Topographagnosia

No sense of direction? On the road to recognizing what’s behind it

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By Kim Painter, USA TODAY
We all get lost sometimes. Some of us have the problem more often than others.

Sharon Roseman, 61, of Littleton, Colo., has a different story: Each morning, she wakes up in a house where all the doors and hallways seem to have moved overnight.

If she stands and spins around, the room rights itself. She can then make her way through her house and drive to work along a well-rehearsed route. But if she takes a detour, especially on a curving or diagonal street, she can become lost in an instant. Once, an icy hill forced her to turn around and seek a new path out of her neighborhood. She spent 40 miserable minutes driving in circles before she recognized her front door, gave up and went inside.

As a child, Roseman says, “I spent all of my time being lost.” Just two months ago, she learned her problem has a name: developmental topographical disorientation — a profound lack of navigational skill, probably rooted in early brain development.

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That makes her part of an increasingly recognized group: people with normal intelligence and no obvious brain injuries, but with extreme, lifelong difficulty in some skill most of us take for granted.

For some, it’s remembering faces (prosopagnosia), naming colors (color agnosia) or recognizing pieces of music (amusia). For Roseman and one Canadian woman recently described in a scientific journal, it is finding their way through the world.

“All of these are things that you might see in people with a brain injury,” says Brad Duchaine, a researcher at the University College of London and an expert on prosopagnosia (also known as face-blindness). But these “selective developmental deficits” show up in otherwise typical, healthy people.

“It’s like a little black hole,” Duchaine says.

Dependent on routine, family members

The woman described in the journal Neuropsychologia has an especially severe, lifelong history of getting lost. She, like Roseman, can get to work along a long-practiced path — but sometimes gets lost walking home from her bus stop, say researcher Giuseppe Iaria and his colleagues at the University of British Columbia and Vancouver General Hospital. She goes nowhere else alone. At 43, she lives with her father, does not drive and “does not have a nice social life,” Iaria says.

In a series of tests, the researchers found that the woman has an inability to create mental maps of the environment. When shown a simple virtual neighborhood on a computer, she can eventually learn a route — but what takes typical people one to five minutes takes her more than half an hour.

The root of her difficulties, Iaria says, most likely lies in a part of the brain called the hippocampus.

The researchers are trying to help the woman through virtual-world training sessions. They also are looking for more lost souls through a new website: gettinglost.ca. More than 80 people already have responded, Iaria says.

A site set up by face-blindness researchers (faceblind.org) has produced 3,000 responses from people who believe they have prosopagnosia, Duchaine says. Some cannot recognize their own spouses; others have milder cases. Interestingly, about 25% also have navigational difficulties.

Duchaine referred Roseman, who has no trouble with faces, to the Vancouver researchers. Roseman says she plans to go to Vancouver soon to see if they can help her. “I have hope,” she says. But, above that, she says, she feels relief — because now she knows that while she may be lost, she is not alone.

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