Structure and function in acquired prosopagnosia: lessons from a series of 10 patients with brain damage

Visual mechanisms for voice-identity recognition flexibly adjust to auditory noise level

Recognising the identity of voices is a key ingredient of communication. Visual mechanisms support this ability: recognition is better for voices previously learned with their corresponding face (compared to a control condition). This so‐called ‘face‐benefit’ is supported by the fusiform face area (FFA), a region sensitive to facial form and identity. Behavioural findings indicate that the face‐benefit increases in noisy listening conditions. The neural mechanisms for this increase are unknown. Here, using functional magnetic resonance imaging, we examined responses in face‐sensitive regions while participants recognised the identity of auditory‐only speakers (previously learned by face) in high (SNR −4 dB) and low (SNR +4 dB) levels of auditory noise. We observed a face‐benefit in both noise levels, for most participants (16 of 21). In high‐noise, the recognition of face‐learned speakers engaged the right posterior superior temporal sulcus motion‐sensitive face area (pSTS‐mFA), a region implicated in the processing of dynamic facial cues. The face‐benefit in high‐noise also correlated positively with increased functional connectivity between this region and voice‐sensitive regions in the temporal lobe in the group of 16 participants with a behavioural face‐benefit. In low‐noise, the face‐benefit was robustly associated with increased responses in the FFA and to a lesser extent the right pSTS‐mFA. The findings highlight the remarkably adaptive nature of the visual network supporting voice‐identity recognition in auditory‐only listening conditions.

Separated and overlapping neural coding of face and body identity

Recognising a person's identity often relies on face and body information, and is tolerant to changes in low‐level visual input (e.g., viewpoint changes). Previous studies have suggested that face identity is disentangled from low‐level visual input in the anterior face‐responsive regions. It remains unclear which regions disentangle body identity from variations in viewpoint, and whether face and body identity are encoded separately or combined into a coherent person identity representation. We trained participants to recognise three identities, and then recorded their brain activity using fMRI while they viewed face and body images of these three identities from different viewpoints. Participants' task was to respond to either the stimulus identity or viewpoint. We found consistent decoding of body identity across viewpoint in the fusiform body area, right anterior temporal cortex, middle frontal gyrus and right insula. This finding demonstrates a similar function of fusiform and anterior temporal cortex for bodies as has previously been shown for faces, suggesting these regions may play a general role in extracting high‐level identity information. Moreover, we could decode identity across fMRI activity evoked by faces and bodies in the early visual cortex, right inferior occipital cortex, right parahippocampal cortex and right superior parietal cortex, revealing a distributed network that encodes person identity abstractly. Lastly, identity decoding was consistently better when participants attended to identity, indicating that attention to identity enhances its neural representation. These results offer new insights into how the brain develops an abstract neural coding of person identity, shared by faces and bodies.

Intracerebral electrical stimulation to understand the neural basis of human face identity recognition

Recognizing people's identity by their faces is a key function in the human species, supported by regions of the ventral occipito-temporal cortex (VOTC). In the last decade, there have been several reports of perceptual face distortion during direct electrical stimulation (DES) with subdural electrodes positioned over a well-known face-selective VOTC region of the right lateral middle fusiform gyrus (LatMidFG; i.e., the "Fusiform Face Area", FFA). However, transient impairments of face identity recognition (FIR) have been extremely rare and only behaviorally quantified during DES with intracerebral (i.e., depth) electrodes in stereo-electroencephalography (SEEG). The three detailed cases reported so far, summarized here, were specifically impaired at FIR during DES inside different anatomical VOTC regions of the right hemisphere: the inferior occipital gyrus (IOG) and the LatMidFG, as well as a region that lies at the heart of a large magnetic susceptibility artifact in functional magnetic resonance imaging (fMRI): the anterior fusiform gyrus (AntFG). In the first two regions, the eloquent electrode contacts were systematically associated with the highest face-selective and (unfamiliar) face individuation responses as measured with intracerebral electrophysiology. Stimulation in the right AntFG did not lead to perceptual changes but also caused an inability to remember having been presented face pictures, as if the episode was never recorded in memory. These observations support the view of an extensive network of face-selective VOTC regions subtending human FIR, with at least three critical nodes in the right hemisphere associated with differential intrinsic and extrinsic patterns of reentrant connectivity.

Multi-modal Mapping of the Face Selective Ventral Temporal Cortex-A Group Study With Clinical Implications for ECS, ECoG, and fMRI

Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation (ECS), electrocorticography (ECoG), and functional magnetic resonance imagining (fMRI). This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest (ROI), which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations.

A Probabilistic Functional Atlas of Human Occipito-Temporal Visual Cortex

Human visual cortex contains many retinotopic and category-specific regions. These brain regions have been the focus of a large body of functional magnetic resonance imaging research, significantly expanding our understanding of visual processing. As studying these regions requires accurate localization of their cortical location, researchers perform functional localizer scans to identify these regions in each individual. However, it is not always possible to conduct these localizer scans. Here, we developed and validated a functional region of interest (ROI) atlas of early visual and category-selective regions in human ventral and lateral occipito-temporal cortex. Results show that for the majority of functionally defined ROIs, cortex-based alignment results in lower between-subject variability compared to nonlinear volumetric alignment. Furthermore, we demonstrate that 1) the atlas accurately predicts the location of an independent dataset of ventral temporal cortex ROIs and other atlases of place selectivity, motion selectivity, and retinotopy. Next, 2) we show that the majority of voxel within our atlas is responding mostly to the labeled category in a left-out subject cross-validation, demonstrating the utility of this atlas. The functional atlas is publicly available (download.brainvoyager.com/data/visfAtlas.zip) and can help identify the location of these regions in healthy subjects as well as populations (e.g., blind people, infants) in which functional localizers cannot be run.

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.

Delayed diagnosis of prosopagnosia following a hemorrhagic stroke in an elderly man: A case report

BACKGROUND

Acquired prosopagnosia is a rare condition characterized by the loss of familiarity with previously known faces and the inability to recognize new ones. It usually occurs after the onset of brain lesions such as in a stroke. The initial identification of prosopagnosia generally relies on a patient’s self-report, which can be challenging if it lacks an associated chief complaint. There were few cases of prosopagnosia presenting purely as eye symptoms in the previous literature confirmed by functional magnetic resonance imaging (MRI).

CASE SUMMARY

We present a case of delayed diagnosis of prosopagnosia after a right hemisphere stroke in an elderly man whose chief complaint was persistent and progressive "blurred vision" without facial recognition impairment. Ophthalmic tests revealed a homonymous left upper quadrantanopia, with normal visual acuity. He was found by accident to barely recognize familiar faces. The patient showed severe deficit in face recognition and perception tests, and mild memory loss in neuropsychological assessments. Further functional MRI revealed the visual recognition deficits were face-specific. After behavioral intervention, the patient started to rely on other cues to compensate for poor facial recognition. His prosopagnosia showed no obvious improvement eight months after the stroke, which had negative impact on his social network.

CONCLUSION

Our case demonstrates that the presentation of prosopagnosia can be atypical, and visual difficulties might be a clinical manifestation solely of prosopagnosia, which emphasizes the importance of routinely considering face recognition impairment among elderly patients with brain lesions.

Impact of visual impairment following stroke (IVIS study): a prospective clinical profile of central and peripheral visual deficits, eye movement abnormalities and visual perceptual deficits

AIM

This study evaluates the spectrum of visual impairment in stroke survivors.

METHODS

The Impact of Visual Impairment after Stroke (IVIS) study is a multi-centre, acute stroke unit, prospective epidemiology study. Comprehensive visual examination was offered to all stroke survivors.

RESULTS

1500 stroke admissions were recruited. 1204 stroke survivors had visual assessment. Reduced central vision was documented in 529, visual field loss in 308, ocular motility abnormalities in 533 stroke survivors, visual perception deficits in 59 stroke survivors and visual inattention in 315 stroke survivors. About half, regardless of visual impairment type, were visually asymptomatic. Recovery, whether full or partial, was best for central vision, ocular motility abnormalities and visual perception deficits (about 70% improvement) occurring over a mean follow-up period of 2-3 months.

CONCLUSIONS

Incidence of impaired central vision, visual field loss, ocular motility disorders and visual inattention was 29.4%, 24.8%, 39.3% and 26.2% respectively. Visual impairment was more likely to occur in more severe stroke and older stroke survivors. Asymptomatic cases raise concerns for acute stroke units where robust specialist vision screening is not routine. Those with partial/no recovery require specialist follow-up and management whilst the wide range of abnormalities highlight the need for specialist visual assessment acutely.Implications for rehabilitationVisual impairment is a common consequence of stroke.Incidence of visual impairment is about 60%.Significant numbers of stroke survivors are visually asymptomatic, highlighting the need for standardised vision assessments.Many stroke survivors have persistent long-term visual impairment, necessitating referral and access to specialist eye care services.

Alternating dual-task interference between visual words and faces

The many-to-many hypothesis proposes that face and visual word recognition share and even compete for high-level perceptual resources in both hemispheres. However, it is still not clear whether the processing performed by the two hemispheres on faces and visual words is equivalent or complementary. We performed an alternating dual-task experiment to determine if the processing of visual words and faces interfered with each other, and if such interference depended upon the stimulus attribute being processed. Subjects saw a series of alternating stimuli and made same-different judgments comparing the current stimulus with the one two trials before. In some blocks faces or visual words alternated with colored gratings, in other blocks they alternated between different sets of words or different sets of faces. In the key experimental blocks they alternated between visual words and faces. Subjects were also asked to focus on different properties of the stimuli (identity or speech sounds for faces, handwriting or word content for visual words, color or orientation for gratings). There was no evidence of specific interference when subjects alternated between face and word attributes thought to be processed by opposite hemispheres (e.g. face identity and word identity, facial speech and handwriting). Rather interference occurred when subjects alternated between attributes that may be processed by the same hemisphere. The results support a modified version of the many-to-many hypothesis which takes into account complementary functions of the left and the right hemispheres in the processing of faces and visual words.

Developmental Prosopagnosia and Elastic Versus Static Face Recognition in an Incidental Learning Task

Previous research on the beneficial effect of motion has postulated that learning a face in motion provides additional cues to recognition. Surprisingly, however, few studies have examined the beneficial effect of motion in an incidental learning task and developmental prosopagnosia (DP) even though such studies could provide more valuable information about everyday face recognition compared to the perception of static faces. In the current study, 18 young adults (Experiment 1) and five DPs and 10 age-matched controls (Experiment 2) participated in an incidental learning task during which both static and elastically moving unfamiliar faces were sequentially presented and were to be recognized in a delayed visual search task during which the faces could either keep their original presentation or switch (from static to elastically moving or vice versa). In Experiment 1, performance in the elastic-elastic condition reached a significant improvement relative to the elastic-static and static-elastic condition, however, no significant difference could be detected relative to the static-static condition. Except for higher scores in the elastic-elastic compared to the static-elastic condition in the age-matched group, no other significant differences were detected between conditions for both the DPs and the age-matched controls. The current study could not provide compelling evidence for a general beneficial effect of motion. Age-matched controls performed generally worse than DPs, which may potentially be explained by their higher rates of false alarms. Factors that could have influenced the results are discussed.

Posterior Fusiform and Midfusiform Contribute to Distinct Stages of Facial Expression Processing

Though the fusiform is well-established as a key node in the face perception network, its role in facial expression processing remains unclear, due to competing models and discrepant findings. To help resolve this debate, we recorded from 17 subjects with intracranial electrodes implanted in face sensitive patches of the fusiform. Multivariate classification analysis showed that facial expression information is represented in fusiform activity and in the same regions that represent identity, though with a smaller effect size. Examination of the spatiotemporal dynamics revealed a functional distinction between posterior fusiform and midfusiform expression coding, with posterior fusiform showing an early peak of facial expression sensitivity at around 180 ms after subjects viewed a face and midfusiform showing a later and extended peak between 230 and 460 ms. These results support the hypothesis that the fusiform plays a role in facial expression perception and highlight a qualitative functional distinction between processing in posterior fusiform and midfusiform, with each contributing to temporally segregated stages of expression perception.

Typical visual unfamiliar face individuation in left and right mesial temporal epilepsy

Patients with chronic mesial temporal lobe epilepsy have difficulties at identifying familiar faces as well as at explicit old/new face recognition tasks. However, the extent to which these difficulties can be attributed to visual individuation of faces, independently of general explicit learning and semantic memory processes, is unknown. We tested 42 mesial temporal lobe epilepsy patients divided into two groups according to the side of epilepsy (left and right) and 42 matched controls on an extensive series of individuation tasks of unfamiliar faces and control visual stimuli, as well as on face detection, famous face recognition and naming, and face and non-face learning. Overall, both patient groups had difficulties at identifying and naming famous faces, and at explicitly learning face and non-face images. However, there was no group difference in accuracy between patients and controls at the two most widely used neuropsychological tests assessing visual individuation of unfamiliar faces (Benton Facial Recognition Test and Cambridge Face Memory Test). While patients with right mesial temporal lobe epilepsy were slowed down at all tasks, this effect was not specific to faces or even high-level stimuli. Importantly, both groups showed the same profile of response as typical participants across various stimulus manipulations, showing no evidence of qualitative processing impairments. Overall, these results point to largely preserved visual face individuation processes in patients with mesial temporal lobe epilepsy, with semantic and episodic memory difficulties being consistent with the localization of the neural structures involved in their epilepsy (anterior temporal cortex and hippocampus). These observations have implications for the prediction of neuropsychological outcomes in the case of surgery and support the validity of intracranial electroencephalographic recordings performed in this population to understand neural mechanisms of human face individuation, notably through intracranial electrophysiological recordings and stimulations.

Selective defects of face familiarity associated to a left temporo-occipital lesion

Acquired prosopagnosia is usually a consequence of bilateral or right hemisphere lesions and is often associated with topographical disorientation and dyschromatopsia. Left temporo-occipital lesions sometimes result in a face recognition disorder but in a context of visual object agnosia with spared familiarity feelings for faces, usually in left-handers. We describe a patient with a left temporo-occipital hemorrhagic lesion unexpectedly resulting in a deficit of face familiarity, which could represent a mild form of associative prosopagnosia. Our patient failed to feel familiarity feelings even with very well-known famous faces but had neither visual object agnosia nor defects with semantics or naming of celebrities. This was confirmed even when the patient was re-tested a year later. We speculate that a graded lateralization of face processing could be at the basis of occasional cases of prosopagnosia.

Interrogating an ICD-coded electronic health records database to characterize the epidemiology of prosopagnosia

INTRODUCTION

Recognition of faces of family members, friends, and colleagues is an important skill essential for everyday life. Individuals affected by prosopagnosia (face blindness) have difficulty recognizing familiar individuals. The prevalence of prosopagnosia has been estimated to be as high as 3%. Prosopagnosia can severely impact the quality of life of those affected, and it has been suggested to co-occur with conditions such as depression and anxiety.

METHODS

To determine real-world diagnostic frequency of prosopagnosia and the spectrum of its comorbidities, we utilized a large database of more than 7.5 million de-identified electronic health records (EHRs) from patients who received care at major academic health centers and Federally Qualified Health Centers in New York City. We designed a computable phenotype to search the database for diagnosed cases of prosopagnosia, revealing a total of n = 902 cases. In addition, data from a randomly sampled matched control population (n = 100,973) were drawn from the database for comparative analyses to study the condition's comorbidity landscape. Diagnostic frequency of prosopagnosia, epidemiological characteristics, and comorbidity landscape were assessed.

RESULTS

We observed prosopagnosia diagnoses at a rate of 0.012% (12 per 100,000 individuals). We discovered elevated frequency of prosopagnosia diagnosis for individuals who carried certain comorbid conditions, such as personality disorder, depression, epilepsy, and anxiety. Moreover, prosopagnosia diagnoses increased with the number of comorbid conditions.

CONCLUSIONS

Results from this study show a wide range of comorbidities and suggest that prosopagnosia is vastly underdiagnosed. Findings imply important clinical consequences for the diagnosis and management of prosopagnosia as well as its comorbid conditions.

Naming famous people through face and voice: a normative study

OBJECTIVES

Within the large topic of naming disorders, an important and separated chapter belongs to proper names. Defects of proper naming could be a selective linguistic problem. Sometimes, it includes names belonging to various kinds of semantically unique entities, but other times, it has been observed for famous people proper names only. According to Bruce and Young's model, different stages allow to recognize, identify, and name famous people from their faces and voices, subsuming different anatomical pathways, both in right temporal lobe, and their different efficiency in this task. The present study aimed to report the normative data concerning the naming of the same famous people from voice and face.

SUBJECTS AND METHODS

One hundred fifty-three normal subjects underwent a test in which they were requested to name famous people from their face and from their voice. The stimuli belonged to the previously published Famous People Recognition Battery.

RESULTS

The mean percentage score on naming from face was 84.42 ± 12.03% (range 55.26-100%) and the mean percentage score on naming from voice was 66.04 ± 16.81% (range 28.13-100%). The difference observed in performance by face and by voice resulted significant (t|₁₅₃ = 15.973; p < 0.001). Regression analyses showed that the percentage score obtained on naming from faces was predicted by education, whereas naming from voice was predicted by education and gender.

DISCUSSION

Naming from voice is more difficult than from face, confirming a different difficulty of the two tasks. Education showed high predicting value for faces and less for voices, whereas gender contributed to predict results only for voices.

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.

Multisensory stimulation modulates perceptual and post perceptual face representations: Evidence from event-related potentials

Seeing a face being touched in spatial and temporal synchrony with the own face produces a bias in self-recognition, whereby the other face becomes more likely to be perceived as the self. The present study employed event-related potentials to explore whether this enfacement effect reflects initial face encoding, enhanced distinctiveness of the enfaced face, modified self-identity representations, or even later processing stages that are associated with the emotional processing of faces. Participants were stroked in synchrony or asynchrony with an unfamiliar face they observed on a monitor in front of them, in a situation approximating a mirror image. Subsequently, event-related potentials were recorded during the presentation of (a) a previously synchronously stimulated face, (b) an asynchronously stimulated face, (c) observers' own face, (d) filler faces, and (e) a to-be-detected target face, which required a response. Observers reported a consistent enfacement illusion after synchronous stimulation. Importantly, the synchronously stimulated face elicited more prominent N170 and P200 responses than the asynchronously stimulated face. By contrast, similar N250 and P300 responses were observed in these conditions. These results suggest that enfacement modulates early neural correlates of face encoding and facial prototypicality, rather than identity self-representations and associated emotional processes.

The Scanpaths of Subjects with Developmental Prosopagnosia during a Face Memory Task

The scanpaths of healthy subjects show biases towards the upper face, the eyes and the center of the face, which suggests that their fixations are guided by a feature hierarchy towards the regions most informative for face identification. However, subjects with developmental prosopagnosia have a lifelong impairment in face processing. Whether this is reflected in the loss of normal face-scanning strategies is not known. The goal of this study was to determine if subjects with developmental prosopagnosia showed anomalous scanning biases as they processed the identity of faces. We recorded the fixations of 10 subjects with developmental prosopagnosia as they performed a face memorization and recognition task, for comparison with 8 subjects with acquired prosopagnosia (four with anterior temporal lesions and four with occipitotemporal lesions) and 20 control subjects. The scanning of healthy subjects confirmed a bias to fixate the upper over the lower face, the eyes over the mouth, and the central over the peripheral face. Subjects with acquired prosopagnosia from occipitotemporal lesions had more dispersed fixations and a trend to fixate less informative facial regions. Subjects with developmental prosopagnosia did not differ from the controls. At a single-subject level, some developmental subjects performed abnormally, but none consistently across all metrics. Scanning distributions were not related to scores on perceptual or memory tests for faces. We conclude that despite lifelong difficulty with faces, subjects with developmental prosopagnosia still have an internal facial schema that guides their scanning behavior.

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.

Visual search for complex objects: Set-size effects for faces, words and cars

To compare visual processing for different object types, we developed visual search tests that generated accuracy and response time parameters, including an object set-size effect that indexes perceptual processing load. Our goal was to compare visual search for two expert object types, faces and visual words, as well as a less expert type, cars. We first asked if faces and words showed greater inversion effects in search. Second, we determined whether search with upright stimuli correlated with other perceptual indices. Last we assessed for correlations between tests within a single orientation, and between orientations for a single object type. Object set-size effects were smaller for faces and words than cars. All accuracy and temporal measures showed an inversion effect for faces and words, but not cars. Face-search accuracy measures correlated with accuracy on the Cambridge Face Memory Test and word-search temporal measures correlated with single-word reading times, but car search did not correlate with semantic car knowledge. There were cross-orientation correlations for all object types, as well as cross-object correlations in the inverted orientation, while in the upright orientation face search did not correlate with word or car search. We conclude that object search shows effects of expertise. Compared to cars, words and faces showed smaller object set-size effects, greater inversion effects, and their search results correlated with other indices of perceptual expertise. The correlation analyses provide preliminary evidence supporting contributions from common processes in the case of inverted stimuli, object-specific processes that operate in both orientations, and distinct processing for upright faces.

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.

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.

Face perception: A brief journey through recent discoveries and current directions

Faces are a rich source of information about the people around us. Identity, state of mind, emotions, intentions, age, gender, ethnic background, attractiveness and a host of other attributes about an individual can be gleaned from a face. When face perception fails, dramatic psycho-social consequences can follow at the individual level, as in the case of prosopagnosic parents who are unable to recognize their children at school pick-up. At the species level, social interaction patterns are shaped by human face perception abilities. The computational feat of recognizing faces and facial attributes, and the challenges overcome by the human brain to achieve this feat, have fascinated generations of vision researchers. In this paper, we present a brief overview of some of the milestones of discovery as well as outline a selected set of current directions and open questions on this topic.

Anodal tDCS and High-Frequency tRNS Targeting the Occipitotemporal Cortex Do Not Always Enhance Face Perception

There has been increasing interest in the utility of transcranial electrical stimulation as a tool to enhance cognitive abilities. In the domain of face perception, enhancements have been reported for both transcranial direct current stimulation (tDCS) and high-frequency transcranial random noise stimulation (tRNS) targeting the occipitotemporal cortex. In a series of two experiments, we attempted to replicate these findings for face identity perception, and extend on previous studies, to determine if similar enhancements are also observed for object and facial expression perception. In Experiment 1, using a single blind, between-subjects design in healthy volunteers (N = 53), we examined whether anodal tDCS over the occipitotemporal cortex enhanced performance on tasks involving perception of face identity, facial expression, and object stimuli, when compared to sham stimulation. We failed to replicate previous findings of enhanced performance on face and object perception, nor extend findings to facial expression perception. In Experiment 2, using a single blind, between-subjects design (N = 39), we examined the effect of high-frequency tRNS over the occipitotemporal cortex using the same three tasks employed in Experiment 1. We failed to replicate previous findings of enhanced face perception following high-frequency tRNS over the occipitotemporal cortex, relative to sham stimulation (although we used different stimulation parameters to that employed in a previous study). We also found no evidence of enhanced facial expression and object perception following high-frequency tRNS. The findings align with a growing body of studies that have failed to replicate previously reported enhancements following administration of tDCS and hint for different efficacy of, on first sight, related stimulation protocols. Future studies should explore the foundation of these differential effects in greater detail.

Perception of musical pitch in developmental prosopagnosia

Studies of developmental prosopagnosia have often shown that developmental prosopagnosia differentially affects human face processing over non-face object processing. However, little consideration has been given to whether this condition is associated with perceptual or sensorimotor impairments in other modalities. Comorbidities have played a role in theories of other developmental disorders such as dyslexia, but studies of developmental prosopagnosia have often focused on the nature of the visual recognition impairment despite evidence for widespread neural anomalies that might affect other sensorimotor systems. We studied 12 subjects with developmental prosopagnosia with a battery of auditory tests evaluating pitch and rhythm processing as well as voice perception and recognition. Overall, three subjects were impaired in fine pitch discrimination, a prevalence of 25% that is higher than the estimated 4% prevalence of congenital amusia in the general population. This was a selective deficit, as rhythm perception was unaffected in all 12 subjects. Furthermore, two of the three prosopagnosic subjects who were impaired in pitch discrimination had intact voice perception and recognition, while two of the remaining nine subjects had impaired voice recognition but intact pitch perception. These results indicate that, in some subjects with developmental prosopagnosia, the face recognition deficit is not an isolated impairment but is associated with deficits in other domains, such as auditory perception. These deficits may form part of a broader syndrome which could be due to distributed microstructural anomalies in various brain networks, possibly with a common theme of right hemispheric predominance.

Praising others differently: neuroanatomical correlates to individual differences in trait gratitude and elevation

Differing from basic emotions such as happiness, gratitude and elevation are important other-praising emotions. Previous behavioral studies have established that these complex emotions differ from each other; however, it remains under-investigated whether proneness to these emotions have common or distinct neuroanatomical correlates. Here we used voxel-based morphometry to identify the common and distinct neuroanatomical correlates of trait (i.e. proneness to) gratitude and elevation. We used the Gratitude Questionnaire-6 and the trait elevation scale to measure these affective traits. We demonstrated that trait gratitude was positively correlated with gray matter volume (GMV) in the left cerebellum extending to fusiform gyrus, and also the right middle occipital gyrus (MOG) extending to posterior superior temporal sulcus (pSTS) and temporoparietal junction (TPJ), while trait elevation was negatively correlated with GMV in the left dorsolateral prefrontal cortex. While controlling each other, all the regions still held significant, except the right MOG and pSTS/TPJ. The results indicate that there are distinct neuroanatomical correlates for proneness to gratitude and elevation, while the evidence is mixed that pSTS/TPJ may be the common correlates for them. The implications of these findings are discussed.

Use-inspired basic research on individual differences in face identification: implications for criminal investigation and security

This journal is dedicated to "use-inspired basic research" where a problem in the world shapes the hypotheses for study in the laboratory. This review considers the role of individual variation in face identification and the challenges and opportunities this presents in security and criminal investigations. We show how theoretical work conducted on individual variation in face identification has, in part, been stimulated by situations presented in the real world. In turn, we review the contribution of theoretical work on individual variation in face processing and how this may help shape the practical identification of faces in applied situations. We consider two cases in detail. The first case is that of security officers; gatekeepers who use facial ID to grant entry or deny access. One applied example, where much research has been conducted, is passport control officers who are asked to match a person in front of them to a photograph shown on their ID. What happens if they are poor at making such face matching decisions and can they be trained to improve their performance? Second, we outline the case of "super-recognisers", people who are excellent at face recognition. Here it is interesting to consider whether these individuals can be strategically allocated to security and criminal roles, to maximise the identification of suspects. We conclude that individual differences are one of the largest documented sources of error in face matching and face recognition but more work is needed to account for these differences within theoretical models of face processing.

Individual differences in face identity processing

We investigated the relationships between individual differences in different aspects of face-identity processing, using the Glasgow Face Matching Test (GFMT) as a measure of unfamiliar face perception, the Cambridge Face Memory Test (CFMT) as a measure of new face learning, and the Before They Were Famous task (BTWF) as a measure of familiar face recognition. These measures were integrated into two separate studies examining the relationship between face processing and other tasks. For Study 1 we gathered participants' subjective ratings of their own face perception abilities. In Study 2 we used additional measures of perceptual and cognitive abilities, and personality factors to place individual differences in a broader context. Performance was significantly correlated across the three face-identity tasks in both studies, suggesting some degree of commonality of underlying mechanisms. For Study 1 the participants' self-ratings correlated poorly with performance, reaching significance only for judgements of familiar face recognition. In Study 2 there were few associations between face tasks and other measures, with task-level influences seeming to account for the small number of associations present. In general, face tasks correlated with each other, but did not show an overall relation with other perceptual, cognitive or personality tests. Our findings are consistent with the existence of a general face-perception factor, able to account for around 25% of the variance in scores. However, other relatively task-specific influences are also clearly operating.

How many faces do people know?

Over our species history, humans have typically lived in small groups of under a hundred individuals. However, our face recognition abilities appear to equip us to recognize very many individuals, perhaps thousands. Modern society provides access to huge numbers of faces, but no one has established how many faces people actually know. Here, we describe a method for estimating this number. By combining separate measures of recall and recognition, we show that people know about 5000 faces on average and that individual differences are large. Our findings offer a possible explanation for large variation in identification performance. They also provide constraints on understanding the qualitative differences between perception of familiar and unfamiliar faces-a distinction that underlies all current theories of face recognition.

The Fusiform and Occipital Face Areas Can Process a Nonface Category Equivalently to Faces

The fusiform and occipital face areas (FFA and OFA) are functionally defined brain regions in human ventral occipitotemporal cortex associated with face perception. There is an ongoing debate, however, whether these regions are face-specific or whether they also facilitate the perception of nonface object categories. Here, we present evidence that, under certain conditions, bilateral FFA and OFA respond to a nonface category equivalently to faces. In two fMRI sessions, participants performed same–different judgments on two object categories (faces and chairs). In one session, participants differentiated between distinct exemplars of each category, and in the other session, participants differentiated between exemplars that differed only in the shape or spatial configuration of their features (featural/configural differences). During the latter session, the within-category similarity was comparable for both object categories. When differentiating between distinct exemplars of each category, bilateral FFA and OFA responded more strongly to faces than to chairs. In contrast, during featural/configural difference judgments, bilateral FFA and OFA responded equivalently to both object categories. Importantly, during featural/configural difference judgments, the magnitude of activity within FFA and OFA evoked by the chair task predicted the participants' behavioral performance. In contrast, when participants differentiated between distinct chair exemplars, activity within these face regions did not predict the behavioral performance of the chair task. We conclude that, when the within-category similarity of a face and a nonface category is comparable and when the same cognitive strategies used to process a face are applied to a nonface category, the FFA and OFA respond equivalently to that nonface category and faces.

A neuronal retuning hypothesis of sentence-specificity in Broca's area

It is clear that the left inferior frontal gyrus (LIFG) contributes in some fashion to sentence processing. While neuroimaging and neuropsychological evidence support a domain-general working memory function, recent neuroimaging data show that particular subregions of the LIFG, particularly the pars triangularis (pTri), show selective activation for sentences relative to verbal working memory and cognitive control tasks. These data suggest a language-specific function rather than a domain-general one. To resolve this apparent conflict, I propose separating claims of domain-generality and specificity independently for computations and representations-a given brain region may respond to a specific representation while performing a general computation over that representation, one shared with other systems. I hypothesize that the pTri underlies a language-specific working memory system, comprised of general memory retrieval/attention operations specialized for syntactic representations. There is a parallelism of top-down retrieval function among the phonological and semantic levels, localized to the pars opercularis and pars orbitalis, respectively. I further explore the idea of how such a system emerges in the human brain through the framework of neuronal retuning: the "borrowing" of domain-general mechanisms for language, either in evolution or development. The empirical data appear to tentatively support a developmental account of language-specificity in the pTri, possibly through connections to the posterior superior temporal sulcus (pSTS), a region that is both anatomically distinct for humans and functionally essential for language. Evidence of representational response specificity obtained from neuroimaging studies is useful in understanding how cognition is implemented in the brain. However, understanding the shared computations across domains and neural systems is necessary for a fuller understanding of this problem, providing potential answers to questions of how specialized systems, such as language, are implemented in the brain.

Adults’ Markers of Face Processing Are Present at Age 6 and Are Interconnected Along Development

Recent studies on the development of face processing argue for a late, quantitative, domain-specific development of face processing, and face memory in particular. Most previous findings were based on separately tracking the developmental course of face perception skills, comparing performance across different age groups. Here, we adopted a different approach studying the mechanisms underlying the development of face processing by focusing on how different face skills are interrelated over the years (age 6 to adulthood). Specifically, we examined correlations within and between different categories of tasks: face domain-specific skills involving face recognition based on long-term representations (famous face), and short-term memory retention (Cambridge Face Memory Test), perceptual face-specific marker (inversion effect), global effects in scene perception (global–local task), and the perception of facial expressions. Factor analysis revealed that face identity skills have a similar pattern of interrelations throughout development, identifying two factors: a face domain-specific factor comprising adultlike markers of face processing and a general factor incorporating related, but nonspecific perceptual skills. Domain-specific age-related changes in face recognition entailing short- and long-term retention of face representations were observed, along with mature perceptual face-specific markers and more general perceptual effects predicting face perception skills already at age 6. The results suggest that the domain-specific changes in face processing are unlikely to result from developmental changes in perceptual skills driving face recognition. Instead, development may either involve improvement in the ability to retain face representations in memory or changes in the interactions between the perceptual representations of faces and their representations in long-term memory.

Damasio's error - Prosopagnosia with intact within-category object recognition

The sudden inability to recognize individual faces following brain damage was first reported in a scientific journal 150 years ago and termed 'prosopagnosia' 70 years ago. While the term originally identified a face-selective neurological condition, it is now obscured by a sequence of imprecisions. First, prosopagnosia is routinely used to define symptoms of individual face recognition (IFR) difficulties in the context of visual object agnosia or other neurological conditions, or even in the normal population. Second, this over-expansive definition has lent support to a long-standing within-category recognition account of prosopagnosia, that is, that the impairment of IFR reflects a general impairment in recognizing within-category objects. However, stringent experimental studies of classical cases of prosopagnosia following brain damage show that their core impairment is not in recognizing physically similar exemplars within non-face object categories. Instead, the impairment presents specifically for recognizing exemplars of the category of faces. Moreover, compared to typical observers, the impairment appears even more severe for recognizing individual faces against physically dissimilar than similar distractors. Here, I argue that we need to limit accordingly our definition of prosopagnosia to a clinical (i.e., neurological) condition in which there is no basic-level object recognition impairment. Other criteria for prosopagnosia are proposed, with the hope that this conservative definition enables the study of human IFR processes in isolation, and supports progress in understanding the nature of these processes.

Split-brain patients: Visual biases for faces

Split-brain patients constitute a small subpopulation of epileptic patients who have received the surgical resection of the callosal fibers in an attempt to reduce the spread of epileptic foci between the cerebral hemispheres. The study of callosotomy patients allowed neuropsychologists to investigate the effects of the hemispheric disconnection, shedding more light on the perceptual and cognitive abilities of each hemisphere in isolation. This view that callosotomy completely isolates the hemispheres has now been revised, in favor of the idea of a dynamic functional reorganization of the two sides of the brain; however, the evidence collected from split-brain patients is still a milestone in the neurosciences. The right-hemispheric superiority found in the healthy population concerning face perception has been further supported with split-brains, and it has been shown that the right disconnected hemisphere appears superior to the left hemisphere in recognizing and processing faces with similar characteristics as the observers' (e.g., gender, identity, etc.). Even more controversial is the field of hemispheric asymmetries for processing facial emotion, some evidence suggesting a right-hemispheric superiority for all emotions, some others showing a complementary hemispheric asymmetry depending on the positive or negative emotional valence. Although the practice of callosotomy is mostly abandoned today in favor of pharmacological alternatives, further studies on the remaining split-brain patients could help advance our understanding of hemispheric specialization for social stimuli.