Abstract

We used a psychophysical task to measure sensitivity to motion direction in 50 stroke patients with unilateral brain lesions and 85 control subjects. Subjects were asked to discriminate the overall direction of motion in dynamic stochastic random dot displays in which only a variable proportion of the spots moved in a single direction while the remainder moved randomly. Behavioural and neurophysiological evidence shows that the middle temporal (MT/V5) and middle superior temporal (MST) areas in the macaque monkey are indispensably involved in the perception of this type of motion. In human subjects too, lesions in the same region disrupt performance on this task. Here we assessed more extensively the correlation between direction sensitivity for global motion and the anatomical locus of the lesion. Thresholds for perceiving the direction of global motion were impaired in the visual field contralateral to the lesion in patients with lesions in the occipitoparietal and parietotemporal areas involving the human analogue of areas MT/V5 and MST, but not by lesions in the occipito-temporal or anterior frontal areas. Patients with lesions involving the anterior temporal or parietal lobes displayed poor performance for stimuli presented in either visual field, which is consistent with the large and bilateral receptive fields in these areas in monkeys. The perception of global motion was also more impaired in the centripetal than the centrifugal direction in the hemifield contralateral to the MT/V5 lesion. Surprisingly, thresholds were normal in all patients when the displays contained static but not dynamic visual noise, suggesting that their deficit reflects an inability to filter out dynamic noise. Although frequent repeated testing of some patients whose lesion involved the human homologue of MT was accompanied by an improvement in performance, this was no greater than in other patients who received training on different motion tasks.