Brain, Vol. 122, No. 9, 1613-1628,
September 1999
© 1999 Oxford University Press
Review article |
Topographical disorientation: a synthesis and taxonomy
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, USA
Correspondence to:
Geoffrey K. Aguirre, Department of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104–4283, USA E-mail: aguirreg{at}mail.med.upenn.edu
Over the last century, several dozen case reports have presented `topographically disoriented' patients who, in some cases, appear to have selectively lost their ability to find their way within large-scale, locomotor environments. A review is offered here that has as its aim the creation of a taxonomy that accurately reflects the behavioural impairments and neuroanatomical findings of this literature. This effort is guided by an appreciation of the models of normative way-finding offered by environmental psychology and recent neuroscience research. It is proposed that several varieties of topographical disorientation exist, resulting from damage to distinct neuroanatomical areas. The particular pattern of impairments that patients evidence is argued to be consonant with the known functions of these cortical regions and with recent neuroimaging results. The conflicting claims of previous reviews of this area are also considered and addressed.
topographical disorientation; topographical agnosia; topographical amnesia; spatial disorientation; way-finding
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