Saliency modulates global perception in simultanagnosia

Patients with parieto-occipital brain damage may show simultanagnosia, a selective impairment in the simultaneous perception and integration of multiple objects (global perception) with normal recognition of individual objects. Recent findings in patients with simultanagnosia indicate improved global perception at smaller spatial distances between local elements of hierarchical organized complex visual arrays. Global perception thus does not appear to be an all-or-nothing phenomenon but can be modified by the spatial relationship between local elements. The present study aimed to define characteristics of a general principle that accounts for improved global perception of hierarchically organized complex visual arrays in patients with simultanagnosia with respect to the spatial properties of local elements. In detail, we investigated the role of the number and size of the local elements as well as their relationship with each other for the global perception. The findings indicate that global perception increases independently of the size of the global object and depends on the spatial relationship between the local elements and the global object. The results further argue against the possibility of a restriction in the attended or perceived area in simultanagnosia, in the sense that the integration of local elements into a global scene is impaired if a certain spatial "field of view" is exceeded. A possible explanation for these observations might be a shift from global to local saliency in simultanagnosia.