Are faces special? A case of pure prosopagnosia

Does acquisition of Greeble expertise in prosopagnosia rule out a domain-general deficit?

According to the expertise account of face specialization, a deficit that affects general expertise mechanisms should similarly impair the expert individuation of both faces and other visually homogeneous object classes. To test this possibility, we attempted to train a prosopagnosic patient, LR, to become a Greeble expert using the standard Greeble expertise-training paradigm (Gauthier & Tarr, 2002). Previous research demonstrated that LR's prosopagnosia was related to an inability to simultaneously use multiple features in a speeded face recognition task (Bukach, Bub, Gauthier, & Tarr, 2006). We hypothesized that LR's inability to use multiple face features would manifest in his acquisition of Greeble expertise, even though his basic object recognition is unimpaired according to standard neuropsychological testing. Although LR was eventually able to reach expertise criterion, he took many more training sessions than controls, suggesting use of an abnormal strategy. To further explore LR's Greeble processing strategies, we assessed his ability to use multiple Greeble features both before and after Greeble training. LR's performance in two versions of this task demonstrates that, even after training, he relies heavily on a single feature to identify Greebles. This correspondence between LR's face recognition and post-training Greeble recognition supports the idea that impaired face recognition is simply the most visible symptom of a more general object recognition impairment in acquired prosopagnosia.

Resting-state neural activity across face-selective cortical regions is behaviorally relevant

Interest has increased recently in correlations across brain regions in the resting-state fMRI blood oxygen level-dependent (BOLD) response, but little is known about the functional significance of these correlations. Here we directly test the behavioral relevance of the resting-state correlation between two face-selective regions in human brain, the occipital face area (OFA) and the fusiform face area (FFA). We found that the magnitude of the resting-state correlation, henceforth called functional connectivity (FC), between OFA and FFA correlates with an individual's performance on a number of face-processing tasks, not non-face tasks. Further, we found that the behavioral significance of the OFA/FFA FC is independent of the functional activation and the anatomical size of either the OFA or FFA, suggesting that face processing depends not only on the functionality of individual face-selective regions, but also on the synchronized spontaneous neural activity between them. Together, these findings provide strong evidence that the functional correlations in the BOLD response observed at rest reveal functionally significant properties of cortical processing.

Differential contribution of right and left temporo-occipital and anterior temporal lesions to face recognition disorders

In the study of prosopagnosia, several issues (such as the specific or non-specific manifestations of prosopagnosia, the unitary or non-unitary nature of this syndrome and the mechanisms underlying face recognition disorders) are still controversial. Two main sources of variance partially accounting for these controversies could be the qualitative differences between the face recognition disorders observed in patients with prevalent lesions of the right or left hemisphere and in those with lesions encroaching upon the temporo-occipital (TO) or the (right) anterior temporal cortex. Results of our review seem to confirm these suggestions. Indeed, they show that (a) the most specific forms of prosopagnosia are due to lesions of a right posterior network including the occipital face area and the fusiform face area, whereas (b) the face identification defects observed in patients with left TO lesions seem due to a semantic defect impeding access to person-specific semantic information from the visual modality. Furthermore, face recognition defects resulting from right anterior temporal lesions can usually be considered as part of a multimodal people recognition disorder. The implications of our review are, therefore, the following: (1) to consider the components of visual agnosia often observed in prosopagnosic patients with bilateral TO lesions as part of a semantic defect, resulting from left-sided lesions (and not from prosopagnosia proper); (2) to systematically investigate voice recognition disorders in patients with right anterior temporal lesions to determine whether the face recognition defect should be considered a form of "associative prosopagnosia" or a form of the "multimodal people recognition disorder."

Holistic perception of the individual face is specific and necessary: evidence from an extensive case study of acquired prosopagnosia

We present an extensive investigation (24 experiments) of a new case of prosopagnosia following right unilateral damage, GG, with the aim of addressing two classical issues: (1) Can a visual recognition impairment truly be specific to faces? (2) What is the nature of acquired prosopagnosia? We show that GG recognizes nonface objects perfectly and quickly, even when it requires fine-grained analysis to individualize these objects. He is also capable of perceiving objects and faces as integrated wholes, as indicated by normal Navon effect, 3D-figures perception and perception of Mooney and Arcimboldo face stimuli. However, the patient could not perceive individual faces holistically, showing no inversion, composite, or whole-part advantage effects for faces. We conclude that an occipito-temporal right hemisphere lesion may lead to a specific impairment of holistic perception of individual items, a function that appears critical for normal face recognition but not for object recognition.

Reading words, seeing style: the neuropsychology of word, font and handwriting perception

The reading of text is predominantly a left hemisphere function. However, it is also possible to process text for attributes other than word or letter identity, such as style of font or handwriting. Anecdotal observations have suggested that processing the latter may involve the right hemisphere. We devised a test that, using the identical stimuli, required subjects first to match on the basis of word identity and second to match on the basis of script style. We presented two versions, one using various computer fonts, and the other using the handwriting of different individuals. We tested four subjects with unilateral lesions who had been well characterized by neuropsychological testing and structural and/or functional MRI. We found that two prosopagnosic subjects with right lateral fusiform damage eliminating the fusiform face area and likely the right visual word form area were impaired in completion times and/or accuracy when sorting for script style, but performed better when sorting for word identity. In contrast, one alexic subject with left fusiform damage showed normal accuracy for sorting by script style and normal or mildly elevated completion times for sorting by style, but markedly prolonged reading times for sorting by word identity. A prosopagnosic subject with right medial occipitotemporal damage sparing areas in the lateral fusiform gyrus performed well on both tasks. The contrast in the performance of patients with right versus left fusiform damage suggests an important distinction in hemispheric processing that reflects not the type of stimulus but the nature of processing required.

Perception of face parts and face configurations: an FMRI study

fMRI studies have reported three regions in human ventral visual cortex that respond selectively to faces: the occipital face area (OFA), the fusiform face area (FFA), and a face-selective region in the superior temporal sulcus (fSTS). Here, we asked whether these areas respond to two first-order aspects of the face argued to be important for face perception, face parts (eyes, nose, and mouth), and the T-shaped spatial configuration of these parts. Specifically, we measured the magnitude of response in these areas to stimuli that (i) either contained real face parts, or did not, and (ii) either had veridical face configurations, or did not. The OFA and the fSTS were sensitive only to the presence of real face parts, not to the correct configuration of those parts, whereas the FFA was sensitive to both face parts and face configuration. Further, only in the FFA was the response to configuration and part information correlated across voxels, suggesting that the FFA contains a unified representation that includes both kinds of information. In combination with prior results from fMRI, TMS, MEG, and patient studies, our data illuminate the functional division of labor in the OFA, FFA, and fSTS.

A new selective developmental deficit: Impaired object recognition with normal face recognition

INTRODUCTION

Studies of developmental deficits in face recognition, or developmental prosopagnosia, have shown that individuals who have not suffered brain damage can show face recognition impairments coupled with normal object recognition (Duchaine and Nakayama, 2005; Duchaine et al., 2006; Nunn et al., 2001). However, no developmental cases with the opposite dissociation - normal face recognition with impaired object recognition - have been reported. The existence of a case of non-face developmental visual agnosia would indicate that the development of normal face recognition mechanisms does not rely on the development of normal object recognition mechanisms.

METHODS

To see whether a developmental variant of non-face visual object agnosia exists, we conducted a series of web-based object and face recognition tests to screen for individuals showing object recognition memory impairments but not face recognition impairments. Through this screening process, we identified AW, an otherwise normal 19-year-old female, who was then tested in the lab on face and object recognition tests.

RESULTS

AW's performance was impaired in within-class visual recognition memory across six different visual categories (guns, horses, scenes, tools, doors, and cars). In contrast, she scored normally on seven tests of face recognition, tests of memory for two other object categories (houses and glasses), and tests of recall memory for visual shapes. Testing confirmed that her impairment was not related to a general deficit in lower-level perception, object perception, basic-level recognition, or memory.

DISCUSSION

AW's results provide the first neuropsychological evidence that recognition memory for non-face visual object categories can be selectively impaired in individuals without brain damage or other memory impairment. These results indicate that the development of recognition memory for faces does not depend on intact object recognition memory and provide further evidence for category-specific dissociations in visual recognition.

Relating visual to verbal semantic knowledge: the evaluation of object recognition in prosopagnosia

Assessment of face specificity in prosopagnosia is hampered by difficulty in gauging pre-morbid expertise for non-face object categories, for which humans vary widely in interest and experience. In this study, we examined the correlation between visual and verbal semantic knowledge for cars to determine if visual recognition accuracy could be predicted from verbal semantic scores. We had 33 healthy subjects and six prosopagnosic patients first rated their own knowledge of cars. They were then given a test of verbal semantic knowledge that presented them with the names of car models, to which they were to match the manufacturer. Lastly, they were given a test of visual recognition, presenting them with images of cars to which they were to provide information at three levels of specificity: model, manufacturer and decade of make. In controls, while self-ratings were only moderately correlated with either visual recognition or verbal semantic knowledge, verbal semantic knowledge was highly correlated with visual recognition, particularly for more specific levels of information. Item concordance showed that less-expert subjects were more likely to provide the most specific information (model name) for the image when they could also match the manufacturer to its name. Prosopagnosic subjects showed reduced visual recognition of cars after adjusting for verbal semantic scores. We conclude that visual recognition is highly correlated with verbal semantic knowledge, that formal measures of verbal semantic knowledge are a more accurate gauge of expertise than self-ratings, and that verbal semantic knowledge can be used to adjust tests of visual recognition for pre-morbid expertise in prosopagnosia.

Impaired holistic processing of unfamiliar individual faces in acquired prosopagnosia

Prosopagnosia is an impairment at individualizing faces that classically follows brain damage. Several studies have reported observations supporting an impairment of holistic/configural face processing in acquired prosopagnosia. However, this issue may require more compelling evidence as the cases reported were generally patients suffering from integrative visual agnosia, and the sensitivity of the paradigms used to measure holistic/configural face processing in normal individuals remains unclear. Here we tested a well-characterized case of acquired prosopagnosia (PS) with no object recognition impairment, in five behavioral experiments (whole/part and composite face paradigms with unfamiliar faces). In all experiments, for normal observers we found that processing of a given facial feature was affected by the location and identity of the other features in a whole face configuration. In contrast, the patient's results over these experiments indicate that she encodes local facial information independently of the other features embedded in the whole facial context. These observations and a survey of the literature indicate that abnormal holistic processing of the individual face may be a characteristic hallmark of prosopagnosia following brain damage, perhaps with various degrees of severity.

Triple dissociation of faces, bodies, and objects in extrastriate cortex

Neuroscientists have long debated whether focal brain regions perform specific cognitive functions [1-5], and the issue remains central to a current debate about visual object recognition. The distributed view of cortical function suggests that object discrimination depends on dispersed but functionally overlapping representations spread across visual cortex [6-8]. The modular view claims different categories of objects are discriminated in functionally segregated and specialized cortical areas [9-11]. To test these competing theories, we delivered transcranial magnetic stimulation (TMS) over three adjacent functionally localized areas in extrastriate cortex. In three experiments, participants performed discrimination tasks involving faces, bodies, and objects while TMS was delivered over the right occipital face area (rOFA) [12], the right extrastriate body area (rEBA) [13], or the right lateral occipital area (rLO) [14]. All three experiments showed a task selective dissociation with performance impaired only by stimulation at the site selective for that category: TMS over rOFA impaired discrimination of faces but not objects or bodies; TMS over rEBA impaired discrimination of bodies but not faces or objects; TMS over rLO impaired discrimination of objects but not faces or bodies. The results support a modular account in which category-selective areas contribute solely to discrimination of their preferred categories.