Dissociation between Mental Imagery and Object Recognition in a Brain-Damaged Patient

VISUAL imagery is the creation of mental representations that share many features with veridical visual percepts. Studies of normal and brain-damaged people reinforce the view that visual imagery and visual perception are mediated by a common neural substrate and activate the same representations1–4. Thus, brain-damaged patients with intact vision who have an impairment in perception should have impaired visual imagery. Here we present evidence to the contrary from a patient with severely impaired object recognition (visual object agnosia) but with normal mental imagery. He draws objects in considerable detail from memory and uses information derived from mental images in a variety of tasks. In contrast, he cannot identify visually presented objects, even those he has drawn himself. He has normal visual acuity and intact perception of equally complex material in other domains. We conclude that rich internal representations can be activated to support visual imagery even when they cannot support visually mediated perception of objects.