Orientation and disorientation: lessons from patients with epilepsy

Area of Science:

• Neuroscience
• Cognitive Science
• Psychiatry

Background:

• Orientation in time, space, and person is a fundamental cognitive ability.
• Research on orientation and disorientation is notably underdeveloped in cognitive science and neuropsychiatry.
• The relationship between different disorientation domains and their underlying neural systems remains unclear.

Purpose of the Study:

• To investigate whether disorientations in time, space, and person arise from a single system or distinct ones.
• To identify the psychological and neural underpinnings of these orientation domains.
• To analyze the anatomical correlates of specific orientation failures.

Main Methods:

• Analysis of patient descriptions with circumscribed cortical lesions, focusing on epilepsy-related disorientation.
• Classification of disorientation types (self-referenced vs. non-self-referenced) based on domain and clinical presentation.
• Examination of cognitive and neural systems implicated in orientation failures.

Main Results:

• Disorientation in various domains can be linked to failures in specific brain mechanisms.
• These mechanisms are predominantly located in the right hemisphere.
• The affected brain regions show partial overlap with the default mode network, including parietal, temporal, and prefrontal cortices.

Conclusions:

• Disorientation in one or more domains may indicate a failure of a shared neural system.
• This system is critical for self-related cognitive functions, including orientation.
• The findings highlight the right hemisphere's significant role in maintaining orientation.