Where Am I? Searching for the Tangle in the Developmental Topographical Disorientation

Round 1

Reviewer 1 Report

This study investigates the proposed pathological condition of Developmental Topographical Disorientation (DTD) through a questionnaire. One primary issue with the research method is that only one group of subjects with DTD was recruited, so there is no direct comparison between the subjects with and without DTD. Therefore, I recommend adding an age- and sex-matched control group to undergo the same questionnaire. The data analysis should be a between-group comparison rather than merely reporting the mean and SD of the DTD group. I suggest the authors add a control group to this study and re-organize the discussion based on comparing the control and DTD groups. 

One interesting finding is that male is more likely to be affected by DTD. However, it is unclear how the subjects were recruited. Please describe the subject recruitment strategy. 

Please describe the diagnosis method to identify the subjects with DTD. How are the subjects identified as DTD? Through self-identification? Were the subjects influenced by any psychological factors when determining themselves as DTD? 

In my opinion, this paper shows a statistic report about DTD, which is not good enough as a scientific peer-reviewed paper. The questionnaire of SBSOD and FSCST might be good enough to identify the potential deficiencies in navigating; however, without a comparison between the DTD and control individuals, it is hard to evaluate the results in Tables 2, 3, and 4. 

I suggest the authors add a control group to this study and re-organize the discussion based on comparing the control and DTD groups.  

Author Response

This study investigates the proposed pathological condition of Developmental Topographical Disorientation (DTD) through a questionnaire. One primary issue with the research method is that only one group of subjects with DTD was recruited, so there is no direct comparison between the subjects with and without DTD. Therefore, I recommend adding an age- and sex-matched control group to undergo the same questionnaire. The data analysis should be a between-group comparison rather than merely reporting the mean and SD of the DTD group. I suggest the authors add a control group to this study and re-organize the discussion based on comparing the control and DTD groups. 

Reply: We thank the Reviewer for his/her comments. The aim of the present study was descriptive of a sample of participants with DTD. However, following the Reviewer 1’s suggestions we added an age-. sex- and instruction level-matched control group (54 participants). We also performed a between-group comparison as suggested. As a consequence we modified results, tables and discussions.

One interesting finding is that male is more likely to be affected by DTD. However, it is unclear how the subjects were recruited. Please describe the subject recruitment strategy.  Please describe the diagnosis method to identify the subjects with DTD. How are the subjects identified as DTD? Through self-identification? Were the subjects influenced by any psychological factors when determining themselves as DTD? 

Reply: Following Reviewer’s suggestions,  we have added the missing information in the participants section, also by clarifying how the identification of individuals with DTD came about. Taking into account for their answers on the FCSQ scale we considered only those participants who deviated from the overall mean of the FCSQ (which is a calibrated and validated scale) by 2 standard deviations, and then from the reported history we also took into account the criteria described in the work of Iaria and Barton (2010) to define the subject as having DTD.

In my opinion, this paper shows a statistic report about DTD, which is not good enough as a scientific peer-reviewed paper. The questionnaire of SBSOD and FSCST might be good enough to identify the potential deficiencies in navigating; however, without a comparison between the DTD and control individuals, it is hard to evaluate the results in Tables 2, 3, and 4. I suggest the authors add a control group to this study and re-organize the discussion based on comparing the control and DTD groups.  

Reply: We did the analysis suggested by the Auditor and now the results are shown both in the text and in the tables. Now it is easier to understand how significantly these subjects differ from subjects without DTD. We would like to thank the Reviewer for his suggestion that allowed us to add more scientific depth to the article.

Reviewer 2 Report

The main point of this study is that the sample size is too small to generalize the findings of this study. Furthermore, the SOD was not objectively measured by standardized tools. Therefore, the author should address these issues in the Discussion section. 

Author Response

The main point of this study is that the sample size is too small to generalize the findings of this study. Furthermore, the SOD was not objectively measured by standardized tools. Therefore, the author should address these issues in the Discussion section.

Reply: We thank Reviewer 2 for his/her comments. Concerning tools, both SBSOD (Hegarty et al 2002) and FCSQ (Piccardi et al 2011; Nori and Piccardi 2012) are standardized and validated. Both are extensively used in experimental and clinical settings (Brock et al., 2015; Pingel and Clarke, 2014; Iwanowska and Voyer, 2013; Halko et al 2014; Wegman et al 2014; Sulpizio et al 2018; Piccardi et al 2016; Zucchelli et al, 2021). However, we agree with the Reviewer that associating the two questionnaires with behavioral navigational tasks would certainly be more appropriate. Following the Reviewer's suggestion we have stressed this within the limits. On the other hand, with respect to the small number of subjects with DTD in reality, it consists in the 3% of a large sample of 1698 individuals and reflects the numerosity of other neurodevelopmental disorders, such as that of developmental prosopagnosia. Certainly in the future it will be appropriate to contact all individuals with DTD and asked them to complete a more comprehensive navigational battery that would allow for a better diversification of the disorder itself.

Round 2

Reviewer 1 Report

My comment has been addressed in the current version. Best wishes for the authors' future study

Reviewer 2 Report

Authors well address my previous comments.