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What If You Had No Sense of Direction

If your phone has ever lost service or died while you were using its GPS feature to navigate your way home from an unfamiliar area, you quickly learn how good (or how bad) your sense of direction is. Maybe you found your way home with relative ease or perhaps it took twice the amount of time. You probably eventually made it home (but maybe had to invest in a car charger to juice up your phone along the way).

Some people get lost on a daily basis – sometimes in surroundings that are not at all unfamiliar, such as in their neighborhoods or even in their own homes. If you have a tendency to get lost easily or feel like you have no sense of direction, have you ever wondered why?  Read on to learn more.

A Natural Lack of Sense of Direction

One cause for impairments in spatial navigation is a relatively new term, known as developmental topographic disorientation (DTD), which is a relatively new term. DTD can manifest even without brain damage and is often a severe and life-long condition associated with navigational deficits.

People with DTD struggle to represent spatial layouts and often get lost in familiar environments, battling difficulty learning new paths or routes.

To better understand this disorder, it is best to understand how people who are able to successfully navigate their environment do so, with two main ways:

  • The first navigational strategy is by following route navigation, which includes a series of steps and paths that people follow to get from one point to the next, as explained from the traveler’s point of view. Turn right out of the driveway and drive to the stop sign. Turn left at the stop sign until you reach the third stop. Turn right, go over the bridge and the store is the fourth building on your left with the flagpole out front.
  • The second strategy is more of a bird’s-eye view, or a map of the area. We typically use cardinal directions (north, south, east and west) to navigate maps and to develop a picture or mental representation of a bigger overall area.

Most people use a combination of navigational strategies to get to our destinations. The store is north of town, toward Leesburg; if we drive there from Warsaw, the sun in the afternoon will be on our right.

The difficulty that people with developmental topographic disorientation face is that they often face a substantial difficulty forming a mental representation or map of the environment around them – or even of a scene that is familiar – while being able to recognize landmarks around them, including distinctive flagpoles or buildings.

The neural mechanism related to DTD isn’t widely understood but preliminary neuroimaging findings in patients with DTD have been linked with decreased functional connectivity between the dorsolateral prefrontal cortex (DLPFC) and the right hippocampus, which is essential for a map formation in humans. The DLPFC is associated with numerous cognitive functions, which are vital when it comes to spatial orientation as people move within, become familiar with and begin to form mental maps of their environments.

Other brain regions important for navigation include the posterior parietal cortex, the occipitotemporal and/or the parahippocampal regions, medial temporal lobes structures and the retro-splenial cortex. When any of these regions is damaged, directional disorientation can occur.

Hope for DTT Treatment

In one case study, a patient (referred to as No Longer Lost, or NLL) was examined who suffered from severe topographical disorientation after traumatic brain injury. NLL was administered imagery-based treatment (IBT) for 8 weeks, which was inspired by human spatial navigation models. After the IBT was completed, NLL experienced improved navigational skills. This study and others provide new insights into human spatial navigation and offer hope for helping those who suffer from the condition, whether they suffer from brain injury or not.

If you are concerned about your sense of direction or have other neurological issues, please reach out to us for a neurological evaluation at


This blog was written by Ms. Courtney Cosby and edited by Dr. Majid Fotuhi.








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Dr. Majid Fotuhi NeuroGrow Brain Fitness Center

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