Wapner W, Judd T, Gardner H
Cortex. 1978 Sep;14(3):343-64. doi: 10.1016/s0010-9452(78)80062-8.
This report describes a 73 year old left-handed male artist who presented with agnosic symptoms following an occipital cerebral vascular accident. Against a background of a memory disturbance, but otherwise essentially intact linguistic and cognitive capacities, the patient was generally unable to identify single objects on visual presentation, and displayed marked difficulty in interpreting complex objects, depicted scenes, and partially occluded figures. The patient's preserved ability to recognize geometric forms, to perceive optical illusions, and to copy designs, and objects with considerable accuracy suggested the clinical picture of visual agnosia. An examination was undertaken of the effects of this recognition disorder on the artist's capacity to draw. Despite an inability to recognize an object or scene, the patient retained various techniques (perspective, shadowing, designation of texture) which allowed him to copy the display in a veridical fashion. When displays were recognized, or when the patient was given only the name of the object and asked to draw it, he adopted a less slavish approach, characteristic of his pre-morbid artwork. While his post-morbid drawings bore a strong similarity to his earlier works, such features as insufficient differentiation of figure from ground, over-elaboration of detail, and areas of neglect revealed the debilitating effects of the recognition disorder. Moreover, an examination of the patient's strategies revealed numerous compensatory verbal and motor procedures which guided his drawing. Acknowledgments. We wish to acknowledge Dr. Prather Palmer, J.R.'s neurologist, for his cooperation and for making available his very thorough examination notes. Thanks also to Dr. Kent Stevens for providing the stereograms, and to Dr. Frank Benson and Dr. Edgar Zurif for their helpful comments on the manuscript.
本报告描述了一位73岁的左撇子男性艺术家,他在枕叶脑血管意外后出现失认症状。在记忆障碍的背景下,患者的语言和认知能力基本完好,但一般无法识别视觉呈现的单个物体,在解释复杂物体、描绘场景和部分遮挡的人物时存在明显困难。患者识别几何图形、感知视错觉以及相当准确地临摹设计和物体的能力得以保留,提示为视觉失认的临床症状。我们对这种识别障碍对艺术家绘画能力的影响进行了检查。尽管无法识别物体或场景,但患者保留了各种技巧(透视、阴影、纹理描绘),使他能够逼真地临摹展示内容。当展示内容能够被识别,或者当患者仅被告知物体名称并被要求画出时,他采用了一种不那么刻板的方法,这是他病前艺术作品的特点。虽然他病后的绘画与早期作品有很强的相似性,但诸如图形与背景区分不足、细节过度雕琢以及忽视区域等特征揭示了识别障碍的削弱作用。此外,对患者策略的检查发现了许多指导他绘画的补偿性言语和运动程序。致谢。我们要感谢普拉瑟·帕尔默医生(J.R.的神经科医生)的合作以及提供他非常详尽的检查记录。还要感谢肯特·史蒂文斯医生提供立体图,以及弗兰克·本森医生和埃德加·祖里夫医生对手稿提出的有益意见。