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The Achromatic ‘Philosophical Zombie’, a Syndrome of Cerebral Achromatopsia with Color Anopsognosia

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We describe a patient with persistent cerebral achromatopsia occurring after bilateral occipital strokes. Blinded color recognition was assessed with a computerized experimental paradigm and the patient reported the degree of confidence in the response exactness on a visual percent scale. Color recognition was accurate and above chance (Fisher's exact test, p < 0.002). The degree of confidence in the answers showed a significant correlation with recognition scores (Spearman rank order correlation, p < 0.0001). These findings constitute the exceptional condition of what we called color anopsognosia (not knowing of seeing colors) and recall the theoretic figure of the 'philosophical zombie'. However, the cognitive mechanisms of the dissociation between a subjective colorless vision and good performance for color naming still remain poorly understood.
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... Indeed, there is evidence that at least some blindsight patients do report some visual experience when carefully queried Ffytche and Zeki, 2011). Similar to blindsight type 2, there is a case of an achromatic patient, who reports color blindness after occipital brain damage but performs well in color discrimination tasks, and his confidence in being correct in the task strongly correlates with task performance (Carota and Calabrese, 2013). Again, it is controversial whether the performance of achromatic patients occurs in complete absence of color experiences or is mediated by residual conscious contents of color (Heywood et al., 1998). ...
... Nevertheless, it seems rather odd why participants would readily acknowledge feelings of rightness while being reluctant to admit visual contents. Moreover, the present pattern of confidence without visibility seems to be reasonably robust as it was replicated in patients (Sahraie et al., 1998;Carota and Calabrese, 2013) and healthy human observers in a range of tasks (Schlagbauer et al., 2012;Charles et al., 2013;Zehetleitner and Rausch, 2013). Finally, the analysis of metacognitive sensitivity suggests that the effect of confidence and visibility as contents of subjective reports is not exhausted by criterion setting. ...
... However, although participants had conscious access when they reported they felt confident about task response, they reported no conscious visual experience. A similar pattern was reported from a patient suffering from achromatopsia (Carota and Calabrese, 2013): After bilateral temporal-occipital lesions, that patient reports to be color-blind although he performs accurately in a color recognition task. A potential explanation why the relation between phenomenal consciousness and conscious access varies is the number of items in the display: Visual short-term memory always used arrays of multiple stimuli. ...
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In several visual tasks, participants report that they feel confident about discrimination responses at a level of stimulation at which they would report not seeing the stimulus. How general and reliable is this effect? We compared subjective reports of discrimination confidence and subjective reports of visibility in an orientation discrimination task with varying stimulus contrast. Participants applied more liberal criteria for subjective reports of discrimination confidence than for visibility. While reports of discrimination confidence were more efficient in predicting trial accuracy than reports of visibility, only reports of visibility but not confidence were associated with stimulus contrast in incorrect trials. It is argued that the distinction between discrimination confidence and visibility can be reconciled with both the partial awareness hypothesis and higher order thought theory. We suggest that consciousness research would benefit from differentiating between subjective reports of visibility and confidence.
... The most extensive meta-nalysis of patients with achromatopsia (Bouvier & Engel, 2006) reported that 29% of achromatic patients tested with the Ishihiara plates read them normally; a majority of those tested with the Fansworth Munsell 100 Hue test performed better than chance (some even performed normally); and, strikingly, 49% of the patients who were asked to name colours succeeded in the task. One case report of achromatopsia demonstrated that patient's response certainty correlated with colour recognition scores (Carota & Calabrese, 2013). ...
Thesis
We examined the effects of brain lesions in humans on the interdependences between three modules of cortical colour processing, namely colour perception, naming and object-colour knowledge. We first focused on colour categorisation - a case-in-point of the interplay between perception and language. Reviewed evidence from cognitive development, comparative psychology and cognitive neuroscience hints that colour categorisation originates from neither perception nor language, as assumed by the Nature-Nurture debate. Instead, colour categories may reflect relevant objects in the environment. To assess the causal link between categorization and naming, we investigated a stroke patient, RDS. Despite severe difficulties in naming chromatic colours, due to a left occipito-temporal lesion, RDS’s colour categorisation was relatively spared. Multimodal MRI experiments revealed that the language-perception connectivity is essential for efficient colour naming but not for categorisation. Investigation of object-colour knowledge in the context of RDS’s colour-naming impairment showed that RDS could not link colour perception to neither language nor semantic knowledge. He could not associate a visual colour to a colour name or to the shape of its typical object. Overall, we demonstrated three functional segregations in colour processing: between (1) colour categorisation and colour naming, (2) naming of chromatic and achromatic colours and (3) knowing about coloured objects and knowing about abstract colours. The main purpose of high-level cortical colour mechanisms could be providing sensory and semantic information to guide object-related behaviour, by achieving (1) stable colour perception, (2) relevant colour categories, and (3) joint mental representations of shapes and colours. These neural computations may have been recycled in cultural evolution to isolate colours from objects and label them with names.
... In this view, sensory color representations might be disconnected from brain networks important for conscious experience (Dehaene and Naccache 2001). Consistent with this hypothesis, a case report demonstrated that the patient's level of confidence in his responses correlated with color recognition scores (Carota and Calabrese 2013). Alternatively, achromatopsia could be understood by analogy with apperceptive agnosia, with patients not being able to establish a global representation of surface colors from local chromatic contrasts (Kentridge and others 2004;Kentridge and others 2007). ...
Article
Color provides valuable information about the environment, yet the exact mechanisms explaining how colors appear to us remain poorly understood. Retinal signals are processed in the visual cortex through high-level mechanisms that link color perception with top-down expectations and knowledge. Here, we review the neuroimaging evidence about color processing in the brain, and how it is affected by acquired brain lesions in humans. Evidence from patients with brain-damage suggests that high-level color processing may be divided into at least three modules: perceptual color experience, color naming, and color knowledge. These modules appear to be functionally independent but richly interconnected, and serve as cortical relays linking sensory and semantic information, with the final goal of directing object-related behavior. We argue that the relations between colors and their objects are key mechanisms to understand high-level color processing.
... También interviene en el procesamiento de la forma, la orientación, la curvatura, el movimiento y la profundidad 2 . Los pacientes con dã no de V4, a veces desarrollan acromatopsia central, lo que se observa en casos de accidente cerebrovascular o tumor cerebral, que consultan por no ver colores y porque el mundo externo les parece completamente negro o blanco o con tonalidades grises con diferentes niveles de brillo como en el paciente descrito 3,4 . En este caso el diagnóstico de acromatopsia cerebral se confirmó con el FM100, que evalúa la capacidad de seleccionar y ordenar fichas coloreadas con variaciones de tono incrementales que abarcan el espectro visible. ...
Article
CLINICAL CASE The case is presented of a 73-year-old male patient who referred to having black and white vision. Computed tomography showed normal pressure hydrocephalus (NPH). Magnetic resonance imaging was not performed because the patient refused to undergo further examinations. DISCUSSION Achromatopsia may be the first or only NPH symptom. It may be prudent to ask patients with NPH regarding colour vision. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.
... At the same time, conscious access of both task-relevant and task-irrelevant features varies as a function of physical stimulus quality; consequently, a state of partial awareness would also explain why the correlations of confidence and visual experience with task difficulty are the same. Finally, if decisional confidence requires conscious access to only that feature which is task-relevant, but visual experience requires conscious access to other features in addition to the taskrelevant one, the condition for reporting confidence may be met more frequently than the condition for reporting a visual experience, thus explaining why reports of visual experience are associated with more restrictive criteria (Carota & Calabrese, 2013;Sahraie et al., 1998;Schlagbauer et al., 2012;Zehetleitner & Rausch, 2013). ...
Article
Previous studies provided contradicting results regarding metacognitive sensitivity estimated from subjective reports of confidence in comparison to subjective reports of visual experience. We investigated whether this effect of content of subjective reports is influenced by the statistical method to quantify metacognitive sensitivity. Comparing logistic regression and meta-d in a masked orientation task, a masked shape task, and a random-dot motion task, we observed metacognitive sensitivity of reports regarding decisional confidence was greater than of reports about visual experience irrespective of mathematical procedures. However, the relationship between subjective reports and the logistic transform of accuracy was often not linear, implying that logistic regression is not a consistent measure of metacognitive sensitivity. We argue that a science of consciousness would benefit from the assessment of both visual experience and decisional confidence, and recommend meta-d as measure of metacognitive sensitivity for future studies. Copyright © 2015 Elsevier Inc. All rights reserved.
Article
Clinical case The case is presented of a 73-year-old male patient who referred to having black and white vision. Computed tomography showed normal pressure hydrocephalus (NPH). Magnetic resonance imaging was not performed because the patient refused to undergo further examinations. Discussion Achromatopsia may be the first or only NPH symptom. It may be prudent to ask patients with NPH regarding colour vision.
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