Family resemblance: ten family members with prosopagnosia and within-class object agnosia

OUP accepted manuscript

While there have been decades of clinical and theoretical interest in developmental and acquired face recognition difficulties, very little work has examined their remediation. Here, we report two studies that examined the efficacy of an existing face training programme in improving face-processing skills in adults and children with developmental face recognition impairments. The programme has only been trialled in typical children to date, where 2 weeks of perceptual training (modelled on an adapted version of the popular family game Guess Who?) resulted in face-specific improvements for memory but not perception after 2 weeks of training. In Study 1, we performed a randomized, parallel groups, placebo-controlled trial of the same programme in 20 adults with a pre-existing diagnosis of developmental prosopagnosia. Assessment tasks were administered immediately before and after training, and 2 weeks later. Face-specific gains in memory (but not perception) were observed in the experimental group and were greatest in those with the poorest face recognition skills at entry. These gains persisted 2 weeks after training ceased. In Study 2, a case-series approach was used to administer the experimental version of the training programme to four children who presented with difficulties in face recognition. Improvements in face memory were observed in three of the participants; while one also improved at face perception, there was mixed evidence for the face specificity of these gains. Together, these findings suggest plasticity in the human face recognition system through to at least mid-adulthood and also pave the way for longer-term implementations of the face training programme that will likely elicit greater gains in both adults and children.

An update of the Benton Facial Recognition Test

The Benton Facial Recognition Test (BFRT) is a paper-and-pen task that is traditionally used to assess face perception skills in neurological, clinical and psychiatric conditions. Despite criticisms of its stimuli, the task enjoys a simple procedure and is rapid to administer. Further, it has recently been computerised (BFRT-c), allowing reliable measurement of completion times and the need for online testing. Here, in response to calls for repeat screening for the accurate detection of face processing deficits, we present the BFRT-Revised (BFRT-r): a new version of the BFRT-c that maintains the task's basic paradigm, but employs new, higher-quality stimuli that reflect recent theoretical advances in the field. An initial validation study with typical participants indicated that the BFRT-r has good internal reliability and content validity. A second investigation indicated that while younger and older participants had comparable accuracy, completion times were longer in the latter, highlighting the need for age-matched norms. Administration of the BFRT-r and BFRT-c to 32 individuals with developmental prosopagnosia resulted in improved sensitivity in diagnostic screening for the BFRT-r compared to the BFRT-c. These findings are discussed in relation to current diagnostic screening protocols for face perception deficits. The BFRT-r is stored in an open repository and is freely available to other researchers.

Accurate but inefficient: Standard face identity matching tests fail to identify prosopagnosia

In recent years, the number of face identity matching tests in circulation has grown considerably and these are being increasingly utilized to study individual differences in face cognition. Although many of these tests were designed for testing typical observers, recent studies have begun to utilize general-purpose tests for studying specific, atypical populations (e.g., super-recognizers and individuals with prosopagnosia). In this study, we examined the capacity of four tests requiring binary face-matching decisions to study individual differences between healthy observers. Uniquely, we used performance of the patient PS (Rossion, 2018), a well-documented case of acquired prosopagnosia (AP), as a benchmark. Two main findings emerged: (i) PS could exhibit typical rates of accuracy in all tests; (ii) compared to age-matched controls and when considering both accuracy and speed to account for potential trade-offs, only the KFMT - but not the EFCT, PICT or GFMT - was able to detect PS's severe impairment. These findings reflect the importance of considering both accuracy and response times to measure individual differences in face matching, and the need for comparing tests in terms of their sensitivity, when used as a measure of human cognition and brain functioning.

Comparing the sensitivity of face matching assessments to detect face perception impairments

Numerous neurological, developmental, and psychiatric conditions demonstrate impaired face recognition, which can be socially debilitating. These impairments can be caused by either deficient face perception or face memory mechanisms. Though there are well-validated, sensitive measures of face memory impairments, it currently remains unclear which assessments best measure face perception impairments. A sensitive, validated face perception measure could help with diagnosing causes of face recognition deficits and be useful in characterizing individual differences in unimpaired populations. Here, we compared the computerized Benton Face Recognition Test (BFRT-c) and Cambridge Face Perception Test (CFPT) in their ability to differentiate developmental prosopagnosics (DPs, N = 30) and age-matched controls (N = 30). Participants completed the BFRT-c, CFPT, and two additional face perception assessments: the University of Southern California Face Perception Test (USCFPT) and a novel same/different face matching test (SDFMT). Participants were also evaluated on objective and subjective face recognition tasks including the Cambridge Face Memory Test, famous faces test, and Prosopagnosia Index-20. We performed a logistic regression with the perception tests predicting DP vs. control group membership and used multiple linear regressions to predict continuous objective and subjective face recognition memory. Our results show that the BFRT-c performed as well as, if not better than, the CFPT, and that both tests clearly outperformed the USCFPT and SDFMT. Further, exploratory analyses revealed that face lighting-change conditions better predicted DP group membership and face recognition abilities than viewpoint-change conditions. Together, these results support the combined use of the BFRT-c and CFPT to best assess face perception impairments.

When two fields collide: Identifying "super-recognisers" for neuropsychological and forensic face recognition research

In the last decade, a novel individual differences approach has emerged across the face recognition literature. While the field has long been concerned with prosopagnosia (the inability to recognise facial identity), it has more recently become clear that there are vast differences in face recognition ability within the typical population. "Super-recognisers" are those individuals purported to reside at the very top of this spectrum. On one hand, these people are of interest to cognitive neuropsychologists who are motivated to explore the commonality of the face recognition continuum, whereas on the other hand, researchers from the forensic face matching field evaluate the implementation of super-recognisers into real-world police and security settings. These two rather different approaches have led to discrepancies in the definition of super-recognisers, and perhaps more fundamentally, the approach to identifying them, resulting in a lack of consistency that prohibits theoretical progress. Here, we review the protocols used in published work to identify super-recognisers, and propose a common definition and screening recommendations that can be adhered to across fields.

Face Processing in Developmental Prosopagnosia: Altered Neural Representations in the Fusiform Face Area

Rationale: Face expertise is a pivotal social skill. Developmental prosopagnosia (DP), i.e., the inability to recognize faces without a history of brain damage, affects about 2% of the general population, and is a renowned model system of the face-processing network. Within this network, the right Fusiform Face Area (FFA), is particularly involved in face identity processing and may therefore be a key element in DP. Neural representations within the FFA have been examined with Representational Similarity Analysis (RSA), a data-analytical framework in which multi-unit measures of brain activity are assessed with correlation analysis. Objectives: Our study intended to scrutinize modifications of FFA-activation during face encoding and maintenance based on RSA. Methods: Thirteen participants with DP (23-70 years) and 12 healthy control subjects (19-62 years) participated in a functional MRI study, including morphological MRI, a functional FFA-localizer and a modified Sternberg paradigm probing face memory encoding and maintenance. Memory maintenance of one, two, or four faces represented low, medium, and high memory load. We examined conventional activation differences in response to working memory load and applied RSA to compute individual correlation-matrices on the voxel level. Group correlation-matrices were compared via Donsker's random walk analysis. Results: On the functional level, increased memory load entailed both a higher absolute FFA-activation level and a higher degree of correlation between activated voxels. Both aspects were deficient in DP. Interestingly, control participants showed a homogeneous degree of correlation for successful trials during the experiment. In DP-participants, correlation levels between FFA-voxels were significantly lower and were less sustained during the experiment. In behavioral terms, DP-participants performed poorer and had longer reaction times in relation to DP-severity. Furthermore, correlation levels were negatively correlated with reaction times for the most demanding high load condition. Conclusion: We suggest that participants with DP fail to generate robust and maintained neural representations in the FFA during face encoding and maintenance, in line with poorer task performance and prolonged reaction times. In DP, alterations of neural coding in the FFA might therefore explain curtailing in working memory and contribute to impaired long-term memory and mental imagery.

Use of the Oxford face matching test reveals an effect of ageing on face perception but not face memory

Effects of ageing on both face perception and face memory have previously been reported. Previous studies, however, have not controlled for the effects of face perception when assessing face memory, meaning that apparent effects of ageing on face memory may actually be due to effects of ageing on face perception. Here, both face perception and face memory were assessed in a sample of adults ranging in age from 18 to 93, and the effect of age on face memory was assessed after controlling for face perception. Face perception was assessed using both a standard test and the Oxford face matching test (OFMT), deliberately designed to avoid the bias towards younger, neurotypical samples that may be present in other tests. An effect of ageing on face perception was found using both tests, with the unbiased OFMT being more sensitive to the effect of age. Importantly, when controlling for face perception using the OFMT, no effect of age on face memory was found. Indicative scores on the OFMT from a sample of 989 participants are provided, broken down by age and gender.

The Twenty Item Prosopagnosia Index (PI20) provides meaningful evidence of face recognition impairment

The Twenty Item Prosopagnosia Index (PI20) is a self-report questionnaire used for quantifying prosopagnosic traits. This scale is intended to help researchers identify cases of developmental prosopagnosia by providing standardized self-report evidence to complement diagnostic evidence obtained from objective computer-based tasks. In order to respond appropriately to items, prosopagnosics must have some insight that their face recognition is well below average, while non-prosopagnosics need to understand that their relative face recognition ability falls within the typical range. There has been considerable debate about whether participants have the necessary insight into their face recognition abilities to respond appropriately. In the present study, we sought to determine whether the PI20 provides meaningful evidence of face recognition impairment. In keeping with the intended use of the instrument, we used PI20 scores to identify two groups: high-PI20 scorers (those with self-reported face recognition difficulties) and low-PI20 scorers (those with no self-reported face recognition difficulties). We found that participant groups distinguished on the basis of PI20 scores clearly differed in terms of their mean performance on objective measures of face recognition ability. We also found that high-PI20 scorers were more likely to achieve levels of face recognition accuracy associated with developmental prosopagnosia.

Face processing predicts reading ability: Evidence from prosopagnosia

There is considerable interest in whether face and word processing are reliant upon shared or dissociable processes. Developmental prosopagnosia is associated with lifelong face processing deficits, with these cases providing strong support for a dissociation between face and word recognition in three recent papers (Burns et al., 2017; Rubino et al., 2016; Starrfelt et al., 2018). However, the sample sizes in each of these studies may have been too small to detect significant effects. We therefore combined their data to increase power and reassessed their results. While only a non-significant trend for reading impairments was found in prosopagnosia using a one-sample t-test, poorer face memory performance was correlated with slower reading speeds across prosopagnosia and control participants. Surprisingly, poorer face perception skills in prosopagnosia were associated with smaller word length effects. This suggests that while mild reading impairments exist in developmental prosopagnosia, there may be a trade-off between their residual face perception abilities and reading skill. A reanalysis of Hills and colleagues' (2015) acquired prosopagnosia data also revealed a positive relationship between words and faces: severe impairments in face recognition were related to poorer word processing. In summary, the developmental and acquired prosopagnosia literature supports models of visual perception that posit face and word processing are reliant upon broadly shared processes.

Face processing in police service: the relationship between laboratory-based assessment of face processing abilities and performance in a real-world identity matching task

In the present study, we investigated whether police officers’ performance in searching for unfamiliar faces in a video-based real-world task is predicted by laboratory-based face processing tests that are typically used to assess individual differences in face processing abilities. Specifically, perceptual performance in the field was operationalized via the identification of target individuals in self-made close-circuit television (CCTV) video tapes. Police officers’ abilities in the laboratory were measured by the Cambridge Face Memory Test long form (CFMT+). We hypothesized that the CFMT+ predicts individual differences in the CCTV task performance. A total of N = 186 police officers of the Rhineland-Palatinate State Police participated in the study (i.e., N = 139 novice and advanced cadets with either 3 months, 15 months or 24 months of pre-service experience; N = 47 experienced police officers with three years of pre-service experience and at least two years of full-service experience, who participated in the assessment center of the special police forces, specifically the surveillance and technical unit). Results revealed that the CFMT+ explained variance in the CCTV task. In sample 1, CFMT+ scores predicted hits, but not false alarms. In contrast, in sample 2, CFMT+ scores were correlated with both hits and false alarms. From a theoretical perspective, we discuss factors that might explain CCTV task performance. From a practical perspective, we recommend that personnel selection processes investigating individual differences of police officers’ face processing abilities should comprise of two steps. At first, laboratory-based tests of face processing abilities should be applied. Subsequently, to validate laboratory-based individual differences in face processing abilities, we recommend that work samples such as CCTV tasks from the field should be added.

Normal colour perception in developmental prosopagnosia

Developmental prosopagnosia (DP) is a selective neurodevelopmental condition defined by lifelong impairments in face recognition. Despite much research, the extent to which DP is associated with broader visual deficits beyond face processing is unclear. Here we investigate whether DP is accompanied by deficits in colour perception. We tested a large sample of 92 DP individuals and 92 sex/age-matched controls using the well-validated Ishihara and Farnsworth–Munsell 100-Hue tests to assess red–green colour deficiencies and hue discrimination abilities. Group-level analyses show comparable performance between DP and control individuals across both tests, and single-case analyses indicate that the prevalence of colour deficits is low and comparable to that in the general population. Our study clarifies that DP is not linked to colour perception deficits and constrains theories of DP that seek to account for a larger range of visual deficits beyond face recognition.

Why the other-race effect matters: Poor recognition of other-race faces impacts everyday social interactions

What happens to everyday social interactions when other-race recognition fails? Here, we provide the first formal investigation of this question. We gave East Asian international students (N = 89) a questionnaire concerning their experiences of the other-race effect (ORE) in Australia, and a laboratory test of their objective other-race face recognition deficit using the Cambridge Face Memory Test (CFMT). As a 'perpetrator' of the ORE, participants reported that their problems telling apart Caucasian people contributed significantly to difficulties socializing with them. Moreover, the severity of this problem correlated with their ORE on the CFMT. As a 'victim' of the ORE, participants reported that Caucasians' problems telling them apart also contributed to difficulties socializing. Further, 81% of participants had been confused with other Asians by a Caucasian authority figure (e.g., university tutor, workplace boss), resulting in varying levels of upset/difficulty. When compared to previously established contributors to international students' high rates of social isolation, ORE-related problems were perceived as equally important as the language barrier and only moderately less important than cultural differences. We conclude that the real-world impact of the ORE extends beyond previously identified specialized settings (eyewitness testimony, security), to common everyday situations experienced by all humans.

Forest Before Trees: Letter Stimulus and Sex Modulate Global Precedence in Visual Perception

The global precedence effect (GPE), originally referring to processing hierarchical visual stimuli composed of letters, is characterised by both global advantage and global interference. We present herein a study of how this effect is modulated by the variables letter and sex. The Navon task, using the letters “H” and “S,” was administered to 78 males and 168 females (69 follicular women, 52 luteal women, and 47 hormonal contraceptive users). No interaction occurred between the letter and sex variables, but significant main effects arose from each of these. Reaction times (RTs) revealed that the letter “H” was identified more rapidly in the congruent condition both in the global and the local task, and the letter “S” in the incongruent condition for the local task. Also, although RTs showed a GPE in both males and females, males displayed shorter reaction times in both global and local tasks. Furthermore, luteal women showed higher d’ index (discrimination sensitivity) in the congruent condition for the local task than both follicular women and hormonal contraceptive users, as well as longer exploration time of the irrelevant level during the global task than males. We conclude that, according to the linear periodicity law, the GPE is enhanced for compound letters with straight vs. curved strokes, whereas it is stronger in males than in females. Relevantly, luteal phase of the menstrual cycle seems to tilt women to rely on finer grained information, thus exhibiting an analytical processing style in global/local visual processing.

Nature and nurture shape structural connectivity in the face processing brain network

Face processing is a key ability facilitating social cognition. Only a few studies explored how nature and nurture shape face processing ontogeny at the behavioral and neural level. Also, very little is known about the contributions of nature and nurture to the establishment of white matter fibers supporting this specific human ability. The main purpose of this study was to assess genetic and environmental influences on white matter bundles connecting atlas-defined and functionally-defined face-responsive areas in the brain. Diffusion weighted images from 408 twins (monozygotic = 264, dizygotic = 144) were obtained from the WU-Minn Human Connectome Project. Fractional anisotropy - a widely used measure of fiber quality - of seven white matter tracts in the face network and ten global white matter tracts was analyzed by means of Structural Equation Modeling for twin data. Results revealed small and moderate genetic effects on face network fiber quality in addition to their shared variance with global brain white matter integrity. Furthermore, a theoretically expected common latent factor accounted for limited genetic and larger environmental variance in multiple face network fibers. The findings suggest that both genetic and environmental factors explain individual differences in fiber quality within the face network, as compared with much larger genetic effects on global brain white matter quality. In addition to heritability, individual-specific environmental influences on the face processing brain network are large, a finding that suggests to connect nature and nurture views on this remarkably specific human ability.

Patterns of perceptual performance in developmental prosopagnosia: An in-depth case series

Developmental prosopagnosia (DP) is a syndrome characterized by lifelong impairment in face recognition in the absence of brain damage. A key question regarding DP concerns which process(es) might be affected to selectively/disproportionally impair face recognition. We present evidence from a group of DPs, combining an overview of previous results with additional analyses important for understanding their pattern of preserved and impaired perceptual abilities. We argue that for most of these individuals, the common denominator is a deficit in (rapid) processing of global shape information. We conclude that the deficit in this group of DPs is not face-selective, but that it may appear so because faces are more visually similar-and recognized at a more fine-grained level-than objects. Indeed, when the demand on perceptual differentiation and visual similarity are held constant for faces and objects, we find no evidence for a disproportionate deficit for faces in this group of DPs.

Typically Efficient Lipreading without Motor Simulation

All it takes is a face-to-face conversation in a noisy environment to realize that viewing a speaker's lip movements contributes to speech comprehension. What are the processes underlying the perception and interpretation of visual speech? Brain areas that control speech production are also recruited during lipreading. This finding raises the possibility that lipreading may be supported, at least to some extent, by a covert unconscious imitation of the observed speech movements in the observer's own speech motor system-a motor simulation. However, whether, and if so to what extent, motor simulation contributes to visual speech interpretation remains unclear. In two experiments, we found that several participants with congenital facial paralysis were as good at lipreading as the control population and performed these tasks in a way that is qualitatively similar to the controls despite severely reduced or even completely absent lip motor representations. Although it remains an open question whether this conclusion generalizes to other experimental conditions and to typically developed participants, these findings considerably narrow the space of hypothesis for a role of motor simulation in lipreading. Beyond its theoretical significance in the field of speech perception, this finding also calls for a re-examination of the more general hypothesis that motor simulation underlies action perception and interpretation developed in the frameworks of motor simulation and mirror neuron hypotheses.

Toward dynamic phenotypes and the scalable measurement of human behavior

Precision psychiatry demands the rapid, efficient, and temporally dense collection of large scale and multi-omic data across diverse samples, for better diagnosis and treatment of dynamic clinical phenomena. To achieve this, we need approaches for measuring behavior that are readily scalable, both across participants and over time. Efforts to quantify behavior at scale are impeded by the fact that our methods for measuring human behavior are typically developed and validated for single time-point assessment, in highly controlled settings, and with relatively homogeneous samples. As a result, when taken to scale, these measures often suffer from poor reliability, generalizability, and participant engagement. In this review, we attempt to bridge the gap between gold standard behavioral measurements in the lab or clinic and the large-scale, high frequency assessments needed for precision psychiatry. To do this, we introduce and integrate two frameworks for the translation and validation of behavioral measurements. First, borrowing principles from computer science, we lay out an approach for iterative task development that can optimize behavioral measures based on psychometric, accessibility, and engagement criteria. Second, we advocate for a participatory research framework (e.g., citizen science) that can accelerate task development as well as make large-scale behavioral research more equitable and feasible. Finally, we suggest opportunities enabled by scalable behavioral research to move beyond single time-point assessment and toward dynamic models of behavior that more closely match clinical phenomena.

Prosopagnosia and disorders of face processing

Face recognition is a form of expert visual processing. Acquired prosopagnosia is the loss of familiarity for facial identity and has several functional variants, namely apperceptive, amnestic, and associative forms. Acquired forms are usually caused by either occipitotemporal or anterior temporal lesions, right or bilateral in most cases. In addition, there is a developmental form, whose functional and structural origins are still being elucidated. Despite their difficulties with recognizing faces, some of these subjects still show signs of covert recognition, which may have a number of explanations. Other aspects of face perception can be spared in prosopagnosic subjects. Patients with other types of face processing difficulties have been described, including impaired expression processing, impaired lip-reading, false familiarity for faces, and a people-specific amnesia. Recent rehabilitative studies have shown some modest ability to improve face perception in prosopagnosic subjects through perceptual training protocols.

Normal recognition of famous voices in developmental prosopagnosia

Developmental prosopagnosia (DP) is a condition characterised by lifelong face recognition difficulties. Recent neuroimaging findings suggest that DP may be associated with aberrant structure and function in multimodal regions of cortex implicated in the processing of both facial and vocal identity. These findings suggest that both facial and vocal recognition may be impaired in DP. To test this possibility, we compared the performance of 22 DPs and a group of typical controls, on closely matched tasks that assessed famous face and famous voice recognition ability. As expected, the DPs showed severe impairment on the face recognition task, relative to typical controls. In contrast, however, the DPs and controls identified a similar number of voices. Despite evidence of interactions between facial and vocal processing, these findings suggest some degree of dissociation between the two processing pathways, whereby one can be impaired while the other develops typically. A possible explanation for this dissociation in DP could be that the deficit originates in the early perceptual encoding of face structure, rather than at later, post-perceptual stages of face identity processing, which may be more likely to involve interactions with other modalities.

Face individual identity recognition: a potential endophenotype in autism

BACKGROUND

Face individual identity recognition skill is heritable and independent of intellectual ability. Difficulties in face individual identity recognition are present in autistic individuals and their family members and are possibly linked to oxytocin polymorphisms in families with an autistic child. While it is reported that developmental prosopagnosia (i.e., impaired face identity recognition) occurs in 2-3% of the general population, no prosopagnosia prevalence estimate is available for autism. Furthermore, an autism within-group approach has not been reported towards characterizing impaired face memory and to investigate its possible links to social and communication difficulties.

METHODS

The present study estimated the prevalence of prosopagnosia in 80 autistic adults with no intellectual disability, investigated its cognitive characteristics and links to autism symptoms' severity, personality traits, and mental state understanding from the eye region by using standardized tests and questionnaires.

RESULTS

More than one third of autistic participants showed prosopagnosia. Their face memory skill was not associated with their symptom's severity, empathy, alexithymia, or general intelligence. Face identity recognition was instead linked to mental state recognition from the eye region only in autistic individuals who had prosopagnosia, and this relationship did not depend on participants' basic face perception skills. Importantly, we found that autistic participants were not aware of their face memory skills.

LIMITATIONS

We did not test an epidemiological sample, and additional work is necessary to establish whether these results generalize to the entire autism spectrum.

CONCLUSIONS

Impaired face individual identity recognition meets the criteria to be a potential endophenotype in autism. In the future, testing for face memory could be used to stratify autistic individuals into genetically meaningful subgroups and be translatable to autism animal models.

Birthweight predicts individual differences in adult face recognition ability

It has long been known that premature birth and/or low birthweight can lead to general difficulties in cognitive and emotional functioning throughout childhood. However, the influence of these factors on more specific processes has seldom been addressed, despite their potential to account for wide individual differences in performance that often appear innate. Here, we examined the influence of gestation and birthweight on adults' face perception and face memory skills. Performance on both sub-processes was predicted by birthweight and birthweight-for-gestation, but not gestation alone. Evidence was also found for the domain-specificity of these effects: No perinatal measure correlated with performance on object perception or memory tasks, but they were related to the size of the face inversion effect on the perceptual test. This evidence indicates a novel, very early influence on individual differences in face recognition ability, which persists into adulthood, influences face-processing strategy itself, and may be domain-specific.

Diagnosing developmental prosopagnosia: repeat assessment using the Cambridge Face Memory Test

Developmental prosopagnosia (DP) is a cognitive condition characterized by a relatively selective impairment in face recognition. Currently, people are screened for DP via a single attempt at objective face-processing tests, usually all presented on the same day. However, several variables probably influence performance on these tests irrespective of actual ability, and the influence of repeat administration is also unknown. Here, we assess, for the first known time, the test-retest reliability of the Cambridge Face Memory Test (CFMT)-the leading task used worldwide to diagnose DP. This value was found to fall just below psychometric standards, and single-case analyses revealed further inconsistencies in performance that were not driven by testing location (online or in-person), nor the time-lapse between attempts. Later administration of an alternative version of the CFMT (the CFMT-Aus) was also found to be valuable in confirming borderline cases. Finally, we found that performance on the first 48 trials of the CFMT was equally as sensitive as the full 72-item score, suggesting that the instrument may be shortened for testing efficiency. We consider the implications of these findings for existing diagnostic protocols, concluding that two independent tasks of unfamiliar face memory should be completed on separate days.

Characterizing developmental prosopagnosia beyond face perception: Impaired recollection but intact familiarity recognition

Converging lines of research suggests that many developmental prosopagnosics (DPs) have impairments beyond face perception, but currently no framework exists to characterize these impaired mechanisms. One potential extra-perceptual deficit is that DPs encode/retrieve faces in a distinct manner from controls that does not sufficiently support individuation. To test this possibility, 30 DPs and 30 matched controls performed an old/new face recognition task while providing confidence ratings, to which a model-based ROC analysis was applied. DPs had significantly reduced recollection compared to controls, driven by fewer 'high-confidence target' responses, but intact familiarity. Recollection and face perception ability uniquely predicted objective and subjective prosopagnosia symptoms, together explaining 51% and 56% of the variance, respectively. These results suggest that a specific deficit in face recollection in DP may represent a core aspect of the difficulty in confidently identifying an individual by their face.

Holistic processing of facial identity in developmental prosopagnosia

The nature of the perceptual deficit seen in developmental prosopagnosia remains poorly understood. One possibility is that these individuals experience face recognition difficulties because they fail to process faces holistically; they may be less able to analyze distal regions in parallel and therefore struggle to integrate information from different regions into a unified perceptual whole. Consequently, developmental prosopagnosics may be forced to base perceptual decisions on a slow, effortful piecemeal analysis of local facial features. In the present study, we sought to test this view by comparing the face recognition of developmental prosopagnosics and typical observers under two viewing conditions: when target faces were briefly presented in their entirety, and when they were inspected region-by-region through a dynamic aperture. If developmental prosopagnosics are forced to base perceptual decisions on information accumulated from a serial piecemeal analysis, one would expect little if any decrement in performance when target faces are viewed through apertures. Contrary to this prediction, however, developmental prosopagnosics showed strong aperture effects comparable with typical observers; their perceptual decisions were more accurate in the whole-face condition than when targets were viewed through the aperture. As expected, the developmental prosopagnosics were less accurate than typical controls when judging briefly presented faces shown in their entirety. Strikingly, however, they were also less able to accumulate perceptual evidence from a serial region-by-region analysis, than typical observers. Our results suggest that the perceptual problems seen in this population arise from imprecise descriptions of local regions, not aberrant holistic processing.

Attentional modulation differentially affects ventral and dorsal face areas in both normal participants and developmental prosopagnosics

Face-selective cortical areas that can be divided into a ventral stream and a dorsal stream. Previous findings indicate selective attention to particular aspects of faces have different effects on the two streams. To better understand the organization of the face network and whether deficits in attentional modulation contribute to developmental prosopagnosia (DP), we assessed the effect of selective attention to different face aspects across eight face-selective areas. Our results from normal participants found that ROIs in the ventral pathway (OFA, FFA) responded strongly when attention was directed to identity and expression, and ROIs in the dorsal pathway (pSTS-FA, IFG-FA) responded the most when attention was directed to facial expression. Response profiles generated by attention to different face aspects were comparable in DPs and normals. Our results demonstrate attentional modulation affects the ventral and dorsal steam face areas differently and indicate deficits in attentional modulation do not contribute to DP.

Efficient recognition of facial expressions does not require motor simulation

What mechanisms underlie facial expression recognition? A popular hypothesis holds that efficient facial expression recognition cannot be achieved by visual analysis alone but additionally requires a mechanism of motor simulation — an unconscious, covert imitation of the observed facial postures and movements. Here, we first discuss why this hypothesis does not necessarily follow from extant empirical evidence. Next, we report experimental evidence against the central premise of this view: we demonstrate that individuals can achieve normotypical efficient facial expression recognition despite a congenital absence of relevant facial motor representations and, therefore, unaided by motor simulation. This underscores the need to reconsider the role of motor simulation in facial expression recognition.

Dorsal-movement and ventral-form regions are functionally connected during visual-speech recognition

Faces convey social information such as emotion and speech. Facial emotion processing is supported via interactions between dorsal-movement and ventral-form visual cortex regions. Here, we explored, for the first time, whether similar dorsal-ventral interactions (assessed via functional connectivity), might also exist for visual-speech processing. We then examined whether altered dorsal-ventral connectivity is observed in adults with high-functioning autism spectrum disorder (ASD), a disorder associated with impaired visual-speech recognition. We acquired functional magnetic resonance imaging (fMRI) data with concurrent eye tracking in pairwise matched control and ASD participants. In both groups, dorsal-movement regions in the visual motion area 5 (V5/MT) and the temporal visual speech area (TVSA) were functionally connected to ventral-form regions (i.e., the occipital face area [OFA] and the fusiform face area [FFA]) during the recognition of visual speech, in contrast to the recognition of face identity. Notably, parts of this functional connectivity were decreased in the ASD group compared to the controls (i.e., right V5/MT-right OFA, left TVSA-left FFA). The results confirmed our hypothesis that functional connectivity between dorsal-movement and ventral-form regions exists during visual-speech processing. Its partial dysfunction in ASD might contribute to difficulties in the recognition of dynamic face information relevant for successful face-to-face communication.

Normative data for two challenging tests of face matching under ecological conditions

Background

Unfamiliar face processing is an ability that varies considerably between individuals. Numerous studies have aimed to identify its underlying determinants using controlled experimental procedures. While such tests can isolate variables that influence face processing, they usually involve somewhat unrealistic situations and optimized face images as stimulus material. As a consequence, the extent to which the performance observed under laboratory settings is informative for predicting real-life proficiency remains unclear.

Results

We present normative data for two ecologically valid but underused tests of face matching: the Yearbook Test (YBT) and the Facial Identity Card Sorting Test (FICST). The YBT (n = 252) measures identity matching across substantial age-related changes in facial appearance, while the FICST (n = 218) assesses the ability to process unfamiliar facial identity despite superficial image variations. To determine the predictive value of both tests, a subsample of our cohort (n = 181) also completed a commonly used test of face recognition and two tests of face perception (the long form of the Cambridge Face Memory Test (CFMT+), the Expertise in Facial Comparison Test (EFCT) and the Person Identification Challenge Test (PICT)).

Conclusions

Focusing on the top performers identified independently per test, we made two important observations: 1) YBT and FICST performance can predict CFMT+ scores and vice versa; and 2) EFCT and PICT scores neither reliably predict superior performance in ecologically meaningful and challenging tests of face matching, nor in the most commonly used test of face recognition. These findings emphasize the necessity for using challenging and ecologically relevant, and thus highly sensitive, tasks of unfamiliar face processing to identify high-performing individuals in the normal population.

Bayesian regression-based developmental norms for the Benton Facial Recognition Test in males and females

Face identity recognition is important for social interaction and is impaired in a range of clinical disorders, including several neurodevelopmental disorders. The Benton Facial Recognition Test (BFRT; Benton & Van Allen, 1968), a widely used assessment of identity recognition, is the only standardized test of face identity perception, as opposed to face memory, that has been normed on children and adolescents. However, the existing norms for the BFRT are suboptimal, with several ages not represented and no established time limit (which can lead to inflated scores by allowing individuals with prosopagnosia to use feature matching). Here we address these issues with a large normative dataset of children and adolescents (ages 5-17, N = 398) and adults (ages 18-55; N = 120) who completed a time-limited version of the BFRT. Using Bayesian regression, we demonstrate that face identity perception increases asymptotically from childhood through adulthood, and provide continuous norms based on age and sex that can be used to calculate standard scores. We show that our time limit of 16 seconds per item yields scores comparable to the existing norms without time limits from the non-prosopagnostic samples. We also find that females (N = 156) score significantly higher than males (N = 362), supporting the existence of a female superiority effect for face identification. Overall, these results provide more robust norms for the BFRT and promote future research on face identity perception in developmental populations.

Search for Face Identity or Expression: Set Size Effects in Developmental Prosopagnosia

The set size effect during visual search indexes the effects of processing load and thus the efficiency of perceptual mechanisms. Our goal was to investigate whether individuals with developmental prosopagnosia show increased set size effects when searching faces for face identity and how this compares to search for face expression. We tested 29 healthy individuals and 13 individuals with developmental prosopagnosia. Participants were shown sets of three to seven faces to judge whether the identities or expressions of the faces were the same across all stimuli or if one differed. The set size effect was the slope of the linear regression between the number of faces in the array and the response time. Accuracy was similar in both controls and prosopagnosic participants. Developmental prosopagnosic participants displayed increased set size effects in face identity search but not in expression search. Single-participant analyses reveal that 11 developmental prosopagnosic participants showed a putative classical dissociation, with impairments in identity but not expression search. Signal detection theory analysis showed that identity set size effects were highly reliable in discriminating prosopagnosic participants from controls. Finally, the set size ratios of same to different trials were consistent with the predictions of self-terminated serial search models for control participants and prosopagnosic participants engaged in expression search but deviated from those predictions for identity search by the prosopagnosic cohort. We conclude that the face set size effect reveals a highly prevalent and selective perceptual inefficiency for processing face identity in developmental prosopagnosia.

Left hemisphere abnormalities in developmental prosopagnosia when looking at faces but not words

Developmental prosopagnosia is a disorder characterized by profound and lifelong difficulties with face recognition in the absence of sensory or intellectual deficits or known brain injury. While there has been a surge in research on developmental prosopagnosia over the last decade and a half, the cognitive mechanisms behind the disorder and its neural underpinnings remain elusive. Most recently it has been proposed that developmental prosopagnosia may be a manifestation of widespread disturbance in neural migration which affects both face responsive brain regions as well as other category-sensitive visual areas. We present a combined behavioural and functional MRI study of face, object and word processing in a group of developmental prosopagnosics (N = 15). We show that developmental prosopagnosia is associated with reduced activation of core ventral face areas during perception of faces. The reductions were bilateral but tended to be more pronounced in the left hemisphere. As the first study to address category selectivity for word processing in developmental prosopagnosia, we do not, however, find evidence for reduced activation of the visual word form area during perception of orthographic material. We also find no evidence for reduced activation of the lateral occipital complex during perception of objects. These imaging findings correspond well with the behavioural performance of the developmental prosopagnosics, who show severe impairment for faces but normal reading and recognition of line drawings. Our findings suggest that a general deficit in neural migration across ventral occipito-temporal cortex is not a viable explanation for developmental prosopagnosia. The finding of left hemisphere involvement in our group of developmental prosopagnosics was at first surprising. However, a closer look at existing studies shows similar, but hitherto undiscussed, findings. These left hemisphere abnormalities seen in developmental prosopagnosia contrasts with lesion and imaging studies suggesting primarily right hemisphere involvement in acquired prosopagnosia, and this may reflect that the left hemisphere is important for the development of a normal face recognition network.

The discrimination of facial sex in developmental prosopagnosia

Developmental prosopagnosia (DP) is a neurodevelopmental condition characterised by difficulties recognising and discriminating faces. It is currently unclear whether the perceptual impairments seen in DP are restricted to identity information, or also affect the perception of other facial characteristics. To address this question, we compared the performance of 17 DPs and matched controls on two sensitive sex categorisation tasks. First, in a morph categorisation task, participants made binary decisions about faces drawn from a morph continuum that blended incrementally an average male face and an average female face. We found that judgement precision was significantly lower in the DPs than in the typical controls. Second, we used a sex discrimination task, where female or male facial identities were blended with an androgynous average face. We manipulated the relative weighting of each facial identity and the androgynous average to create four levels of signal strength. We found that DPs were significantly less sensitive than controls at each level of difficulty. Together, these results suggest that the visual processing difficulties in DP extend beyond the extraction of facial identity and affects the extraction of other facial characteristics. Deficits of facial sex categorisation accord with an apperceptive characterisation of DP.

Training face perception in developmental prosopagnosia through perceptual learning

BACKGROUND

Recent work has shown that perceptual learning can improve face discrimination in subjects with acquired prosopagnosia.

OBJECTIVE

In this study, we administered the same program to determine if such training would improve face perception in developmental prosopagnosia.

METHOD

We trained ten subjects with developmental prosopagnosia for several months with a program that required shape discrimination between morphed facial images, using a staircase procedure to keep training near each subject's perceptual threshold. To promote ecological validity, training progressed from blocks of neutral faces in frontal view through increasing variations in view and expression. Five subjects did 11 weeks of a control television task before training, and the other five were re-assessed for maintenance of benefit 3 months after training.

RESULTS

Perceptual sensitivity for faces improved after training but did not improve after the control task. Improvement generalized to untrained expressions and views of these faces, and there was some evidence of transfer to new faces. Benefits were maintained over three months. Training also led to improvements on standard neuropsychological tests of short-term familiarity, and some subjects reported positive effects in daily life.

CONCLUSION

We conclude that perceptual learning can lead to persistent improvements in face discrimination in developmental prosopagnosia. The strong generalization suggests that learning is occurring at the level of three-dimensional representations with some invariance for the dynamic effects of expression.

Gender and hometown population density interact to predict face recognition ability

Several studies have found that individuals from small hometowns show diminished face recognition ability as compared with individuals from larger hometowns. We further this line of research by relating six measures of face recognition ability to hometown density. We predicted that the three face recognition ability measures which included a learning component would relate to hometown density whereas the three measures which did not include such a learning component would not. Instead, we found that none of the six measures related to hometown density. Interestingly, we found interactions between gender and hometown population density on many of these measures and on a general index of face recognition, with females from small hometowns outperforming males from small hometowns but no such differences in the large hometown group. In a follow-up re-analysis of a previous study, we found a similar interaction in one of two face recognition ability measures. Together, these results reveal a pattern of gender differences modulated by hometown population density. If indeed experience with faces in one's hometown influences face recognition ability, understanding these effects may require more than a quantification of the environment. Men and women growing up in the same environment likely have different experiences, which likely modulates effects on visual abilities.

Eye movements and retinotopic tuning in developmental prosopagnosia

Despite extensive investigation, the causes and nature of developmental prosopagnosia (DP)-a severe face identification impairment in the absence of acquired brain injury-remain poorly understood. Drawing on previous work showing that individuals identified as being neurotypical (NT) show robust individual differences in where they fixate on faces, and recognize faces best when the faces are presented at this location, we defined and tested four novel hypotheses for how atypical face-looking behavior and/or retinotopic face encoding could impair face recognition in DP: (a) fixating regions of poor information, (b) inconsistent saccadic targeting, (c) weak retinotopic tuning, and (d) fixating locations not matched to the individual's own face tuning. We found no support for the first three hypotheses, with NTs and DPs consistently fixating similar locations and showing similar retinotopic tuning of their face perception performance. However, in testing the fourth hypothesis, we found preliminary evidence for two distinct phenotypes of DP: (a) Subjects characterized by impaired face memory, typical face perception, and a preference to look high on the face, and (b) Subjects characterized by profound impairments to both face memory and perception and a preference to look very low on the face. Further, while all NTs and upper-looking DPs performed best when faces were presented near their preferred fixation location, this was not true for lower-looking DPs. These results suggest that face recognition deficits in a substantial proportion of people with DP may arise not from aberrant face gaze or compromised retinotopic tuning, but from the suboptimal matching of gaze to tuning.

Age-Related Declines in Occipital GABA are Associated with Reduced Fluid Processing Ability

RATIONALE AND OBJECTIVES

Healthy aging is associated with pervasive declines in cognitive, motor, and sensory functioning. There are, however, substantial individual differences in behavioral performance among older adults. Several lines of animal research link age-related reductions of gamma-aminobutyric acid (GABA), the brain's primary inhibitory neurotransmitter, to age-related cognitive, motor, and sensory decline. Our study used proton magnetic resonance spectroscopy (MRS) at 3T to explore whether occipital GABA declines with age in humans and whether individual differences in occipital GABA are linked to individual differences in fluid processing ability.

MATERIALS AND METHODS

We used a MEGA-PRESS sequence that combines frequency spectral editing with a point-resolved spectroscopy sequence to quantify GABA. Spectra were obtained from a 30 × 30 × 25 mm voxel placed in the occipital cortex of 20 young adults (mean age 20.7 years) and 18 older adults (mean age 76.5 years). Participants also performed 11 fluid processing tasks outside the scanner, the results of which were z-scored and averaged to calculate a summary measure of fluid processing ability. Regression analysis was employed to determine the relationship between GABA concentrations in the occipital cortex and a summary measure of fluid processing ability.

RESULTS

Occipital GABA was significantly lower in older participants compared to the younger participants. We also observed a significant positive relationship between occipital GABA and fluid processing ability. In fact, higher GABA was associated with better task performance in 10 of the 11 tasks.

CONCLUSION

These findings suggest that GABA levels decline with age in humans and are associated with declines in fluid processing ability.

The domain-specificity of face matching impairments in 40 cases of developmental prosopagnosia

A prevailing debate in the psychological literature concerns the domain-specificity of the face recognition system, where evidence from typical and neurological participants has been interpreted as evidence that faces are "special". Although several studies have investigated the same question in cases of developmental prosopagnosia, the vast majority of this evidence has recently been discounted due to methodological concerns. This leaves an uncomfortable void in the literature, restricting our understanding of the typical and atypical development of the face recognition system. The current study addressed this issue in 40 individuals with developmental prosopagnosia, completing a sequential same/different face and biological (hands) and non-biological (houses) object matching task, with upright and inverted conditions. Findings support domain-specific accounts of face-processing for both hands and houses: while significant correlations emerged between all the object categories, no condition correlated with performance in the upright faces condition. Further, a categorical analysis demonstrated that, when face matching was impaired, object matching skills were classically dissociated in six out of 15 individuals (four for both categories). These findings provide evidence about domain-specificity in developmental disorders of face recognition, and present a theoretically-driven means of partitioning developmental prosopagnosia.

Objective Patterns of Face Recognition Deficits in 165 Adults with Self-Reported Developmental Prosopagnosia

In the last 15 years, increasing numbers of individuals have self-referred to research laboratories in the belief that they experience severe everyday difficulties with face recognition. The condition “developmental prosopagnosia” (DP) is typically diagnosed when impairment is identified on at least two objective face-processing tests, usually involving assessments of face perception, unfamiliar face memory, and famous face recognition. While existing evidence suggests that some individuals may have a mnemonic form of prosopagnosia, it is also possible that other subtypes exist. The current study assessed 165 adults who believe they experience DP, and 38% of the sample were impaired on at least two of the tests outlined above. While statistical dissociations between face perception and face memory were only observed in four cases, a further 25% of the sample displayed dissociations between impaired famous face recognition and intact short-term unfamiliar face memory and face perception. We discuss whether this pattern of findings reflects (a) limitations within dominant diagnostic tests and protocols, (b) a less severe form of DP, or (c) a currently unrecognized but prevalent form of the condition that affects long-term face memory, familiar face recognition or semantic processing.

Coping strategies for developmental prosopagnosia

Developmental prosopagnosia (DP) is a cognitive condition characterised by a relatively selective deficit in face recognition. Some adults and children with DP experience severe psychosocial consequences related to the condition, yet are reluctant to disclose it to others. The remediation of DP is therefore an urgent issue, but has been met with little success. Given that developmental conditions may only benefit from compensatory rather than remedial training, this study aimed to examine (a) the positive and negative effects of DP disclosure, and (b) compensatory techniques that may circumvent recognition failure. Qualitative questionnaires and interviews were carried out with 79 participants: 50 adults with DP, 26 of their non-affected significant others, and three parents of DP children. Findings indicated positive effects of disclosure, yet most adults choose not to do so in the workplace. Effective compensatory strategies include the use of extra-facial information, identity prompts from others, and preparation for planned encounters. However, changes in appearance, infrequent contact, or encounters in unexpected contexts often cause strategy failure. As strategies are effortful and disrupted by heavily controlled appearance (e.g., the wearing of uniform), disclosure of DP may be necessary for the safety, wellbeing and optimal education of children with the condition.

An objective, sensitive and ecologically valid neural measure of rapid human individual face recognition

Humans may be the only species able to rapidly and automatically recognize a familiar face identity in a crowd of unfamiliar faces, an important social skill. Here, by combining electroencephalography (EEG) and fast periodic visual stimulation (FPVS), we introduce an ecologically valid, objective and sensitive neural measure of this human individual face recognition function. Natural images of various unfamiliar faces are presented at a fast rate of 6 Hz, allowing one fixation per face, with variable natural images of a highly familiar face identity, a celebrity, appearing every seven images (0.86 Hz). Following a few minutes of stimulation, a high signal-to-noise ratio neural response reflecting the generalized discrimination of the familiar face identity from unfamiliar faces is observed over the occipito-temporal cortex at 0.86 Hz and harmonics. When face images are presented upside-down, the individual familiar face recognition response is negligible, being reduced by a factor of 5 over occipito-temporal regions. Differences in the magnitude of the individual face recognition response across different familiar face identities suggest that factors such as exposure, within-person variability and distinctiveness mediate this response. Our findings of a biological marker for fast and automatic recognition of individual familiar faces with ecological stimuli open an avenue for understanding this function, its development and neural basis in neurotypical individual brains along with its pathology. This should also have implications for the use of facial recognition measures in forensic science.

Progress in perceptual research: the case of prosopagnosia

Prosopagnosia is an impairment in the ability to recognize faces and can be acquired after a brain lesion or occur as a developmental variant. Studies of prosopagnosia make important contributions to our understanding of face processing and object recognition in the human visual system. We review four areas of advances in the study of this condition in recent years. First are issues surrounding the diagnosis of prosopagnosia, including the development and evaluation of newer tests and proposals for diagnostic criteria, especially for the developmental variant. Second are studies of the structural basis of prosopagnosia, including the application of more advanced neuroimaging techniques in studies of the developmental variant. Third are issues concerning the face specificity of the defect in prosopagnosia, namely whether other object processing is affected to some degree and in particular the status of visual word processing in light of recent predictions from the "many-to-many hypothesis". Finally, there have been recent rehabilitative trials of perceptual learning applied to larger groups of prosopagnosic subjects that show that face impairments are not immutable in this condition.

Does developmental prosopagnosia impair identification of other-ethnicity faces?

Current approaches to the diagnosis of developmental prosopagnosia emphasise the perception and identification of same-ethnicity faces. This convention ensures that perceptual impairment arising from developmental prosopagnosia can be distinguished from problems arising from a lack of visual experience with particular facial ethnicities - the so-called 'Other-Ethnicity Effect'. The present study sought to determine whether the perceptual difficulties seen in developmental prosopagnosia - diagnosed using same-ethnicity faces - extend to other-ethnicity faces. First, we sought to determine whether a group of Caucasian developmental prosopagnosics (N = 15) and typical Caucasian controls (N = 30) had similar experience with same- and other-ethnicity faces during development. All participants therefore completed a contact questionnaire that enquired about their experience of Caucasian, Black, and East Asian faces, at different developmental stages. Importantly, the two groups described very similar levels of visual experience with other-ethnicity faces. Second, we administered a sequential matching task to measure participants' ability to discriminate same- (Caucasian) and other-ethnicity (Black, East Asian) faces. Relative to the experience-matched controls, the prosopagnosics were less accurate at discriminating both same- and other-ethnicity faces, and we found no evidence of disproportionate impairment for same-ethnicity faces. Given that the prosopagnosics and controls had similar opportunity to develop visual expertise for other-ethnicity faces, these results indicate that developmental prosopagnosia impairs recognition of both same- and other-ethnicity faces. The fact that developmental prosopagnosia affects the perception of both same- and other-ethnicity faces suggests that different facial ethnicities engage similar visual processing mechanisms. Our findings support the view that susceptibility to developmental prosopagnosia, and a lack of contact with other-ethnicity faces, contribute independently to the poor recognition of other-ethnicity faces.