechanisms may
be involved.
It nevertheless remains to be seen to what extent
the recognition of environmental features and knowledge
of spatial relationships can be dissociated. Milner and
Goodale (1995) have attacked the idea that there are
separate neural pathways for the location of objects and the
identification of objects. They claim that the two cortical
visual streams do not deal separately with object identifi-
cation and object localization, but that both systems are
concerned with object identity and location, although for
different purposes: the dorsal stream deals with the
guidance of actions and the ventral stream is involved in
perception and identification. The different purposes to
which these pathways are dedicated require that location be
encoded differently in each. The ventral stream encodes
spatial information allocentrically; the dorsal stream
encodes spatial information egocentrically. It is the allo-
centric ventral stream that Milner and Goodale believe
underlies topographical disorientation. Such a model would
not predict a double dissociation between the identification
of objects and knowledge of spatial relationships as they
are both served by the same subsystem. The Levine et al.
approach, however, clearly would make such a prediction.
Impairments of recognition and identification of
environmental features
Griisser and Landis (1991) distinguished four diRerent
types of impairment of environmental object recognition:
perceptive topographagnosia, apperceptive topograph-
agnosia, associative topographagnosia, and cognitive-
emotional topographagnosia. Perceptive topographagnosia
is the result of impaired perception of environmental
features. The underlying visuospatial representation of
these features is, however, undamaged. Thus. there is an
incompatibility between the degraded perceptual input and
the intact representation. This incompatibility produces
disorientation in the patient who, nevertheless, as the
environmental representation is intact, still retains a sense
of familiarity with the environment.
Apperceptive topographagnosia is often characterized
by difficulties in directing eye movements and by poor
depth perception. Patients seem to have difficulty i n
integrating environmental features into a whole and this
may be manifested differently according to which hemi-
sphere is damaged. Patients with right lateral temporo-
parieto-occipital lesions may recognize local features, but
cannot put them together to form a more global perception;
patients with left hemisphere lesions may have problems
with the local information itself. Again, the underlying
representations of the environmental features are thought to
be intact, but again, due to the impaired perceptual input,
there is a conflict between perception and memory. Associ-
ative topographagnosia also results from a mismatch
between perceptual input and the underlying visuospatial
memories, but in this case there is a feeling of strange-
ness and a loss of familiarity on the part of the patient.
With cognitive-emotional topographagnosia the underlying
visuospatial representations are themselves destroyed,
resulting in a loss of environmental familiarity.
It is not clear, however, whether the representations
referred to are predominantly map-like or image-like. One
is therefore not sure to what extent it is correct, in the case

of cognitive-emotional topographagnosia, to characterize
patients’ impairments as problems of recognition. If
the representations referred to are image-like, then the
problems arising from their loss could adequately be
described as problems of recognition, but if the representa-
tions are map-like, the underlying deficit would seem to be
quite similar to what other authors refer to as loss of spatial
relational information.
Nevertheless, Griisser and Landis’s emphasis is on
definite recognition impairments as, in the first three types
of impairment that they mention, the underlying environ-
mental representations are thought to be undamaged. In
perceptive and apperceptive topographagnosia it is the
perceptual input that is degraded in various ways; in asso-
ciative topographagnosia the visual representation of space
may itself be damaged but spatial representations are
thought to be undamaged for other modalities. In such
cases it should be possible for patients to describe routes
Downloaded by [UQ Library] at 20:46 01 November 2014
and to draw plans of rooms and towns, thus demonstrating
that they have a specific recognition deficit for environ-
mental features while having intact representations of
spatial relationships. There are, as we will see, some cases
in which impaired recognition co-exists with intact spatial
relational information. Such cases, however, are by no
means as common as the Griisser and Landis approach
would lead one to believe, suggesting that their position,
while it may be appropriate for some cases of topographical
disorientation, does not address the full variety of way-
finding impairments that exist.
Concerning the proposed priority of recognition deficits
over loss of spatial relational information, one should note
that several well known cases in which patients have had
severe problems in recognizing previously familiar build-
ings also exhibited disorganized spatial relational know-
ledge. Paterson and Zangwill’s (1945) patient, for example,
could only recognize places on the basis of individual cues.
Such ‘piecemeal’ recognition of places has also been
reported by, for example, Whitty and Newcombe (1973).
But, like Whitty and Newcombe’s patient, he was also
unable to describe routes in, and to draw maps of, the town
where he lived. Sometimes cases in which environmental
recognition difficulties are reported have not fully assessed
the patient’s spatial relational knowledge and so cannot
tell us whether recognition and relational knowledge are
separable. One such case is that reported by Assal (1969).
This patient, who also had difficulty in recognizing faces,
was unable, for example, to recognize his room in the
hospital, though he was reportedly able to situate himself
correctly on a plan of the examination room. This latter
ability suggests that the patient’s appreciation of immedi-
ately perceivable spatial relationships was adequate, but the
patient’s memory and knowledge of spatial relationships
was not tested, e.g. by asking him to describe routes or to
draw maps of well known places. In this case, then, we
cannot conclusively say that the patient’s spatial repre-
sentations of the environment were intact, as no such
Topographical disorientation 5 13
representations would be needed in the test that he was
given. The patient also had slight difficulty in recognizing
objects, though Assal suggests that this was due to neglect,
and though the patient was able to match photographs of
objects correctly, he performed this task with abnormal
slowness. As has been pointed out by Farah (1990), the
time taken to do such tasks is often neglected and can
indicate difficulties that do not appear in the final result.
Thus, in a case such as this one, one cannot argue that the
patient has a specific recognition difficulty for environ-
mental stimuli as neither his perception of other objects nor
his knowledge of spatial relationships has been demon-
strated to be intact.
Another case that could be discussed in the context of
topographical recognition deficits was reported by Whiteley
and Warrington (1978). This patient was able to match
different views of the same building, but had difficulties
with the recognition of buildings and streets. Whiteley and
Warrington attribute the patient’s difficulties to ‘loss of
memory for topographical features information’, which
they distinguish from loss of memory for spatial relational
information. It is not clear, however, whether this patient’s
knowledge of spatial relational information really was
intact, as Whiteley and Warrington base their conclusion on
the success with which the patient could navigate using a
map. But as De Renzi (1982) points out, map-based naviga-
tion places no load on stored spatial relational information
as all the necessary information is encoded in the map.
There have been some cases, however, in which there
does seem to have been impaired recognition of environ-
mental features alongside relatively intact spatial relational
knowledge. Cole and Perez-Cruet ( I 964) described a case
of topographical disorientation in a patient whose main
impairment was in face recognition. This case constitutes a
more persuasive argument for Levine et al.’s (1985) and
Griisser and Landis’s (199 1) proposal that recognition
deficits for environmental features can exist alongside
intact knowledge of spatial relationships. The patient was
unable to find his way around the hospital but could draw
an accurate plan of it and find locations on maps. Interest-
ingly, he was nevertheless unable to describe routes,
suggesting that the drawing of a plan, though an important
test of knowledge of spatial relationships, does not test all
spatial knowledge. It would seem intuitively plausible that
the tasks of drawing a plan and of describing a route
through the same environment would both tap into the
same sort of allocentric spatial relational knowledge, but it
may be the case that, in addition to such allocentric spatial
information, describing a route requires some sort of
mental re-enactment, involving action-based egocentric
information, of actually moving through the route.
PCron et al.’s (1946) patient could not recognize the
streets near his house, nor the house itself, but he could,
however, describe accurately the route from his house to the
hospital. Nevertheless, he was only able to follow this route
as far as he was taken by the bus and he got lost covering the
 514 M. J. Farrell
last 300 m from the bus stop to the hospital. In this case
there do seem to have been recognition impairments
existing alongside intact spatial relational knowledge.
Probably the most striking case of a relatively pure place
recognition disorder reported in the literature was that
described by Pallis (1955). This patient reported that the
rooms in his house seemed unfamiliar and that places
seemed strange. This unfamiliarity caused him to lose his
way. The patient was, however, able to draw accurate maps
and to describe routes, suggesting that the underlying
knowledge of spatial relationships, i.e. the patient’s spatial
representations, was intact. Thus, it appears that it is indeed
possible for the visual recognition of environmental objects
to be impaired, but for knowledge of spatial relationships to
remain intact. This patient also exhibited symptoms of
prosopagnosia and achromatopsia, which have been
reported in several other cases of topographical disorienta-
tion (e.g. Bornstein and Kidron, 1959; Beyn and Knyazeva,
Downloaded by [UQ Library] at 20:46 01 November 2014
1962; Pevzner et al., 1962).
Landis et ai. ( 1 986) report 16 cases, four in detail, of
topographical disorientation, which they ascribed to an
inability to recognize environmental features and objects.
The first patient reported had a right medial occipital lesion
and was able to recognize local features, but had difficulty
in putting them together. He could nevertheless locate his
house on a road map and locate cities on a map of the USA,
suggesting that the patient retained some spatial know-
ledge. Case 2, who experienced loss of familiarity for
previously well known surroundings, could draw maps and
copy complex constructions. Again, in this case there
appears to have been impaired recognition in conjunction
with intact spatial relational information.
From the above cases one can conclude that loss of place
recognition in conjunction with spared spatial relational
knowledge has been demonstrated in several cases, though
in others in which a failure to recognize environmental
features is a major factor, there has been no testing of
spatial relational knowledge or it too has been shown to be
impaired. It should also be noted, however, that impaired
recognition of places, along with seemingly intact spatial
relational information, does not necessarily mean that the
patient has a problem purely with the visual recognition of
places. McCarthy et al. ( 1996) reported the case of a patient
whose visual recognition of buildings was severely
impaired, although he was able to draw a plan of his home
town. In addition, however, the patient had great difficulties
in providing information about famous places and build-
ings when presented verbally with their names. Thus the
deficit was better characterized as a loss of semantic
memory relating to place, which was not limited to one
modality, rather than as a purely visual recognition deficit.
Loss of spatial relational information
Prosopagnosics can often identify a face via particular
cues, rather than recognizing the appearance of the whole
face. A similar approach to identification in the context of
environmental objects is illustrated by the case reported by
Clarke et al. (1993):
‘The patient recognised familiar landmarks in town or in
buildings . . . However, she made mistakes that none of
the controls made, which betrayed her strategies; she
twice mistook another castle, also at the lakeside, for
Chillon. When asked how she identified Chillon, she
said that Chillon ‘was a castle, with towers, at the
lakeside’. She did not use at all the overall impression
that these buildings made; Chillon is a massive.
medieval castle rather highly built whereas the other
one is a rather widespread castle from a later period and
its outer buildings are only two stories high’ (p. 107).
One must, therefore, be cautious with respect to seem-
ingly correct recognition - it may be done on the basis of
distinctive cues (‘piecemeal’ recognition; Paterson and
Zangwill, 1944) rather than on an appreciation of the
building’s appearance as a whole. In cases where recogni-
tion is reportedly good, then, we still need to know how this
recognition was achieved. If recognition only proceeded in
a ‘piecemeal’ fashion, one cannot say that spatial relational
information was selectively damaged. One must also be
sure that a patient’s ability to form images of buildings and
features, sometimes taken as an indication that the visual
representations underlying recognition are undamaged, has
been adequately tested and that one does not solely rely on
the patient’s own claim about his or her ability.
Again, as with the recognition deficits described pre-
viously, there are several cases in which lack of formal
testing prevents one from concluding that the patient’s
deficit was either exclusively with recognition or exclu-
sively with spatial relational knowledge. Cogan ( 1979,
case I), for example, describes a patient who was unable to
describe routes between locations previously well known to
him, while claiming to be able to visualize the places and
buildings themselves. Though this would seem to be a
case of impairment to ‘where’ representations alongside
intact ‘what’ representations, one cannot simply accept the
patient’s claims at face value. As has already been men-
tioned, when patients who claim to have intact imagery are
actually tested o n this ability, their images sometimes turn
out to be rather sketchy and lacking in detail (Levine et al.,
1985).
In many of the cases in which a loss of spatial relational
information has been reported alongside intact recognition
it has not been possible to test whether recognition is intact
or, if it is, how it has been achieved. Stracciari (1994)
reports 10 cases of ‘transitory topographical amnesia’, and
describes three of them in closer detail. In all of these cases
the patients reported sudden temporary episodes, lasting up
to 40 minutes, of disorientation in familiar surroundings.
All claimed that they were able to recognize environmental
features but were unable to use them to orientate and to
guide themselves to their desired destinations. Further

cases of transitory topographical disorientation were
reported by Moretti et al. (1981; 1983). Again, the patients
reported that they had been unable to find their way in
familiar surroundings despite being able to recognize them.
In these cases, then, it appears that spatial relational
information was temporarily disrupted, but that recognition
was unimpaired. The transitory nature of these patients’
problems, however, prevented testing of whether recogni-
tion of environmental features really could be achieved
and, if so, how. One must also be aware that, while these
patients may have been quite confident that they had
recognized buildings, this is no guarantee that they did so
correctly. Indeed, a common feature of deficits of environ-
mental feature recognition is not that the patient says that
s h e is unable to identify a particular building, but rather
that s h e will identify it wrongly. The deficit is often one of
misidentification rather than lack of identification.
A case that is in some ways similar to those just
Downloaded by [UQ Library] at 20:46 01 November 2014
discussed and which illustrates the need for caution
towards claims that recognition was intact in these patients
was described by De Renzi and Faglioni ( 1 962). Again, this
patient suffered a sudden onset of disorientation in which
he was unable to orientate in a familiar environment
despite claiming that it remained familiar and that he was
able to recognize buildings and features. Unlike the
patients discussed by Stracciari (1994) and by Moretti
et al. (198 1, 1983), however, this disorientation persisted,
permitting a more systematic test of the patient’s abilities.
It was found that the patient’s copies of a complex figure
were slow and effortful and that the constituent elements,
while individually correct, were not properly organized or
proportioned to make up the whole correctly. Such
behaviour is suggestive of a piecemeal approach to the
perception of complex objects and scenes. Furthermore,
when the patient was later taken out into the streets of
Milan (where he lived), he was unable to recognize what
should have been well known places and buildings. The
fact that when the patient’s recognition was tested it was
found to be impaired despite his earlier assertions should
make one sceptical about uncorroborated claims that
patients can recognize environmental features.
Indeed, when one considers the cases in which patients
have lost knowledge of spatial relationships, as assessed by
tasks such as map drawing, there are in fact very few cases
in which one can say conclusively that the patient’s ability
to recognize buildings and other environmental features
was unimpaired. In many cases when recognition is
formally tested it is found to fail almost completely
(e.g. Whitty and Newcombe, 1973) or to be achieved only
via distinctive individual cues or features which, when
controlled for, result in a dramatic reduction in recognition
ability. For example, the patient reported by Scotti (1968)
was successful in identifying buildings in the city where he
lived, but when this ability was tested further by asking him
to distinguish between architecturally similar buildings the
patient had great difficulty.
Topographical disorientation 5 15
One case in which there does seem to be a stronger case
for arguing that spatial relational knowledge can be
damaged while recognition remains intact is Levine
et al.’s (1985) case 2. This patient had a right parieto-
occipital lesion and had no problems with forming images
of objects and recognizing faces. He was reportedly able to
describe his local grocery shop but was unable to describe
how he would get to this shop from his house. At first sight
this would appear to demonstrate that impaired allocentric
spatial relational knowledge can exist, if not with intact
recognition, at least with intact imagery, suggesting that the
visual representations that underlie the recognition and
identification of environmental features were intact. It is,
however, questionable whether the task of mentally
evoking a route is a purely allocentric task. Indeed, it has
already been noted in the case described by Cole and Perez-
Cruet (1964) that intact map-drawing can coexist with an
inability to evoke a route mentally. In addition to allo-
centric spatial relational information, imagining a route
may involve imagining oneself following the route, or, at
the very least, imagining the route from an egocentric point
of view. The egocentric component in mentally evoking a
route has been demonstrated in the case of the neglect
patients reported by Bisiach et al. (1993), who ignored
turnings that would have been to their left had they actually
been following the route. Thus, one possibility is that the
lesion in Levine et al.’s case 2 affected this egocentric,
action-based component of route evocation, rather than the
allocentric information itself. This interpretation is
supported by the patient’s inability to tailor his actions
accurately to the spatial layout of his immediate surround-
ings. He described his difficulties in the following way:
‘When I walk, I can’t see that good - seems like every-
thing is running in together. As long as I’m sitting, I can see
pretty good’ (p. 1014). Thus, the patient’s inability to
evoke a familiar route could be interpreted in terms of an
inability to deal with changing egocentric spatial relation-
ships, either as a result of actual or imagined actions, rather
than as a result of loss of allocentric information.
There is one more convincing case for the separability of
spatial relational knowledge and the recognition of build-
ings. Aimard er al.’s (1981) case 4 was a 52-year-old man
who experienced an episode of disorientation in familiar
surroundings. In a similar way to the patients described by
De Renzi and Faglioni (1962), Moretti et al. (198 I), and
Stracciari (1994), he claimed to be able to recognize
buildings, but not to be able to use this knowledge to
orientate himself. Indeed, it was through the recognition of
one particular church that he realized that he was lost,
because he knew that this church was not in the area that he
wanted to be in. When tested later, this patient was unable
to draw a map of his apartment, suggesting a loss of spatial
relational knowledge. He was, however, reportedly able
to describe well known places, suggesting that the under-
lying visual knowledge of the appearances of places was
intact .
 516 M. J. Farrell
Thus, the case for the presence of impaired spatial
relational information alongside intact recognition or
description of environmental features is somewhat less
convincing than that for the existence of impaired recog-
nition and intact spatial relational information as, in many
cases, recognition has not been tested. Even in cases where
there seems to have been some intact recognition, such as
in the case (Aimard et al., 1981, case 4) just described, that
recognition only seems to exist for very specific individual
buildings and the vast majority of individual buildings still
remain unrecognized. Paterson and Zangwill’s (1945)
patient illustrates this:
‘He recognized without difficulty the church which he
had attended before the war (on which he failed in the
earlier test) but completely failed to identify a neigh-
bouring church, suggesting that it might be one in a
district through which we had already passed and which
was now some two miles from our present location.’
Downloaded by [UQ Library] at 20:46 01 November 2014
(P. 200)
Another example is that of HCcaen et al.’s (1980)
patient who, though he had difficulty in recognizing
familiar streets, could nevertheless recognize the Arc de
Triomphe. In such cases it is hardly appropriate to say that
the patient’s recognition is intact, even though certain
distinctive buildings can be identified. Nevertheless, it
appears possible, though rare, that certain individual
buildings can be recognized while spatial relational know-
ledge is disordered. However, it does not appear to be the
case that the recognition of environmental features in
general can exist if spatial relational information is also
degraded.
One reason why recognition, on the very rare occasions
when it coexists with impaired spatial relational know-
ledge, is restricted to very distinctive buildings is that the
recognition of environmental features relies on spatial
relational information in all but the most particular cases.
In other words, the spatial location of an environmental
feature is not extrinsic to its identity as might be the case
with other classes of things (e.g. people, objects): the
identity of an environmental feature (‘what’ it is) is partly
determined by its location (‘where’ it is). Thus, for all but
the most distinctive buildings, top-down spatial knowledge,
in addition to bottom-up feature analysis, may be involved
to a greater extent in the identification of buildings and
landmarks than would be the case for moveable things. In
this case, ‘what’ and ‘where’ should not be seen as two
separate systems, as has been suggested by Levine et al.
( 1985). but as two aspects of the same recognition process.
It is difficult to tell from some of the above cases whether
the dorsal stream, ventral stream, or both were damaged.
Some cases (e.g. Pallis, 1955) have occipital damage,
which could affect either or both of the two visual streams.
Other cases (e.g. Assal et al., 1969; Whitty and Newcombe,
1973; Clarke et al., 1993) have relatively widespread
damage and diverse problems, which again make concrete
conclusions difficult to draw with respect to localization.
It does seem to be the case, however, that impairments
both to recognition and to spatial relational knowledge can
arise from ventral lesions. Paterson and Zangwill’s (1945)
patient, who had problems with both recognition and
spatial knowledge, had a right temporal lesion. Aimard
et al.’s (1981) case 4, who had impaired spatial relational
knowledge, also had a lesion in the right temporal lobe.
Such findings are difficult to square with the idea that all
knowledge of location is dealt with by the dorsal stream.
Egocentric updating and the manipulation of
spatial reference frames
We have seen above that the evidence does not unequivo-
cally support separate representations in the ventral and
dorsal streams of, respectively, the identity and location of
environmental objects. The ventral stream, in agreement
with Milner and Goodale (1995), may be involved in both
the encoding of object location and object recognition.
Such allocentric spatial information could be used in the
mode of navigation that has been called piloting (see
above, Types of navigation), in which one’s position is
determined relative to visible landmarks whose location is
encoded in a cognitive map. Nevertheless, contrary to the
assertions of De Renzi (1982) and Milner and Goodale
(1995) that navigation relies only on allocentric spatial
information, it is also the case that topographical dis-
orientation is produced by damage to the ‘egocentric’
dorsal areas, suggesting that piloting is not the only mode
of navigation used by humans. In particular, such cases
suggest that damage to the areas dealing with the sort of
egocentric spatial information that would be important in
dead reckoning or the continuous updating of one’s
heading also disrupt navigation. It would appear that these
processes may play a more important role in wayfinding
than has been thought.
We have seen in the introduction that orientation can be
seen as the process whereby one’s egocentric frame of
reference is brought into alignment with the more stable
frame of reference provided by the cognitive map. Though
sighting via visible landmarks is one way in which this
could be done, it could also be done via the continuous
updating of one’s egocentric reference frame, rather than
through periodic visual ‘fixes’ on landmarks. Such ego-
centric updating seems to be envisaged by Griisser and
Landis (1991) when they argue that body-centred spatial
information ‘is continuously integrated into the perception
of the extra-personal space coordinates’ while ‘the per-
ceived extra-personal space depends on the body-related
‘egocentric’ coordinates’ (p. 416). Though they do not go
on to discuss the effects that damage to the egocentric
system would have, it follows that body-centred updating
would become difficult or impossible and that patients
would be forced to rely on the allocentric landmark-based
system instead. Such an interpretation is consistent with

Whitty and Newcombe’s (1973) description of a patient
with a right hemisphere occipital-parietal lesion:
‘When watched in his perambulations he appeared to get
no help from a sense of direction: at each turn there was
a pause and the need to recognise some detail of a
landmark before he could proceed. Until he learned such
cues he would invariably get lost.’ (p. 472)
It is precisely this searching for the detail of a landmark that
egocentric updating would allow one to dispense with: one
would keep track of one’s changing body-centred spatial
relationships so that egocentric and allocentric frames of
reference would always be in alignment. The complexity of
everyday topographical orientation, however, means that it
is not always possible to infer from the description of a
patient’s behaviour whether there is indeed some problem
with updating egocentric reference frames, as there are
alternative ways in which orientation can be achieved.
Downloaded by [UQ Library] at 20:46 01 November 2014
Certain more constrained experimental tasks, however, do
allow examination of some of the more abstract spatial
abilities that may be connected to updating. One such task is
mental rotation, and it certainly seems to be the case that
patients with right posterior lesions are impaired at such
tasks (e.g. Ratcliff, 1979). In addition, it has been argued
that such problems arise more specifically from damage to
the dorsal stream of the right hemisphere (e.g. Farah and
Hammond, 1988) rather than the ventral stream of the right
hemisphere (e.g. Farah et al., 1988). Fine et al. (1 980) also
report a topographically disorientated patient with right
parietal damage due to Dyke-Davidoff-Masson syndrome
who was unable to perform mental rotation tasks.
Another task that seems to involve the mental manipula-
tion of reference frames and which is intuitively more
closely linked with topographical orientation is the Money
Road-Map Test of Directional Sense (e.g. Alexander and
Money, 1966). In this test, the subject is presented with a
schematic street map, on which is marked a route. The
subject’s task is to imagine that s h e is following the route
and to say, without turning the map around or changing
hisher orientation with respect to the map, whether each
successive turn is to the right or to the left. In some
instances the subject’s actual and imagined orientations
with respect to the map are the same, and so no mental
transformation is necessary, but on other occasions the
actual and imagined orientations of the subject are not
aligned ( e g when the direction of the marked path is
towards the subject, right and left are reversed with respect
to the subject’s imagined orientation). In such cases some
form of mental transformation must be carried out to bring
the actual and imagined frames of reference into alignment.
Kohn and Dennis (1974) asked children who had had one of
the cerebral hemispheres removed to relieve epilepsy to
perform the Money road map test. They found that children
who had undergone right hemisphere decortication were
significantly impaired at this test compared to those who
had undergone left hemisphere decortication.
Topographical disorientation 5 17
A further task dealing with egocentric reference frames
and their manipulation was used by Ettlinger et al. (1957).
They referred to this task as a ‘test of abstract orientation’.
The patients were asked to imagine that they were facing
in one compass direction and then asked to say in which
direction they would be facing if they performed a
particular movement, e.g. the patient would be instructed
to imagine that s h e was facing south and then be asked to
say what direction s h e would be facing after turning to the
left. Of the total of 10 patients tested, information on six is
given with respect to this task. All had lesions with some
right hemisphere parietal involvement, and only one of the
six was unimpaired. Such findings are consistent with the
idea that the dorsal stream is involved with the manipula-
tion of egocentric reference frames.
The locomotor map test
A test that is closer to the task of actually finding one’s way
through the environment is the locomotor map test. The
basic version of the test was developed by Semmes and her
collaborators (e.g. Semmes et al., 1955). A series of large
dots was laid on the floor in a 3 x 3 pattern and the subjects
were given a map that represented these dots and a path
between them. The patient’s task was to follow the path
between the dots in accordance with what was marked on the
map. The subjects, however, had to do this without turning
the map round, so that sometimes the map ceased to be in
alignment with the path and the patient had to convert what
was marked on the map into the appropriate path to take
between the real dots marked on the floor. As noted by
De Renzi et al. (1977), ‘This task has an important feature in
common with the attempt to follow an itinerary in the real
world - namely, it requires the subject to maintain his
orientation despite the repeated shifts in body position that
occur as he walks along the route. No demand is, however,
made on the patient’s memory, because all the information
necessary to trace the path is provided’ (p. 499). Thus,
in such a task it becomes possible to investigate the
patient’s orientation ability directly without other contribu-
tory factors, such as loss of spatial relational information,
being involved.
This basic locomotor map test was used by Semmes et al.
(1955), and it was found that, as a whole, the group with
parietal lesions (left, right, or bilateral) were impaired
relative to non-brain-damaged controls and to a group with
non-parietal lesions. The authors remarked that ‘men who
complained that the injury had affected their “sense of
direction” were among those who made the poorest scores
on the test’ (p. 237). Such results are consistent with the
idea that the dorsal visual stream plays an important role in
keeping one’s egocentric reference frame in alignment with
the environment, but unfortunately, no investigation was
made as to whether there was a difference in the effects of
left and right hemisphere parietal lesions.
 518 M. J. Farrell
A later study (Semmes et al., 1963) found that patients
with left posterior lesions and those with bilateral posterior
lesions were impaired with respect to control subjects on
the locomotor map test. Though, at first, this seems to go
against most other findings, in which the right hemisphere
is implicated in spatial tasks, the fact that patients with
bilateral posterior lesions showed the worst performance of
all the groups does suggest right hemisphere involvement.
However, it is not clear how far one can interpret such
results. If it is the case that it is largely a subset of those
with posterior lesions, i.e. those with dorsal lesions, who
are impaired on the locomotor map task, then putting them
together with patients whose lesions do not produce the
same impairment will create problems when it comes to
comparing the groups as a whole. A further confounding
factor is that the relative severity of the lesions in each
group was not controlled for: any lesion in the appropriate
area was sufficient for group membership. Thus, we can
Downloaded by [UQ Library] at 20:46 01 November 2014
conclude from the Semmes studies that the posterior part of
the brain, and particularly the parietal lobes, seems to be
important in the locomotor map test. The results with
respect to laterality of lesion are more difficult to interpret,
though one cannot rule out the possibility that the left
hemisphere plays a role in such tasks as well as the right
hemisphere, which is traditionally seen as being of import-
ance in spatial tasks.
HCcaen et al. ( 1 972). using a test similar to that used by
Semmes and her collaborators, found that both right and
left hemisphere patients were impaired relative to controls,
though the right hemisphere patients were also worse than
the left hemisphere patients. In both groups of brain-
damaged patients, those with posterior lesions were worse
than those with anterior lesions, but only in the right
hemisphere group did there appear to be any particular
deficit associated with parietal damage. Again, one cannot
rule out a role for the left hemisphere in such abilities, but it
does seem as though the right parietal lobe does have a
particu 1arly important role.
A different sort of locomotor map-following test was
used by HCcaen et al. (1980). As in previous studies, the
patient had to follow a path marked on a map between
landmarks, but three different types of landmark were used.
In one case the landmarks were identical black rectangles,
in a second condition they consisted of different, but non-
verbalizable, graphic patterns, and in the third case they
consisted of drawings of different objects, allowing the
patient to remember the landmarks verbally. The patient
that they tested was severely impaired at following the path
when the landmarks were identical. Performance improved
with the different but non-verbalizable landmarks, and
performance was perfect when the subject could name the
landmarks. In the first case, when there was nothing to
differentiate the landmarks apart from their position in
space and their ordinal position in the path series, the only
way that the subject could have followed the path was to
keep track of which targets he had already visited by
updating his position and bringing this into relation with
the path marked on the map. With distinguishable land-
marks the patient would not have had to rely on updating
his heading and position, but could have used these land-
marks to fix his position. Performance with distinguishable
landmarks was almost perfect in the case described by
HCcaen et al. (1980): 15 of 16 path segments were correctly
followed. The introduction of verbalizable landmarks
resulted in perfect performance, suggesting that the added
ease of being able to individuate the landmarks further
facilitated the landmark-based fixing of position. It is
interesting to note that this patient reported that he had to
pay particular attention to landmarks as he moved around
in his everyday life if he was to remain orientated and avoid
getting lost.
Aimard et al. (1981, case 3) also tested a topographically
disorientated patient with the map-following test using
three classes of landmark (identical, different but not
verbalizable, different and verbalizable). This subject, who
had a right parieto-temporal lesion, succeeded in following
the path once with identical landmarks and once with
verbalizable landmarks. He did not successfully perform
the task when there were different but non-verbalizable
landmarks. However, Aimard rt al. only crudely described
their patient’s performance in terms of overall success or
failure, and this method of scoring is not enough to allow
one to decide the extent to which the patient was
impaired - as we have seen above in the case reported
by HCcaen et al. (1980), even a performance that was not
perfect may have included a large number of correct
segments; on the other hand, the patient may have been
completely disorientated.
Hublet and Demeurisse (1992) describe the case of a
patient who could not follow or describe routes that
were encountered after his stroke. Investigations revealed
reduced regional cerebral blood flow in the right parietal
region. The patient was given a map-following task under
two conditions: either with completely identical landmarks
or with different, nameable objects as landmarks. The
patient could follow the path when it connected the verbal-
izable landmarks, but when the landmarks were identical
he was impaired: the first three or four segments of the path
were correct, but after that the patient began to make errors
and became progressively more lost. One possible reason
for this is that the first sections on the path did not require
the patient to change direction completely: he was still
heading in the same general direction, though at slightly
different angular bearings. Problems seem to have arisen on
subsequent path segments, which required more radical
changes in direction, including complete about turns. It is
possible that, while the patient could deal with small
changes in heading, the more extensive reorientation that
was required by the later path segments was too much to
cope with.
It would appear that it is the change in heading as a result
of body rotation rather than change in position as a result of

translation that is the most problematic factor in locomotor
map tasks. This point seems to be borne out by the fact that
some patients perform accurately until they have to turn
(e.g. Bottini et al., 1990), at which point the map becomes
misaligned with the patient’s position in the environment.
It should also be noted that normal subjects find the task of
using a map that is misaligned with respect to the environ-
ment that it represents a rather difficult one (e.g. Levine
et al., 1982; Shepard and Hurwitz, 1984; Rossano and
Warren, 1989; Boer, 1991; PCruch and Lapin, 1993) and
that they may have to employ special strategies to bring
map and environment mentally into alignment. The
impairment of such processes may partly underlie some
cases of topographical disorientation.
Conclusions
The notion that topographical orientation depends on two
Downloaded by [UQ Library] at 20:46 01 November 2014
functionally and physiologically distinct mechanisms, one
for dealing with the recognition and identification of
environmental features and the other with the location of
environmental features, is not supported by the evidence. It
would appear rather that these are two aspects of the same
allocentric system which is located in the ventral stream.
One cannot, however, rule out the possibility that the dorsal
stream is also involved in topographical orientation and
navigation, although in a different way to the ventral
stream. Whereas the ventral stream is involved with
navigation via the sighting of landmarks, the dorsal system
may permit the continuous updating and manipulation of
body-centred spatial reference frames and their relation to
more stable allocentric cognitive maps. Though this
conclusion is tentative, it is consistent with the fact that
dorsal lesions, as well as ventral lesions, can lead to topo-
graphical disorientation and, in particular, to problems with
tasks, such as the locomotor map test, that involve the
manipulation of body-centred reference frames.
Acknowledgements
This work was supported by a grant from the UK Stroke
Association.
References
Aimard G, Vighetto A, Confavreux C, Devic M. La dtsorientation
spatiale. Revue Neurologique 198 1; 137: 97- 1 11
Alexander D, Money J. Turner’s syndrome and Gerstmann’s syndrome:
neuropsychologic comparisons. Neuropsychologia 1966; 4: 265-73.
Assal G. RCgression des troubles de la reconnaissance des physionomies
et de la mtmoire topographique chez un malade optrC d’un hCmatomie
intracCrCbral paritto-temporal droit. Revue Neurologique 1969; I2 1:
184-5.
Badal J. Contribution I? I’Ctude des ctcites psychiques: alexie, agraphie,
hemianopsie inferieure, trouble du sens de I’espace. Archives
d’Ophtalmologie 1888; 8: 97-1 17.
Beyn ES, Knyazeva GR. The problem of prosopagnosia. Journal of
Neurology, Neurosurgery, and Psychiatry 1962; 25: 154-8.
Bisiach E, Brouchon M, Poncet M, Rusconi ML. Unilateral neglect in
route description. Neuropsychologia 1993; 3 1 : 1255-62.
Topographical disorientation 5 19
Boer LC. Mental rotation in perspective problems. Acta Psychologica
1991; 76: 1-9.
Bornstein B, Kidron DP. Prosopagnosia. Journal of Neurology.
Neurosurgery and Psychiatry 1959; 22: 124-3 1.
Bottini G, Cappa S, Geminiani G, Sterzi R. Topographic disorienta-
tion - a case report. Neuropsychologia 1990; 28: 309-12.
Clarke S, Assal G, de Tribolet N. Left hemisphere strategies in visual
recognition, topographical orientation and time planning. Neuro-
psychologia 1993; 31: 99-1 13.
Cogan DG. Visuo-spatial dysgnosia. American Journal of Ophthal-
mology 1979; 88: 361 -8.
Cole M, Perez-Cruet J. Prosopagnosia. Neuropsychologia 1964; 2:
237-346.
De Renzi E. Disorders of space exploration and cognition. New York:
John Wiley and Sons, 1982.
De Renzi E, Faglioni P, Villa P. Topographical amnesia. Journal of
Neurology, Neurosurgery, and Psychiatry 1977; 40: 498-505.
De Renzi E, Faglioni P. II disorientamento spaziale de la lesione
cerebrale. Sistema Nervoso 1962; 14: 409-36.
Ettlinger G, Warrington E, Zangwill OL. A further study of visual-spatial
agnosia. Brain 1957; 80: 335-61.
Farah MJ. Visual agnosia. Cambridge, MA: MIT Press, 1990.
Farah MJ, Hammond KM. Mental rotation and orientation-invariant
object recognition: dissociable processes. Cognition 1988; 29:
29-46.
Farah MJ, Hammond KM, Levine DN, Calvanio R. Visual and spatial
mental imagery: dissociable systems of representation. Cognitive
Psychology 1988; 20: 439-62.
Fine EJ, Mellstrom M, Mani SS, Timmins J. Spatial disorientation and
the Dyke-Davidoff-Masson syndrome. Cortex 1980; 16: 493-9.
Gallistel CR. The organization of learning. Cambridge, MA: MIT Press,
1990.
Griisser 0 - J , Landis T. Visual agnosias and other disturbances of visual
perception and cognition. London: MacMillan Press, 1991.
Habib M. Sirigu A. Pure topographical disorientation: a definition and
anatomical basis. Cortex 1987; 23: 73-85.
Hkcaen H, Tzortzis C, Masure MC. Troubles de I’orientation spatiale
dans un epreuve de recherche d’itineraire lors des lesions corticales
unilaterales. Perception 1972; 1: 325-30.
HCcaen H, Tzortzis C, Rondot P. Loss of topographic memory with
learning deficits. Cortex 1980; 16: 525-42.
Hublet C, Demeurisse G. Pure topographical disorientation due to a deep-
seated lesion with cortical remote effects. Cortex 1992; 28: 123-8.
Jackson JH. Case of large cerebral tumour without optic neuritis and
with left hemiplegia and imperception. Originally published in 1876.
Reprinted in: Taylor J, editor. Selected writings of John Hughlings
Jackson. New York: Basic Books, 1958: 146-52.
Kohn B, Dennis M. Selective impairments of visuo-spatial abilities in
infantile hemiplegics after right cerebral hemidecortication. Neuro-
psychologia 1974; 12: 505- 12.
Landis T, Cummings JL, Benson DF, Palmer EP. Loss of topographic
familiarity: an environmental agnosia. Archives of Neurology 1986;
43: 132-6.
Levine DN, Warach J, Farah M. Two visual systems in mental imagery:
dissociation of ‘what’ and ‘where’ in imagery disorders due to bilateral
posterior cerebral lesions. Neurology 1985; 35: 1010- 18.
Levine M, Jankovic IN, Palij M. Principles of spatial problem solving.
Journal of Experimental Psychology: General 1982; 1 11: 157-75.
Loomis JM, Da Silva JA, Fujita N, Fukusima SS. Visual space percep-
tion and visually directed action. Journal of Experimental Psychology:
Human Perception and Performance 1992; 18: 906-2 1.
McCarthy RA, Evans JJ, Hodges JR. Topographic amnesia: spatial
memory disorder, perceptual dysfunction, or category specific semantic
memory impairment? Journal of Neurology, Neurosurgery, and Psychi-
atry 1996; 60: 318-25.
McNaughton BL, Knierim JJ, Wilson MA. Vector encoding and the
vestibular foundations of spatial cognition: neurophysiological and
computational mechanisms. In: Gazzaniga MS, editor. The cognitive
neurosciences. Cambridge, MA: MIT Press, 1995: 585-95.
Meyer 0. Ein- und doppelseitige homonyme hemianopsie mit orient-
irungsstoren. Monatsschrift fur Psychiatrie und Neurologie 1900; 8:
440-56.
Milner AD, Goodale MA. The visual brain in action. Oxford: Oxford
University Press, 1995.
 520 M. J. Farrell
Moretti G. Caffarra P, Manzoni GC, Scarano C, Arnone F. L’amnesia
topografica transitoria. Acta Bio-Medica de I’ Ateneo Parmense I98 1;
52: 119-22.
Moretti G, Caffarra P,Parma M. Transient topographical amnesia. Italian
Journal of Neurological Science 1983; 3: 36 I .
O’Keefe J , Nadel L. The hippocampus as a cognitive map. Oxford:
Clarendon Press, 1978.
Pallis CA. Impaired identification of faces and places with agnosia
for colours. Report of a case due to cerebral embolism. Journal of
Neurology, Neurosurgery, and Psychiatry 1955; 18: 21 8-24.
Paterson A, Zangwill OL. Disorders of visual space perception
associated with lesions of the right cerebral hemisphere. Brain 1944;
67: 33 1-58.
Paterson A, Zangwill OL. A case of topographical disorientation
associated with a unilateral cerebral lesion. Brain 1945; 68: 188-21 I .
PCron N. Droguet P, Granier M. Agnosie visuelle avec perte Blective de
la reconnaissance topographique; hkmianopsie homonym gauche.
Revue Neurologique 1946; 78: 596-7.
PCruch P. Lapin EA. Route knowledge in different spatial frames of
reference. Acta Psychologica 1993; 84: 253-69.
Pevzner S, Bornstein B, Loewenthal M. Prosopagnosia. Journal of
Neurology, Neurosurgery, and Psychiatry 1962; 25: 336-8.
Ratcliff G. Spatial thought, mental rotation and the right cerebral
hemisphere. Neuropsychologia 1979; 17: 49-54.
Downloaded by [UQ Library] at 20:46 01 November 2014
Rossano MJ, Warren DH. Misaligned maps lead to predictable errors.
Perception 1989; 18: 215-29.
Runeson S. On the possibility of ‘smart’ perceptual mechanisms.
Scandinavian Journal of Psychology 1977; 18: 172-9.
Scotti C. La perdita della memoria topografica: descrizione di un caso.
Sistemu Nervoso 1968; 20: 352-61.
Senimes J. Weinstein S. Ghent L. Teuber HL. Spatial orientation in man. I.
Analyses by locus of lesion. Journal of Psychology 1955; 39: 227-44.
Semmes J , Weinstein S, Ghent L, Teuber HL. Correlates of impaired
orientation in personal and extrapersonal space. Brain 1963; Xh:
742-72.
Shepard RN, Hurwitz S. Upward direction, mental rotation, and discrim-
ination of left and right turns in maps. Cognition 1984; 18: 161-93.
Siege1 A, White SH. The development of spatial representation o l
large-scale environments. In: Reese HW, editor. Advances in child
development and behavior. Vol. 10. London: Academic Press, 1975.
Stracciari A, Lorusso S, Pazzaglia P. Transient topographical amnesia.
Journal of Neurology, Neurosurgery, and Psychiatry 1994; 57:
1423-5.
Ungerleider LG, Mishkin M. Two conical visual systems. In: Ingle DJ.
Goodale MA, Mansfield RJW, editors. Analysis of visual behavior.
Cambridge, MA: MIT Press, 1982: 549-86.
Vighetto A, Aimard G. Les troubles specifique de I’utilisation de
I’espace de dkambulation. Journal des AgrBgts 198 I ; 14: 325- 34.
Wehner R, Srinivasan MV. Searching behavior of desert ants, genus
Cataglyphis (Formicidae, Hymenoptera). Journal of Comparative
Physiology 1981; 142: 315-38.
Whiteley AM, Warrington EK. Selective impairment of’ topographical
memory: a single case study. Journal of Neurology, Neurosurgery, and
Psychiatry 1978; 41: 575-8.
Whitty CWM, Newcombe FRC. Oldfield’s study of visual and
topographic disturbances in a right occipito-parietal lesion of 30 years
duration. Neuropsychologia 1973; 1 I : 47 1-5.
Wilbrand H. Ein fall von seelenblindheit und hemianopsie mit section-
befund. Deutsche Zeitschrift fur die Nervenheilkunde 1892; 2:
361-87.
Received on 30 January, 1996; resubmitted o n 24 July 1996:
accepted on 20 September, 1996