Face-selective activation in a congenital prosopagnosic subject

Anterior insular cortex is necessary for empathetic pain perception

Empathy refers to the ability to perceive and share another person's affective state. Much neuroimaging evidence suggests that observing others' suffering and pain elicits activations of the anterior insular and the anterior cingulate cortices associated with subjective empathetic responses in the observer. However, these observations do not provide causal evidence for the respective roles of anterior insular and anterior cingulate cortices in empathetic pain. Therefore, whether these regions are 'necessary' for empathetic pain remains unknown. Herein, we examined the perception of others' pain in patients with anterior insular cortex or anterior cingulate cortex lesions whose locations matched with the anterior insular cortex or anterior cingulate cortex clusters identified by a meta-analysis on neuroimaging studies of empathetic pain perception. Patients with focal anterior insular cortex lesions displayed decreased discrimination accuracy and prolonged reaction time when processing others' pain explicitly and lacked a typical interference effect of empathetic pain on the performance of a pain-irrelevant task. In contrast, these deficits were not observed in patients with anterior cingulate cortex lesions. These findings reveal that only discrete anterior insular cortex lesions, but not anterior cingulate cortex lesions, result in deficits in explicit and implicit pain perception, supporting a critical role of anterior insular cortex in empathetic pain processing. Our findings have implications for a wide range of neuropsychiatric illnesses characterized by prominent deficits in higher-level social functioning.

Electrophysiological studies of face processing in developmental prosopagnosia: neuropsychological and neurodevelopmental perspectives

People with developmental prosopagnosia (DP) show severe face-recognition deficits that typically emerge during childhood without history of neurological damage. We review findings from recent event-related brain potential (ERP) studies of face perception and face recognition in DP. The generic face-sensitivity of the N170 component is present in most DPs, suggesting rapid category-selective streaming of facial information. In contrast, DPs show atypical N170 face inversion effects, indicative of impaired structural encoding, specifically for upright faces. In line with neurodevelopmental accounts of DP, these effects are similar to those observed for other developmental disorders, as well as for younger children and older adults. Identity-sensitive ERP components (N250, P600f) triggered during successful face recognition are similar for DPs and control participants, indicating that the same mechanisms are active in both groups. The presence of covert face-recognition effects for the N250 component suggests that visual face memory and semantic memory can become disconnected in some individuals with DP. The implications of these results for neuropsychological and neurodevelopmental perspectives on DP are discussed.

Psychotherapy and neuroscience: towards closer integration

The original aim of psychology was to study and understand the spirit-from the Latin spiritus, literally "breath." The limitations of scientific methods in the past favoured psychology's aloofness in terms of studying the "intangible," while medicine developed methods of examining the body (Latin corpus: essential part). Until 20 years ago, knowledge of the localization of brain functions was limited to inferences from clinical observation of brain-lesioned patients or parallel studies of primate brains. Current neuroscience, with its integrative approach, is bringing together research from molecular through cognitive levels, and psychotherapy has benefited from these findings. Functional neuroimaging studies may make specific and more far-reaching contributions in this respect, since cerebral dynamics may be observed in vivo and in controlled situations. Methods such as single photon emission tomography, positron emission tomography, and functional magnetic resonance imaging have been able to evaluate the neural correlates involved in psychotherapy for individuals with obsessive-compulsive disorder, major depression, social phobia, specific phobia, and post-traumatic disorder. Researchers have found that psychotherapy has the potential to modify dysfunctional neural circuits associated with these disorders. However, precautions are required in constructing feasible designs for neurofunctional investigations. This article reviews the 21 studies that have been published on the subject, and sets out the main advantages and limitations of the technologies used most frequently in protocols involving psychotherapies, and prerequisites for experimental designs. We also pose ways in which the findings from neuroimaging may produce knowledge to guide psychotherapeutic interventions by specifying what should be stimulated in these individuals in order to normalize deficient neural activities.

The right place at the right time: priming facial expressions with emotional face components in developmental visual agnosia

The current study examined the nature of deficits in emotion recognition from facial expressions in case LG, an individual with a rare form of developmental visual agnosia (DVA). LG presents with profoundly impaired recognition of facial expressions, yet the underlying nature of his deficit remains unknown. During typical face processing, normal sighted individuals extract information about expressed emotions from face regions with activity diagnostic for specific emotion categories. Given LG's impairment, we sought to shed light on his emotion perception by examining if priming facial expressions with diagnostic emotional face components would facilitate his recognition of the emotion expressed by the face. LG and control participants matched isolated face components with components appearing in a subsequently presented full-face and then categorized the face's emotion. Critically, the matched components were from regions which were diagnostic or non-diagnostic of the emotion portrayed by the full face. In experiment 1, when the full faces were briefly presented (150 ms), LG's performance was strongly influenced by the diagnosticity of the components: his emotion recognition was boosted within normal limits when diagnostic components were used and was obliterated when non-diagnostic components were used. By contrast, in experiment 2, when the face-exposure duration was extended (2000 ms), the beneficial effect of the diagnostic matching was diminished as was the detrimental effect of the non-diagnostic matching. These data highlight the impact of diagnostic facial features in normal expression recognition and suggest that impaired emotion recognition in DVA results from deficient visual integration across diagnostic face components.

Fusiform gyrus face selectivity relates to individual differences in facial recognition ability

Regions of the occipital and temporal lobes, including a region in the fusiform gyrus (FG), have been proposed to constitute a "core" visual representation system for faces, in part because they show face selectivity and face repetition suppression. But recent fMRI studies of developmental prosopagnosics (DPs) raise questions about whether these measures relate to face processing skills. Although DPs manifest deficient face processing, most studies to date have not shown unequivocal reductions of functional responses in the proposed core regions. We scanned 15 DPs and 15 non-DP control participants with fMRI while employing factor analysis to derive behavioral components related to face identification or other processes. Repetition suppression specific to facial identities in FG or to expression in FG and STS did not show compelling relationships with face identification ability. However, we identified robust relationships between face selectivity and face identification ability in FG across our sample for several convergent measures, including voxel-wise statistical parametric mapping, peak face selectivity in individually defined "fusiform face areas" (FFAs), and anatomical extents (cluster sizes) of those FFAs. None of these measures showed associations with behavioral expression or object recognition ability. As a group, DPs had reduced face-selective responses in bilateral FFA when compared with non-DPs. Individual DPs were also more likely than non-DPs to lack expected face-selective activity in core regions. These findings associate individual differences in face processing ability with selectivity in core face processing regions. This confirms that face selectivity can provide a valid marker for neural mechanisms that contribute to face identification ability.

What can emerging cortical face networks tell us about mature brain organisation?

This opinion paper suggests that developmental neuroimaging studies investigating emerging cortical networks for specific cognitive functions can contribute substantially to our understanding of mature brain organisation. Based on a review of the literature on the neural correlates of face processing abilities, this paper shows how developmental neuroimaging can help resolve outstanding issues, such as whether specific brain regions actually start out by responding to specific stimulus classes, and how this response changes with development. It has been suggested for example, that improving specialisation in a particular brain regions may be the result of increasing connectivity with other network regions supporting the same cognitive function. Developmental neuroimaging studies are particularly well suited to disentangle the interplay between changes at different network levels, such as improving behavioural proficiencies and functional and structural brain development, as well as overall network configuration changes. However, much of the future progress will depend on whether developmental changes are assessed by combining multiple network observations. This paper makes specific suggestions as to how such a multifaceted approach may look like by exploring the suitability of different theoretical frameworks, such as the neural re-use theory or the neuroconstructivist approach for providing guiding principles for future research.

Impaired holistic processing in congenital prosopagnosia

It has long been argued that face processing requires disproportionate reliance on holistic or configural processing, relative to that required for non-face object recognition, and that a disruption of such holistic processing may be causally implicated in prosopagnosia. Previously, we demonstrated that individuals with congenital prosopagnosia (CP) did not show the normal face inversion effect (better performance for upright compared to inverted faces) and evinced a local (rather than the normal global) bias in a compound letter global/local (GL) task, supporting the claim of disrupted holistic processing in prosopagnosia. Here, we investigate further the nature of holistic processing impairments in CP, first by confirming, in a large sample of CP individuals, the absence of the normal face inversion effect and the presence of the local bias on the GL task, and, second, by employing the composite face paradigm, often regarded as the gold standard for measuring holistic face processing. In this last task, we show that, in contrast with controls, the CP group perform equivalently with aligned and misaligned faces and was impervious to (the normal) interference from the task-irrelevant bottom part of faces. Interestingly, the extent of the local bias evident in the composite task is correlated with the abnormality of performance on diagnostic face processing tasks. Furthermore, there is a significant correlation between the magnitude of the local bias in the GL and performance on the composite task. These results provide further evidence for impaired holistic processing in CP and, moreover, corroborate the critical role of this type of processing for intact face recognition.

Congenital prosopagnosia: A case report

Abstract Prosopagnosia is a visual agnosia characterized by an inability to recognize previously known human faces and to learn new faces. The aim of this study was to present a forty-six year-old woman with congenital prosopagnosia, and to discuss the neural bases of perception and recognition of faces. The patients had a lifetime impairment in recognizing faces of family members, close friends, and even her own face in photos. She also had impairment in recognizing animals such as discriminating between cats and dogs. The patient's basic visual skills showed impairment in identifying and recognizing the animal form perception on the coding subtest of the WAIS-R, recognizing overlapping pictures (Luria), and in identifying silhouettes depicting animals and objects (VOSP). Unconventional tests using pictures evidenced impairment in her capacity to identify famous faces, facial emotions and animals. Her face perception abilities were preserved, but recognition could not take place. Therefore, it appears that the agnosia in this case best fits the group of categories termed "associative".

Deficits in long-term recognition memory reveal dissociated subtypes in congenital prosopagnosia

The study investigates long-term recognition memory in congenital prosopagnosia (CP), a lifelong impairment in face identification that is present from birth. Previous investigations of processing deficits in CP have mostly relied on short-term recognition tests to estimate the scope and severity of individual deficits. We firstly report on a controlled test of long-term (one year) recognition memory for faces and objects conducted with a large group of participants with CP. Long-term recognition memory is significantly impaired in eight CP participants (CPs). In all but one case, this deficit was selective to faces and didn't extend to intra-class recognition of object stimuli. In a test of famous face recognition, long-term recognition deficits were less pronounced, even after accounting for differences in media consumption between controls and CPs. Secondly, we combined test results on long-term and short-term recognition of faces and objects, and found a large heterogeneity in severity and scope of individual deficits. Analysis of the observed heterogeneity revealed a dissociation of CP into subtypes with a homogeneous phenotypical profile. Thirdly, we found that among CPs self-assessment of real-life difficulties, based on a standardized questionnaire, and experimentally assessed face recognition deficits are strongly correlated. Our results demonstrate that controlled tests of long-term recognition memory are needed to fully assess face recognition deficits in CP. Based on controlled and comprehensive experimental testing, CP can be dissociated into subtypes with a homogeneous phenotypical profile. The CP subtypes identified align with those found in prosopagnosia caused by cortical lesions; they can be interpreted with respect to a hierarchical neural system for face perception.

The Gender of Face Stimuli is Represented in Multiple Regions in the Human Brain

Face perception in humans is mediated by activation in a network of brain areas. Conventional univariate fMRI data analysis has not localized differential responses to viewing male as compared with viewing female faces within this network. We tested whether we could detect neural response patterns specific to viewing male vs. female faces in 40 participants. Replicating earlier work, face stimuli evoked activation in the core (inferior occipital gyrus, IOG; fusiform gyrus, FG; and superior temporal sulcus, STS), as well as extended (amygdala, inferior frontal gyrus, IFG; insula, INS; and orbitofrontal cortex, OFC) regions of the face network. Multivariate pattern classification of activity within these regions revealed successful decoding of gender information, significantly above chance, in the IOG, FG, STS, IFG, INS, and OFC, but not in the amygdala. Multiple control regions indicated that this result might be restricted to face-responsive regions. Our findings suggest that gender information is distributed across the face network and is represented in the core regions that process invariant facial features, as well as the extended regions that process changeable aspects of faces.

Holistic face categorization in higher order visual areas of the normal and prosopagnosic brain: toward a non-hierarchical view of face perception

How a visual stimulus is initially categorized as a face in a network of human brain areas remains largely unclear. Hierarchical neuro-computational models of face perception assume that the visual stimulus is first decomposed in local parts in lower order visual areas. These parts would then be combined into a global representation in higher order face-sensitive areas of the occipito-temporal cortex. Here we tested this view in fMRI with visual stimuli that are categorized as faces based on their global configuration rather than their local parts (two-tones Mooney figures and Arcimboldo's facelike paintings). Compared to the same inverted visual stimuli that are not categorized as faces, these stimuli activated the right middle fusiform gyrus (“Fusiform face area”) and superior temporal sulcus (pSTS), with no significant activation in the posteriorly located inferior occipital gyrus (i.e., no “occipital face area”). This observation is strengthened by behavioral and neural evidence for normal face categorization of these stimuli in a brain-damaged prosopagnosic patient whose intact right middle fusiform gyrus and superior temporal sulcus are devoid of any potential face-sensitive inputs from the lesioned right inferior occipital cortex. Together, these observations indicate that face-preferential activation may emerge in higher order visual areas of the right hemisphere without any face-preferential inputs from lower order visual areas, supporting a non-hierarchical view of face perception in the visual cortex.

The early time course of compensatory face processing in congenital prosopagnosia

Background

Prosopagnosia is a selective deficit in facial identification which can be either acquired, (e.g., after brain damage), or present from birth (congenital). The face recognition deficit in prosopagnosia is characterized by worse accuracy, longer reaction times, more dispersed gaze behavior and a strong reliance on featural processing.

Methods/Principal Findings

We introduce a conceptual model of an apperceptive/associative type of congenital prosopagnosia where a deficit in holistic processing is compensated by a serial inspection of isolated, informative features. Based on the model proposed we investigated performance differences in different face and shoe identification tasks between a group of 16 participants with congenital prosopagnosia and a group of 36 age-matched controls. Given enough training and unlimited stimulus presentation prosopagnosics achieved normal face identification accuracy evincing longer reaction times. The latter increase was paralleled by an equally-sized increase in stimulus presentation times needed achieve an accuracy of 80%. When the inspection time of stimuli was limited (50ms to 750ms), prosopagnosics only showed worse accuracy but no difference in reaction time. Tested for the ability to generalize from frontal to rotated views, prosopagnosics performed worse than controls across all rotation angles but the magnitude of the deficit didn't change with increasing rotation. All group differences in accuracy, reaction or presentation times were selective to face stimuli and didn't extend to shoes.

Conclusions/Significance

Our study provides a characterization of congenital prosopagnosia in terms of early processing differences. More specifically, compensatory processing in congenital prosopagnosia requires an inspection of faces that is sufficiently long to allow for sequential focusing on informative features. This characterization of dysfunctional processing in prosopagnosia further emphasizes fast and holistic information encoding as two defining characteristics of normal face processing.

Voxel-based morphometry reveals reduced grey matter volume in the temporal cortex of developmental prosopagnosics

Individuals with developmental prosopagnosia exhibit severe and lasting difficulties in recognizing faces despite the absence of apparent brain abnormalities. We used voxel-based morphometry to investigate whether developmental prosopagnosics show subtle neuroanatomical differences from controls. An analysis based on segmentation of T1-weighted images from 17 developmental prosopagnosics and 18 matched controls revealed that they had reduced grey matter volume in the right anterior inferior temporal lobe and in the superior temporal sulcus/middle temporal gyrus bilaterally. In addition, a voxel-based morphometry analysis based on the segmentation of magnetization transfer parameter maps showed that developmental prosopagnosics also had reduced grey matter volume in the right middle fusiform gyrus and the inferior temporal gyrus. Multiple regression analyses relating three distinct behavioural component scores, derived from a principal component analysis, to grey matter volume revealed an association between a component related to facial identity and grey matter volume in the left superior temporal sulcus/middle temporal gyrus plus the right middle fusiform gyrus/inferior temporal gyrus. Grey matter volume in the lateral occipital cortex was associated with component scores related to object recognition tasks. Our results demonstrate that developmental prosopagnosics have reduced grey matter volume in several regions known to respond selectively to faces and provide new evidence that integrity of these areas relates to face recognition ability.

Top-down activation of fusiform cortex without seeing faces in prosopagnosia

Face processing can be modified by bottom-up and top-down influences, but it is unknown how these processes interact in patients with face-recognition impairments (prosopagnosia). We investigated a prosopagnosic with lesions in right occipital and left fusiform cortex but whose right fusiform gyrus is intact and still activated during face-processing tasks. P.S., a patient with a well-established and selective agnosia for faces, was instructed to detect the presence of either faces or houses in pictures with different amounts of noise. The right fusiform face area (FFA) showed reduced responses to face information when visual images were degraded with noise. However, her right FFA still activated to noise-only images when she was instructed to detect faces. These results reveal that fusiform activation is still selectively modulated by task demands related to the anticipation of a face, despite severe face-recognition deficits and the fact that no reliable stimulus-driven response is evoked by actual facial information. Healthy controls showed stimulus-driven responses to faces in fusiform, and in right but not left occipital cortex, suggesting that the latter area alone might provide insufficient facial information in P.S. These results provide a novel account for residual activation of the FFA and underscore the importance of controlling task demands during functional magnetic resonance imaging.

Functional MRI reveals compromised neural integrity of the face processing network in congenital prosopagnosia

The summed activity of multiple nodes of a distributed cortical network supports face recognition in humans, including "core" ventral occipitotemporal cortex (VOTC) regions, and "extended" regions outside VOTC. Many individuals with congenital prosopagnosia-an impairment in face processing-exhibit normal blood oxygenation level-dependent (BOLD) activation in the core VOTC regions. These individuals evince a reduction in the structural integrity of the white matter tracts connecting VOTC to anterior temporal and frontal cortices, part of the "extended" face network. The impairment in congenital prosopagnosia may arise, therefore, not from a dysfunction of the core VOTC areas but from a failure to propagate signals between the intact VOTC and the extended nodes of the network. Using the fMR adaptation paradigm with famous and unknown faces, we show that individuals with congenital prosopagnosia evince normal adaptation effects in VOTC, indicating sensitivity to facial identity, but show no differential activation for familiar versus unknown faces outside VOTC, particularly in the precuneus/posterior cingulate cortex and the anterior paracingulate cortex. Normal BOLD activation in VOTC is thus insufficient to subserve intact face recognition, and disrupted information propagation between VOTC and the extended face processing network may explain the functional impairment in congenital prosopagnosia.

Implicit familiarity processing in congenital prosopagnosia

A particularly interesting and somewhat puzzling finding in the face-processing literature is that, despite the absence of overt recognition of most faces, many patients with acquired prosopagnosia (AP) exhibit evidence of intact covert face recognition of the very same faces. This phenomenon has important implications for the understanding of the mechanism underlying AP and, by extension, the mechanism underlying normal face processing. Here, we set out to examine whether individuals with congenital prosopagnosia (CP) exhibit a similar dissociation between overt and covert face recognition. We first confirmed that all six of our CP individuals were significantly impaired in face recognition in comparison with controls. Participants then completed a matching task with both famous and unknown faces in which they decided whether two consecutive images have the same identity or not. Critically, the level of face familiarity was orthogonal to the task at hand and this enabled us to examine whether the familiarity of a face enhanced identity matching, a finding which would implicate implicit face processing. As expected, the CP individuals were slower and less accurate than the control participants. More importantly, like the controls, the CP individuals were faster and more accurate at matching famous compared with unknown faces. Also, for both groups, matching performance on unrecognized famous faces fell at an intermediate level between performance on explicitly recognized famous faces and faces which are unknown. These results provide the first solid evidence for the existence of implicit familiarity processing in CP and suggest that, despite the marked impairment in explicit face recognition, these individuals still have some familiarity representation which manifests in the form of covert recognition. We discuss possible models to account for the apparent dissociation of overt and covert face processing in CPR.

Task-specific codes for face recognition: how they shape the neural representation of features for detection and individuation

BACKGROUND

The variety of ways in which faces are categorized makes face recognition challenging for both synthetic and biological vision systems. Here we focus on two face processing tasks, detection and individuation, and explore whether differences in task demands lead to differences both in the features most effective for automatic recognition and in the featural codes recruited by neural processing.

METHODOLOGY/PRINCIPAL FINDINGS

Our study appeals to a computational framework characterizing the features representing object categories as sets of overlapping image fragments. Within this framework, we assess the extent to which task-relevant information differs across image fragments. Based on objective differences we find among task-specific representations, we test the sensitivity of the human visual system to these different face descriptions independently of one another. Both behavior and functional magnetic resonance imaging reveal effects elicited by objective task-specific levels of information. Behaviorally, recognition performance with image fragments improves with increasing task-specific information carried by different face fragments. Neurally, this sensitivity to the two tasks manifests as differential localization of neural responses across the ventral visual pathway. Fragments diagnostic for detection evoke larger neural responses than non-diagnostic ones in the right posterior fusiform gyrus and bilaterally in the inferior occipital gyrus. In contrast, fragments diagnostic for individuation evoke larger responses than non-diagnostic ones in the anterior inferior temporal gyrus. Finally, for individuation only, pattern analysis reveals sensitivity to task-specific information within the right "fusiform face area".

CONCLUSIONS/SIGNIFICANCE

OUR RESULTS DEMONSTRATE: 1) information diagnostic for face detection and individuation is roughly separable; 2) the human visual system is independently sensitive to both types of information; 3) neural responses differ according to the type of task-relevant information considered. More generally, these findings provide evidence for the computational utility and the neural validity of fragment-based visual representation and recognition.

Prevalence of hereditary prosopagnosia (HPA) in Hong Kong Chinese population

Prosopagnosia (PA), or the inability to recognize a familiar person by the face alone, had been considered to be a rare dysfunction mainly acquired by trauma to the brain. Recently we have shown that the congenital form of PA, which was considered to be even rarer, is common in Caucasians, with a prevalence of 2.5%. As these cases were familial we coined the term Hereditary Prosopagnosia (HPA). The present study is the first systematic screening for HPA in a defined population of ethnic Chinese. In 2004-2005, 533 out of around 750 medical students of The University of Hong Kong took part in a questionnaire-based screening. The responses of 133 students indicated that they were likely to be candidates for PA. One hundred twenty agreed for diagnostic interview. Finally we made the clinical diagnosis of PA in 10 subjects. A prevalence of 1.88% (95% CI, 1.05-2.71) is established which is in the same range as in Caucasians. We took a detailed family history of four index prosopagnosic persons and were able to further investigate the families of four probands. Each had other first-degree relatives with the same visual cognitive dysfunction. Thus, as in the Caucasians, regular autosomal dominant inheritance might best explain the segregation pattern.

Reduced structural connectivity in ventral visual cortex in congenital prosopagnosia

Using diffusion tensor imaging and tractography, we found that a disruption in structural connectivity in ventral occipito-temporal cortex may be the neurobiological basis for the lifelong impairment in face recognition that is experienced by individuals who suffer from congenital prosopagnosia. Our findings suggest that white-matter fibers in ventral occipito-temporal cortex support the integrated function of a distributed cortical network that subserves normal face processing.

A bilateral occipitotemporal network mediates face perception

The aim of the present study was to further explore the neuronal mechanisms of face processing in healthy subjects which may help to understand the difficulties experienced by prosopagnosia subjects. A further goal was to compare face specific activation patterns in the right and left occipital face area (OFA) and fusiform face area (FFA) for famous faces, non-famous faces and caricatures of famous faces in four individuals suffering from developmental prosopagnosia (DP) and seven healthy controls, using functional magnetic resonance imaging and psychophysiological interaction analysis (PPI). Control subjects showed higher face related activations in the right compared to the left FFA. Caricatures of faces of famous people and photographs of non-famous faces yielded higher percent signal changes in the OFA and FFA compared to photographs of famous faces. These data support the idea that the OFA and FFA discriminate between familiar and new face representations. The activation patterns of DP subjects were heterogeneous, with none of the patients showing bilateral face related activations in both OFA and FFA. There was no evidence of a left hemispheric activation when the right homologue failed to be activated, supporting the view of a right hemispheric dominance in face perception. PPI analysis indicated a link between activation of the right FFA and the other three tested regions, the left FFA and the right and left OFA. In summary, all four face related brain regions appear to be necessary for successful face processing, and disruption of one component may lead to face recognition deficits.

Neural correlates of perceiving emotional faces and bodies in developmental prosopagnosia: an event-related fMRI-study

Many people experience transient difficulties in recognizing faces but only a small number of them cannot recognize their family members when meeting them unexpectedly. Such face blindness is associated with serious problems in everyday life. A better understanding of the neuro-functional basis of impaired face recognition may be achieved by a careful comparison with an equally unique object category and by a adding a more realistic setting involving neutral faces as well facial expressions. We used event-related functional magnetic resonance imaging (fMRI) to investigate the neuro-functional basis of perceiving faces and bodies in three developmental prosopagnosics (DP) and matched healthy controls. Our approach involved materials consisting of neutral faces and bodies as well as faces and bodies expressing fear or happiness. The first main result is that the presence of emotional information has a different effect in the patient vs. the control group in the fusiform face area (FFA). Neutral faces trigger lower activation in the DP group, compared to the control group, while activation for facial expressions is the same in both groups. The second main result is that compared to controls, DPs have increased activation for bodies in the inferior occipital gyrus (IOG) and for neutral faces in the extrastriate body area (EBA), indicating that body and face sensitive processes are less categorically segregated in DP. Taken together our study shows the importance of using naturalistic emotional stimuli for a better understanding of developmental face deficits.

Early left-hemispheric dysfunction of face processing in congenital prosopagnosia: an MEG study

BACKGROUND

Congenital prosopagnosia is a severe face perception impairment which is not acquired by a brain lesion and is presumably present from birth. It manifests mostly by an inability to recognise familiar persons. Electrophysiological research has demonstrated the relevance to face processing of a negative deflection peaking around 170 ms, labelled accordingly as N170 in the electroencephalogram (EEG) and M170 in magnetoencephalography (MEG). The M170 was shown to be sensitive to the inversion of faces and to familiarity--two factors that are assumed to be crucial for congenital prosopagnosia. In order to locate the cognitive dysfunction and its neural correlates, we investigated the time course of neural activity in response to these manipulations.

METHODOLOGY

Seven individuals with congenital prosopagnosia and seven matched controls participated in the experiment. To explore brain activity with high accuracy in time, we recorded evoked magnetic fields (275 channel whole head MEG) while participants were looking at faces differing in familiarity (famous vs. unknown) and orientation (upright vs. inverted). The underlying neural sources were estimated by means of the least square minimum-norm-estimation (L2-MNE) approach.

PRINCIPAL FINDINGS

The behavioural data corroborate earlier findings on impaired configural processing in congenital prosopagnosia. For the M170, the overall results replicated earlier findings, with larger occipito-temporal brain responses to inverted than upright faces, and more right- than left-hemispheric activity. Compared to controls, participants with congenital prosopagnosia displayed a general decrease in brain activity, primarily over left occipitotemporal areas. This attenuation did not interact with familiarity or orientation.

CONCLUSIONS

The study substantiates the finding of an early involvement of the left hemisphere in symptoms of prosopagnosia. This might be related to an efficient and overused featural processing strategy which serves as a compensation of impaired configural processing.

Are faces special? A case of pure prosopagnosia

The ability to recognize individual faces is of crucial social importance for humans and evolutionarily necessary for survival. Consequently, faces may be "special" stimuli, for which we have developed unique modular perceptual and recognition processes. Some of the strongest evidence for face processing being modular comes from cases of prosopagnosia, where patients are unable to recognize faces whilst retaining the ability to recognize other objects. Here we present the case of an acquired prosopagnosic whose poor recognition was linked to a perceptual impairment in face processing. Despite this, she had intact object recognition, even at a subordinate level. She also showed a normal ability to learn and to generalize learning of nonfacial exemplars differing in the nature and arrangement of their parts, along with impaired learning and generalization of facial exemplars. The case provides evidence for modular perceptual processes for faces.

Spatio-temporal dynamics of neural mechanisms underlying component operations in working memory

Neuroimaging and neurophysiology evidence suggests that component operations in working memory (WM) emerge from the coordinated interaction of posterior perceptual cortices with heteromodal regions in the prefrontal and parietal cortices. Still, little is known about bottom-up and top-down signaling during the formation and retrieval of WM representations. In the current set of experiments, we combine complementary fMRI and EEG measures to obtain high-resolution spatial and temporal measures of neural activity during WM encoding and retrieval processes. Across both experiments, participants performed a face delayed recognition WM task in which the nature of sensory input across stages was held constant. In experiment 1, we utilized a latency-resolved fMRI approach to assess temporal parameters of the BOLD response during stage-specific encoding and retrieval waveforms. Relative to the latency at encoding, the PFC exhibited an earlier peak of fMRI activity at retrieval showing stage-specific differences in the temporal dynamics of PFC engagement across WM operations. In experiment 2, we analyzed the first 200 ms of the ERP response during this WM task providing a more sensitive temporal measure of these differences. Divergence of the ERP pattern during encoding and retrieval began as early as 60 ms post-stimulus. The parallel fMRI and ERP results during memory-guided decisions support a key role of the PFC in top-down biasing of perceptual processing and reveal rapid differences across WM component operations in the presence of identical bottom-up sensory input.

Reduction in white matter connectivity, revealed by diffusion tensor imaging, may account for age-related changes in face perception

An age-related decline in face processing, even under conditions in which learning and memory are not implicated, has been well documented, but the mechanism underlying this perceptual alteration remains unknown. Here, we examine whether this behavioral change may be accounted for by a reduction in white matter connectivity with age. To this end, we acquired diffusion tensor imaging data from 28 individuals aged 18 to 86 years and quantified the number of fibers, voxels, and fractional anisotropy of the two major tracts that pass through the fusiform gyrus, the pre-eminent face processing region in the ventral temporal cortex. We also measured the ability of a subset of these individuals to make fine-grained discriminations between pairs of faces and between pairs of cars. There was a significant reduction in the structural integrity of the inferior fronto-occipital fasciculus (IFOF) in the right hemisphere as a function of age on all dependent measures and there were also some changes in the left hemisphere, albeit to a lesser extent. There was also a clear age-related decrement in accuracy of perceptual discrimination, especially for more challenging perceptual discriminations, and this held to a greater degree for faces than for cars. Of greatest relevance, there was a robust association between the reduction of IFOF integrity in the right hemisphere and the decline in face perception, suggesting that the alteration in structural connectivity between the right ventral temporal and frontal cortices may account for the age-related difficulties in face processing.

Individual faces elicit distinct response patterns in human anterior temporal cortex

Visual face identification requires distinguishing between thousands of faces we know. This computational feat involves a network of brain regions including the fusiform face area (FFA) and anterior inferotemporal cortex (aIT), whose roles in the process are not well understood. Here, we provide the first demonstration that it is possible to discriminate cortical response patterns elicited by individual face images with high-resolution functional magnetic resonance imaging (fMRI). Response patterns elicited by the face images were distinct in aIT but not in the FFA. Individual-level face information is likely to be present in both regions, but our data suggest that it is more pronounced in aIT. One interpretation is that the FFA detects faces and engages aIT for identification.

Functional Plasticity in Ventral Temporal Cortex following Cognitive Rehabilitation of a Congenital Prosopagnosic

We used functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to measure neural changes associated with training configural processing in congenital prosopagnosia, a condition in which face identification abilities are not properly developed in the absence of brain injury or visual problems. We designed a task that required discriminating faces by their spatial configuration and, after extensive training, prosopagnosic MZ significantly improved at face identification. Event-related potential results revealed that although the N170 was not selective for faces before training, its selectivity after training was normal. fMRI demonstrated increased functional connectivity between ventral occipital temporal face-selective regions (right occipital face area and right fusiform face area) that accompanied improvement in face recognition. Several other regions showed fMRI activity changes with training; the majority of these regions increased connectivity with face-selective regions. Together, the neural mechanisms associated with face recognition improvements involved strengthening early face-selective mechanisms and increased coordination between face-selective and nonselective regions, particularly in the right hemisphere.

Impaired face and body perception in developmental prosopagnosia

Prosopagnosia is a deficit in face recognition in the presence of relatively normal object recognition. Together with older lesion studies, recent brain-imaging results provide evidence for the closely related representations of faces and objects and, more recently, for brain areas sensitive to faces and bodies. This evidence raises the issue of whether developmental prosopagnosics may also have an impairment in encoding bodies. We investigated the first stages of face, body, and object perception in four developmental prosopagnosics by comparing event-related potentials to canonically and upside-down presented stimuli. Normal configural encoding was absent in three of four developmental prosopagnosics for faces at the P1 and for both faces and bodies at the N170 component. Our results demonstrate that prosopagnosics do not have this normal processing routine readily available for faces or bodies. A profound face recognition deficit characteristic of developmental prosopagnosia may not necessarily originate in a category-specific face recognition deficit in the initial stages of development. It may also have its roots in anomalous processing of the configuration, a visual routine that is important for other stimuli besides faces. Faces and bodies trigger configuration-based visual strategies that are crucial in initial stages of stimulus encoding but also serve to bootstrap the acquisition of more feature-based visual skills that progressively build up in the course of development.

Event-related potentials reflect heterogeneity of developmental prosopagnosia

Event-related potential (ERP) studies of developmental prosopagnosia (DP) are rare. Previous ERP investigations have reported smaller N170 amplitude differences between faces and objects in at least three prosopagnosics. The present study is based on a combination of behavioural and electrophysiological assessment of face processing. The aim was to investigate the face-specificity of the N170 in both healthy subjects and a group of DP individuals (N = 4), using famous and nonfamous faces, caricatures and houses as stimuli. All prosopagnosic subjects showed impairments in recognition of famous faces, memory for faces and learning new faces in behavioural assessment. In healthy subjects the largest effects were found at parieto-occipital electrode positions (PO7 and PO8), along with a familiarity effect at these electrode positions. Thus, parieto-occipital areas appear to play an important role in face processing. Three prosopagnosics showed reliable N170 amplitude differences between faces and nonface stimuli, whereas one DP individual showed significantly reduced amplitude differences between faces and nonface objects. The behavioural and electrophysiological data support the idea that DP reflects a heterogeneous impairment and that face processing deficits are not necessarily correlated with a lack of face-specific N170.

First report of prevalence of non-syndromic hereditary prosopagnosia (HPA)

Acquired prosopagnosia (PA) is a rare condition after, for example, a stroke or brain injury. The congenital form of PA is generally considered to be even less common. Beside a few single case reports and anecdotal mentioning of familial cases no data on the epidemiology exists. Following a questionnaire-based screening in local secondary schools and at our medical faculty, candidates suspicious for PA underwent a semi-structured interview followed by examinations of first degree relatives. Among 689 local pupils and medical students of our university we found 17 with congenital PA. This corresponds to a prevalence rate of 2.47% (95% CI 1.31-3.63). The frequency is among the highest known for a monogenic disorder. All those index subjects (n = 14) of the target group who agreed to further examinations of their family members had other first degree relatives with the same cognitive disorder. This study provides epidemiological evidence that congenital PA is a very common cognitive disorder which almost always runs in families. The segregation pattern of this hereditary prosopagnosia (HPA) is fully compatible with autosomal dominant inheritance.

Structural imaging reveals anatomical alterations in inferotemporal cortex in congenital prosopagnosia

Congenital prosopagnosia (CP) refers to the lifelong impairment in face recognition in individuals who have intact low-level visual processing, normal cognitive abilities, and no known neurological disorder. Although the face recognition impairment is profound and debilitating, its neural basis remains elusive. To investigate this, we conducted detailed morphometric and volumetric analyses of the occipitotemporal (OT) cortex in a group of CP individuals and matched control subjects using high-spatial resolution magnetic resonance imaging. Although there were no significant group differences in the depth or deviation from the midline of the OT or collateral sulci, the CP individuals evince a larger anterior and posterior middle temporal gyrus and a significantly smaller anterior fusiform (aF) gyrus. Interestingly, this volumetric reduction in the aF gyrus is correlated with the behavioral decrement in face recognition. These findings implicate a specific cortical structure as the neural basis of CP and, in light of the familial history of CP, target the aF gyrus as a potential site for further, focused genetic investigation.

Neural correlates of processing facial identity based on features versus their spacing

Adults' expertise in recognizing facial identity involves encoding subtle differences among faces in the shape of individual facial features (featural processing) and in the spacing among features (a type of configural processing called sensitivity to second-order relations). We used fMRI to investigate the neural mechanisms that differentiate these two types of processing. Participants made same/different judgments about pairs of faces that differed only in the shape of the eyes and mouth, with minimal differences in spacing (featural blocks), or pairs of faces that had identical features but differed in the positions of those features (spacing blocks). From a localizer scan with faces, objects, and houses, we identified regions with comparatively more activity for faces, including the fusiform face area (FFA) in the right fusiform gyrus, other extrastriate regions, and prefrontal cortices. Contrasts between the featural and spacing conditions revealed distributed patterns of activity differentiating the two conditions. A region of the right fusiform gyrus (near but not overlapping the localized FFA) showed greater activity during the spacing task, along with multiple areas of right frontal cortex, whereas left prefrontal activity increased for featural processing. These patterns of activity were not related to differences in performance between the two tasks. The results indicate that the processing of facial features is distinct from the processing of second-order relations in faces, and that these functions are mediated by separate and lateralized networks involving the right fusiform gyrus, although the FFA as defined from a localizer scan is not differentially involved.

Too Many Trees to See the Forest: Performance, Event-related Potential, and Functional Magnetic Resonance Imaging Manifestations of Integrative Congenital Prosopagnosia

Neuropsychological, event-related potential (ERP), and functional magnetic resonance imaging (fMRI) methods were combined to provide a comprehensive description of performance and neurobiological profiles for K.W., a case of congenital prosopagnosia. We demonstrate that K.W.'s visual perception is characterized by almost unprecedented inability to identify faces, a large bias toward local features, and an extreme deficit in global/configural processing that is not confined to faces. This pattern could be appropriately labeled congenital integrative prosopagnosia, and accounts for some, albeit not all, cases of face recognition impairments without identifiable brain lesions. Absence of face selectivity is evident in both biological markers of face processing, fMRI (the fusiform face area [FFA]), and ERPs (N170). Nevertheless, these two neural signatures probably manifest different perceptual mechanisms. Whereas the N170 is triggered by the occurrence of physiognomic stimuli in the visual field, the deficient face-selective fMRI activation in the caudal brain correlates with the severity of global processing deficits. This correlation suggests that the FFA might be associated with global/configural computation, a crucial part of face identification.

The fusiform face area: a cortical region specialized for the perception of faces

Faces are among the most important visual stimuli we perceive, informing us not only about a person's identity, but also about their mood, sex, age and direction of gaze. The ability to extract this information within a fraction of a second of viewing a face is important for normal social interactions and has probably played a critical role in the survival of our primate ancestors. Considerable evidence from behavioural, neuropsychological and neurophysiological investigations supports the hypothesis that humans have specialized cognitive and neural mechanisms dedicated to the perception of faces (the face-specificity hypothesis). Here, we review the literature on a region of the human brain that appears to play a key role in face perception, known as the fusiform face area (FFA). Section 1 outlines the theoretical background for much of this work. The face-specificity hypothesis falls squarely on one side of a longstanding debate in the fields of cognitive science and cognitive neuroscience concerning the extent to which the mind/brain is composed of: (i) special-purpose ('domain-specific') mechanisms, each dedicated to processing a specific kind of information (e.g. faces, according to the face-specificity hypothesis), versus (ii) general-purpose ('domain-general') mechanisms, each capable of operating on any kind of information. Face perception has long served both as one of the prime candidates of a domain-specific process and as a key target for attack by proponents of domain-general theories of brain and mind. Section 2 briefly reviews the prior literature on face perception from behaviour and neurophysiology. This work supports the face-specificity hypothesis and argues against its domain-general alternatives (the individuation hypothesis, the expertise hypothesis and others). Section 3 outlines the more recent evidence on this debate from brain imaging, focusing particularly on the FFA. We review the evidence that the FFA is selectively engaged in face perception, by addressing (and rebutting) five of the most widely discussed alternatives to this hypothesis. In section 4, we consider recent findings that are beginning to provide clues into the computations conducted in the FFA and the nature of the representations the FFA extracts from faces. We argue that the FFA is engaged both in detecting faces and in extracting the necessary perceptual information to recognize them, and that the properties of the FFA mirror previously identified behavioural signatures of face-specific processing (e.g. the face-inversion effect). Section 5 asks how the computations and representations in the FFA differ from those occurring in other nearby regions of cortex that respond strongly to faces and objects. The evidence indicates clear functional dissociations between these regions, demonstrating that the FFA shows not only functional specificity but also area specificity. We end by speculating in section 6 on some of the broader questions raised by current research on the FFA, including the developmental origins of this region and the question of whether faces are unique versus whether similarly specialized mechanisms also exist for other domains of high-level perception and cognition.

Hereditary prosopagnosia (HPA): the first report outside the Caucasian population

Prosopagnosia (PA) or face blindness is characterized by a deficiency in identifying familiar faces. Almost all reports are single cases or collections of unrelated patients who acquired prosopagnosia after brain injuries, strokes or atrophy of at least the right occipito-temporal cortex. Until 2001, the inborn form - in the absence of any brain lesions - was described in fewer than 20 probands exclusively of Caucasian origin. We recently found that in the German Caucasian population, congenital prosopagnosia has a very high prevalence of at least 2.5% and that it is genetically determined. It is best described by autosomal-dominant inheritance in the more than 50 families investigated. We therefore introduced the term non-syndromic hereditary PA for the congenital form of a monosymptomatic or isolated PA. This surprisingly high frequency in the Caucasian population prompted us to extend our search to other ethnic groups. We performed a questionnaire-based screening among 198 native Indian students at Banaras Hindu University in Varanasi. In a then selected subset, we found after further detailed diagnostic interviews one Bengali female student with visual agnosia for face recognition only. Several other members of her large family reported the same impairment of face recognition. The segregation pattern of PA in this family is also compatible with autosomal-dominant inheritance.

Task-related laterality effects in the lateral occipital complex

Using functional imaging, we investigated the effects of two different tasks on activation in the lateral occipital complex (LOC). Alternating blocks of intact and scrambled objects were presented. In one task, subjects responded when an object repeated (matching task). In a second task subjects silently named objects (naming task). Identical objects (tools, animals and letters) were presented for both tasks. A relative measure of the number of voxels activated in LOC in left and right hemispheres was calculated for each task across a range of thresholds. Also the effects of task demands on category specific areas in LOC were examined. The object matching task resulted in proportionally more activity in the right hemisphere. The object naming task resulted in proportionally more activity in the left hemisphere, most prominently in the anterior portion of LOC. Effectively, changing the task changed the lateralization of activation to intact objects in LOC. In contrast, changing the task did not change the lateralization of category-specific activations. The results suggest that there are task-related top-down influences on the activation of neural populations in LOC as a whole, but the lateralization of category-specific regions in LOC is independent of task demands and may reflect bottom-up processing.

A detailed investigation of facial expression processing in congenital prosopagnosia as compared to acquired prosopagnosia

Whether the ability to recognize facial expression can be preserved in the absence of the recognition of facial identity remains controversial. The current study reports the results of a detailed investigation of facial expression recognition in three congenital prosopagnosic (CP) participants, in comparison with two patients with acquired prosopagnosia (AP) and a large group of 30 neurologically normal participants, including individually age- and gender-matched controls. Participants completed a fine-grained expression recognition paradigm requiring a six-alternative forced-choice response to continua of morphs of six different basic facial expressions (e.g. happiness and surprise). Accuracy, sensitivity and reaction times were measured. The performance of all three CP individuals was indistinguishable from that of controls, even for the most subtle expressions. In contrast, both individuals with AP displayed pronounced difficulties with the majority of expressions. The results from the CP participants attest to the dissociability of the processing of facial identity and of facial expression. Whether this remarkably good expression recognition is achieved through normal, or compensatory, mechanisms remains to be determined. Either way, this normal level of performance does not extend to include facial identity.

What aspects of face processing are impaired in developmental prosopagnosia?

Developmental prosopagnosia (DP) is a severe impairment in identifying faces that is present from early in life and that occurs despite no apparent brain damage and intact visual and intellectual function. Here, we investigated what aspects of face processing are impaired/spared in developmental prosopagnosia by examining a relatively large group of individuals with DP (n = 8) using an extensive battery of well-established tasks. The tasks included measures of sensitivity to global motion and to global form, detection that a stimulus is a face, determination of its sex, holistic face processing, processing of face identity based on features, contour, and the spacing of features, and judgments of attractiveness. The DP cases showed normal sensitivity to global motion and global form and performed normally on our tests of face detection and holistic processing. On the other tasks, many DP cases were impaired but there was no systematic pattern. At least half showed deficits in processing of facial identity based on either the outer contour or spacing of the internal features, and/or on judgments of attractiveness. Three of the eight were impaired in processing facial identify based on the shape of internal features. The results show that DP is a heterogeneous condition and that impairment in recognizing faces cannot be predicted by poor performance on any one measure of face processing.

Gaze behaviour in hereditary prosopagnosia

Prosopagnosia is the inability to recognize someone by the face alone in the absence of sensory or intellectual impairment. In contrast to the acquired form of prosopagnosia we studied the congenital form. Since we could recently show that this form is inherited as a simple monogenic trait we called it hereditary form. To determine whether not only face recognition and neuronal processing but also the perceptual acquisition of facial information is specific to prosopagnosia, we studied the gaze behaviour of four hereditary prosopagnosics in comparison to matched control subjects. This rarely studied form of prosopagnosia ensures that deficits are limited to face recognition. Whereas the control participants focused their gaze on the central facial features, the hereditary prosopagnosics showed a significantly different gaze behaviour. They had a more dispersed gaze and also fixated external facial features. Thus, the face recognition impairment of the hereditary prosopagnosics is reflected in their gaze behaviour.

Developmental prosopagnosia: a window to content-specific face processing

Developmental prosopagnosia is characterized by severely impaired face recognition. Individuals with this disorder, which often runs in families, have no history of brain damage and intact early visual processing systems. Recent research has also demonstrated that many developmental prosopagnosics have normal or relatively good object recognition, indicating that their impairments are not the result of deficits to a unitary visual recognition mechanism. To investigate the nature of the impaired mechanisms, extensive testing was done on an individual with especially pure face processing deficits. The results ruled out all extant explanations of prosopagnosia except one that proposed that faces are recognized by a content-specific face processing mechanism. fMRI and MEG studies show that there are a variety of neural profiles in developmental prosopagnosia, which is consistent with behavioral studies demonstrating that it is a heterogeneous disorder.

Sub-exemplar Shape Tuning in Human Face-Related Areas

Although human face recognition performance shows high selectivity, even for unfamiliar faces, the neuronal circuitry underlying this high performance is poorly understood. Two extreme alternatives can be considered: either a "labeled-line" principle, in which subtle changes in face images lead to activation of differently tuned neuronal populations, or a coarse coding principle, where the high face selectivity is coded by the relative activation of broadly tuned neurons. In this study, we set to parametrically examine the shape and selectivity profile of face-related visual areas. To that end, we applied the functional magnetic resonance (fMR)-adaptation paradigm. Unfamiliar face stimuli were morphed into sets ranging from identical faces, through subtle morphing, to completely different exemplars. The fusiform face area (FFA) revealed high face sensitivity, so that even facial images perceived as belonging to the same individual (<35%) were sufficient to produce full recovery from adaptation. Interestingly, the psychophysical detectability of facial differences paralleled the release from fMR-adaptation. These results support the labeled-line model where high sensitivity to face changes is paralleled by narrow tuning of neuronal populations selective to each face image, and they suggest that fMR-adaptation is closely related to behavior. The results bear strong implications to the nature of face-related neuronal responses.

The fusiform face area is not sufficient for face recognition: Evidence from a patient with dense prosopagnosia and no occipital face area

We tested functional activation for faces in patient D.F., who following acquired brain damage has a profound deficit in object recognition based on form (visual form agnosia) and also prosopagnosia that is undocumented to date. Functional imaging demonstrated that like our control observers, D.F. shows significantly more activation when passively viewing face compared to scene images in an area that is consistent with the fusiform face area (FFA) (p < 0.01). Control observers also show occipital face area (OFA) activation; however, whereas D.F.'s lesions appear to overlap the OFA bilaterally. We asked, given that D.F. shows FFA activation for faces, to what extent is she able to recognize faces? D.F. demonstrated a severe impairment in higher level face processing--she could not recognize face identity, gender or emotional expression. In contrast, she performed relatively normally on many face categorization tasks. D.F. can differentiate faces from non-faces given sufficient texture information and processing time, and she can do this is independent of color and illumination information. D.F. can use configural information for categorizing faces when they are presented in an upright but not a sideways orientation and given that she also cannot discriminate half-faces she may rely on a spatially symmetric feature arrangement. Faces appear to be a unique category, which she can classify even when she has no advance knowledge that she will be shown face images. Together, these imaging and behavioral data support the importance of the integrity of a complex network of regions for face identification, including more than just the FFA--in particular the OFA, a region believed to be associated with low-level processing.

Cortical correlates of face and scene inversion: a comparison

Face recognition is more strongly impaired by stimulus inversion than nonface object recognition. This phenomenon, known as the face inversion effect (FIE), suggests that the visual system contains specialized processing mechanisms that are more engaged by upright faces than by inverted faces or nonface objects. Neuroimaging and neuropsychological studies indicate that environmental scenes may also recruit specialized-purpose processing machinery but a comparable inversion effect for scenes has not been established. Here we demonstrate that both face and scene inversion lead to behavioral penalties during performance of a continuous visual matching task; however, the scene inversion effect was less robust and declined in magnitude over the course of the experiment. Scene inversion led to greater neural response in the functionally defined lateral occipital (LO) object area for inverted versus upright scenes and reduced response in the parahippocampal place area (PPA), while face inversion lead to greater response in LO and the right middle fusiform (MF) object area for inverted versus upright faces but no change in the fusiform face area (FFA). A whole-brain analysis revealed several regions that responded more strongly to either upright versus inverted faces or upright versus inverted scenes, some of which may be involved in post-recognition processing. These results demonstrate that both face and scene inversion cause a shift from specialized processing streams towards generic object-processing mechanisms; however, this shift only leads to a reliable behavioral penalty in the case of face inversion.

Voice Recognition and Cross-Modal Responses to Familiar Speakers' Voices in Prosopagnosia

Recognizing the voices of people we know does not only activate "voice areas" in the temporal lobe but also extraauditory areas including the fusiform "face area" (FFA). This cross-modal effect could reflect that individual face and voice information become specifically associated when becoming acquainted with a person. Here, we addressed whether the ability to have individual face representations 1) plays a role in voice recognition and 2) is required to observe cross-modal responses to voices in face areas. We compared speaker recognition performance and neuroimaging responses during the processing of familiar and nonfamiliar speakers' voices in a developmental prosopagnosic subject (SO) with the respective findings obtained in a group of 9 control subjects. Despite scoring worse than controls on recognition of familiar speakers' voices, SO had normal cross-modal responses in the FFA and normal connectivity between FFA and the voice regions. However, she had reduced activations in areas that usually respond to familiarity with people. An indication for the malfunctioning of her FFA was reduced connectivity of the FFA to a subset of these supramodal areas. In combination these data suggest that 1) voice recognition benefits from the ability to process faces at an individual level and 2) cross-modal association of voices and faces in the brain is achieved by a sensory binding and does not depend on a top-down mechanism subsequent to successful person recognition.