Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Neuropsychology Unit, Hopital Fribourgeois, Fribourg, Switzerland.
Neuropsychology Unit, Hopital Fribourgeois, Fribourg, Switzerland; Department of Special Education, University of Fribourg, Fribourg, Switzerland.
Neuropsychologia. 2022 Sep 9;174:108331. doi: 10.1016/j.neuropsychologia.2022.108331. Epub 2022 Jul 13.
We report the clinical case of AB, a right-handed 19-year-old woman who presents severe developmental topographical disorientation, a relatively rare syndrome, leading to difficulties in navigating in familiar (and novel) environments. This symptomatology appears without acquired cerebral damage (MRI described as normal) nor more global cognitive disability (high degree of education achieved). An extensive assessment of spatial cognition with different aspects of underlying cognitive processes is first presented. Second, the patient's preserved cognitive abilities and her major difficulties in calculation, as well as her attention deficit, as seen in a detailed neuropsychological assessment, are reported. For the first time to our knowledge, we show that developmental topographical disorientation can be associated with other developmental cognitive disorders affecting number processing (dyscalculia) and attention (Attention Deficit-Hyperactivity Disorder (ADHD)). We discuss the links between these different cognitive processes in relation to visuo-spatial working memory and magnitude representation, which could represent common denominators for all these syndromes. This case report highlights the importance of thoroughly assessing potentially associated neurocognitive disorders in developmental topographical disorientation. In addition, it highlights the necessity to keep in mind the prevalence of spatial difficulties in the assessment of children and adolescents with other neurodevelopmental syndromes. Finally, this case study raises a new question about the nosology of developmental disorders affecting the visuo-spatial and spatial domains.
我们报告了 AB 的临床病例，她是一名 19 岁的右利手女性，表现出严重的发育性拓扑方向障碍，这是一种相对罕见的综合征，导致她在熟悉（和新的）环境中导航困难。这种症状出现在没有获得性脑损伤（MRI 描述正常）或更全面的认知障碍（获得高学历）的情况下。首先，我们对患者的空间认知进行了广泛的评估，包括潜在认知过程的不同方面。其次，我们报告了患者保留的认知能力以及她在计算方面的主要困难，以及她在详细的神经心理学评估中表现出的注意力缺陷。据我们所知，这是首次表明发育性拓扑方向障碍可能与其他影响数字处理（计算障碍）和注意力（注意力缺陷多动障碍（ADHD））的发育性认知障碍相关。我们讨论了这些不同认知过程之间的联系，涉及到视空间工作记忆和数量表示，这可能是所有这些综合征的共同因素。这个病例报告强调了在发育性拓扑方向障碍中彻底评估潜在相关神经认知障碍的重要性。此外，它还强调了在评估其他神经发育综合征的儿童和青少年时，必须牢记空间困难的普遍性。最后，这个病例研究提出了一个关于影响视空间和空间领域的发育障碍分类学的新问题。
