Developmental prosopagnosia: a window to content-specific face processing

Global changes in the pattern of connectivity in developmental prosopagnosia

Developmental prosopagnosia is a neurodevelopmental condition characterized by difficulties in recognizing the identity of a person from their face. While current theories of the neural basis of developmental prosopagnosia focus on the face processing network, successful recognition of face identities requires broader integration of neural signals across the whole brain. Here, we asked whether disruptions in global functional and structural connectivity contribute to the face recognition difficulties observed in developmental prosopagnosia. We found that the left temporal pole was less functionally connected to the rest of the brain in developmental prosopagnosia. This was driven by weaker contralateral connections to the middle and inferior temporal gyri, as well as to the medial prefrontal cortex. The pattern of global connectivity in the left temporal pole was also disrupted in developmental prosopagnosia. Critically, these changes in global functional connectivity were only evident when participants viewed faces. Structural connectivity analysis revealed localized reductions in connectivity between the left temporal pole and a number of regions, including the fusiform gyrus, inferior temporal gyrus, and orbitofrontal cortex. Our findings underscore the importance of whole-brain integration in supporting typical face recognition and provide evidence that disruptions in connectivity involving the left temporal pole may underlie the characteristic difficulties of developmental prosopagnosia.

Poor face recognition predicts social anxiety in autism: A short report

LAY ABSTRACT

Research has shown that some autistic people have severe difficulties in recognising other people's faces. However, little is understood about how these difficulties impact the daily life and the mental well-being of autistic people. In this study, we asked 60 autistic adults with varying degrees of face recognition ability to complete two tests of face recognition, a questionnaire about social anxiety and a bespoke survey which asked participants about their experiences of face recognition and social interaction. We found that participants who had poor face recognition reported experiencing higher levels of social anxiety compared to those with average or better face recognition skills. More than half felt that their face recognition difficulties affected their social interactions, and over a third believed it hindered their ability to make friends. These findings suggest that face recognition difficulties may contribute to social anxiety among autistic individuals.

Information sampling differences supporting superior face identity processing ability

Face recognition in humans is often cited as a model example of perceptual expertise that is characterized by an increased tendency to process faces as holistic percepts. However emerging evidence across different domains of expertise points to a critical role of feature-based processing strategies during the initial encoding of information. Here, we examined the eye-movement patterns of super-recognisers-individuals with extremely high face identification ability compared with the average person-using gaze-contingent "spotlight" apertures that restrict visual face information in real time around their point of fixation. As an additional contrast, we also compared their performance with that of facial examiners-highly trained individuals whose superiority has been shown to rely heavily on featural processing. Super-recognisers and facial examiners showed equivalent face matching accuracy in both spotlight aperture and natural viewing conditions, suggesting that they were equally adept at using featural information for face identity processing. Further, both groups sampled more information across the face than controls. Together, these results show that the active exploration of facial features is an important determinant of face recognition ability that generalizes across different types of experts.

Autistic adults have insight into their relative face recognition ability

The PI20 is a self-report questionnaire that assesses the presence of lifelong face recognition difficulties. The items on this scale ask respondents to assess their face recognition ability relative to the rest of the population, either explicitly or implicitly. Recent reports suggest that the PI20 scores of autistic participants exhibit little or no correlation with their performance on the Cambridge Face Memory Test-a key measure of face recognition ability. These reports are suggestive of a meta-cognitive deficit whereby autistic individuals are unable to infer whether their face recognition is impaired relative to the wider population. In the present study, however, we observed significant correlations between the PI20 scores of 77 autistic adults and their performance on two variants of the Cambridge Face Memory Test. These findings indicate that autistic individuals can infer whether their face recognition ability is impaired. Consistent with previous research, we observed a wide spread of face recognition abilities within our autistic sample. While some individuals approached ceiling levels of performance, others met the prevailing diagnostic criteria for developmental prosopagnosia. This variability showed little or no association with non-verbal intelligence, autism severity, or the presence of co-occurring alexithymia or ADHD.

White matter connections of human ventral temporal cortex are organized by cytoarchitecture, eccentricity, and category-selectivity from birth

Category-selective regions in ventral temporal cortex (VTC) have a consistent anatomical organization, which is hypothesized to be scaffolded by white matter connections. However, it is unknown how white matter connections are organized from birth. Here, we scanned newborn to 6-month-old infants and adults and used a data-driven approach to determine the organization of the white matter connections of VTC. We find that white matter connections are organized by cytoarchitecture, eccentricity, and category from birth. Connectivity profiles of functional regions in the same cytoarchitectonic area are similar from birth and develop in parallel, with decreases in endpoint connectivity to lateral occipital, and parietal, and somatosensory cortex, and increases to lateral prefrontal cortex. Additionally, connections between VTC and early visual cortex are organized topographically by eccentricity bands and predict eccentricity biases in VTC. These data have important implications for theories of cortical functional development and open new possibilities for understanding typical and atypical white matter development.

Familiarity enhances functional connectivity between visual and nonvisual regions of the brain during natural viewing

We explored the neural correlates of familiarity with people and places using a naturalistic viewing paradigm. Neural responses were measured using functional magnetic resonance imaging, while participants viewed a movie taken from Game of Thrones. We compared inter-subject correlations and functional connectivity in participants who were either familiar or unfamiliar with the TV series. Higher inter-subject correlations were found between familiar participants in regions, beyond the visual brain, that are typically associated with the processing of semantic, episodic, and affective information. However, familiarity also increased functional connectivity between face and scene regions in the visual brain and the nonvisual regions of the familiarity network. To determine whether these regions play an important role in face recognition, we measured responses in participants with developmental prosopagnosia (DP). Consistent with a deficit in face recognition, the effect of familiarity was significantly attenuated across the familiarity network in DP. The effect of familiarity on functional connectivity between face regions and the familiarity network was also attenuated in DP. These results show that the neural response to familiarity involves an extended network of brain regions and that functional connectivity between visual and nonvisual regions of the brain plays an important role in the recognition of people and places during natural viewing.

Perceptual heterogeneity in developmental prosopagnosia is continuous, not categorical

Developmental prosopagnosia (DP) is associated with considerable perceptual heterogeneity, though the nature of this heterogeneity and whether there are discrete subgroups versus continuous deficits remains unclear. Bennetts et al. (2022) recently found that holistic versus featural processing deficits distinguished discrete DP subgroups, but their sample was relatively small (N = 37), and subgroups were defined using a single task. To characterize perceptual heterogeneity in DPs more comprehensively, we administered a broad face perception battery to a large sample of 109 DPs and 134 controls, including validated measures of face matching (Cambridge Face Perception Test - CFPT, Computerized Benton Facial Recognition Test, Same/Different Face Matching Task), holistic processing (Part-Whole Task), and feature processing (Georges Task and Part-Whole part trials). When examining face matching measures, DPs exhibited a similar distribution of performance as controls, though shifted towards impairment by an average of 1.4 SD. We next applied Bennetts (2022) hierarchical clustering approach and k-means clustering to the CFPT upright, inverted, and inversion index measures, similarly finding one group of DPs with poorer inverted face performance and another with a decreased face inversion effect (holistic processing). However, these subgroup differences failed to generalize to other measures of feature and holistic processing beyond the CFPT. We finally ran hierarchical and k-means cluster analyses on our larger battery of face matching, feature, and holistic processing measures. Results clearly showed subgroups with generally better versus worse performance across all measures, with the distinction between groups being somewhat arbitrary. Together, these findings support a continuous account of DP perceptual heterogeneity, with performance differing primarily across all aspects of face perception.

Human genetics of face recognition: discovery of MCTP2 mutations in humans with face blindness (congenital prosopagnosia)

Face recognition is important for both visual and social cognition. While prosopagnosia or face blindness has been known for seven decades and face-specific neurons for half a century, the molecular genetic mechanism is not clear. Here we report results after 17 years of research with classic genetics and modern genomics. From a large family with 18 congenital prosopagnosia (CP) members with obvious difficulties in face recognition in daily life, we uncovered a fully cosegregating private mutation in the MCTP2 gene which encodes a calcium binding transmembrane protein expressed in the brain. After screening through cohorts of 6589, we found more CPs and their families, allowing detection of more CP associated mutations in MCTP2. Face recognition differences were detected between 14 carriers with the frameshift mutation S80fs in MCTP2 and 19 noncarrying volunteers. Six families including one with 10 members showed the S80fs-CP correlation. Functional magnetic resonance imaging found association of impaired recognition of individual faces by MCTP2 mutant CPs with reduced repetition suppression to repeated facial identities in the right fusiform face area. Our results have revealed genetic predisposition of MCTP2 mutations in CP, 76 years after the initial report of prosopagnosia and 47 years after the report of the first CP. This is the first time a gene required for a higher form of visual social cognition was found in humans.

Neural computations in prosopagnosia

We report an investigation of the neural processes involved in the processing of faces and objects of brain-lesioned patient PS, a well-documented case of pure acquired prosopagnosia. We gathered a substantial dataset of high-density electrophysiological recordings from both PS and neurotypicals. Using representational similarity analysis, we produced time-resolved brain representations in a format that facilitates direct comparisons across time points, different individuals, and computational models. To understand how the lesions in PS's ventral stream affect the temporal evolution of her brain representations, we computed the temporal generalization of her brain representations. We uncovered that PS's early brain representations exhibit an unusual similarity to later representations, implying an excessive generalization of early visual patterns. To reveal the underlying computational deficits, we correlated PS' brain representations with those of deep neural networks (DNN). We found that the computations underlying PS' brain activity bore a closer resemblance to early layers of a visual DNN than those of controls. However, the brain representations in neurotypicals became more akin to those of the later layers of the model compared to PS. We confirmed PS's deficits in high-level brain representations by demonstrating that her brain representations exhibited less similarity with those of a DNN of semantics.

Relationship between face recognition ability and anxiety tendencies in healthy young individuals: A prosopagnosia index and state-trait anxiety inventory study

Developmental prosopagnosia (DP) is a condition that indicates the inability to recognize individuals by their faces from birth, without any history of brain damage. The assessment of face recognition ability and diagnosis of DP involve the use of face tests such as the Cambridge Face Memory Test (CFMT) and the Cambridge Face Perception Test, along with self-reported measures like the 20-Item Prosopagnosia Index (PI20). Face recognition accuracy is affected by anxiety. However, previous studies on the relationship between face recognition ability and anxiety have not used the PI20 measure. This study aimed to investigate the relationship between self-reported measures of face recognition ability and anxiety tendencies among healthy young individuals for DP diagnosis and its implications. We used a face recognition test, involving the PI20, CFMT, Visual Perception Test for Agnosia-Famous Face Test (VPTA-FFT), and State-Trait Anxiety Inventory (STAI). We assessed the performance of 116 Japanese young adults (75 females, median age of 20.7 years, with a standard deviation of 1.2). Subsequently, we conducted a statistical analysis to examine the relationship between the outcomes of the face recognition tests and STAI scores using Pearson correlation analysis and single correlation coefficients. The results showed a positive correlation between state anxiety and PI20 (r = 0.308, p = 0.007), and a weak positive correlation was also observed between trait anxiety and PI20 (r = 0.268, p = 0.04). In contrast, there was no correlation between CFMT and VPTA-FFT with respect to STAI. The results of the hierarchical multiple regression analysis also suggested that the correlation between the performance on the PI20 (self-report) and objective measures of face recognition performance (the CFMT and the VPTA-FFT) are driven by differences in anxiety. This study is the first to explore the relationship between face recognition abilities and anxiety using the PI20 self-report measure. There are implications for future research on the diagnosis of DP and the relationship between anxiety and face recognition.

Binocular rivalry reveals differential face processing in congenital prosopagnosia

Congenital Prosopagnosia (CP) is an innate impairment in face perception with heterogeneous characteristics. It is still unclear if and to what degree holistic processing of faces is disrupted in CP. Such disruption would be expected to lead to a focus on local features of the face. In this study, we used binocular rivalry (BR) to implicitly measure face perception in conditions that favour holistic or local processing. The underlying assumption is that if stimulus saliency affects the perceptual dominance of a given stimulus in BR, one can deduce how salient a stimulus is for a given group (here: participants with and without CP) based on the measured perceptual dominance. A further open question is whether the deficit in face processing in CP extends to the processing of the facial display of emotions. In experiment 1, we compared predominance of upright and inverted faces displaying different emotions (fearful, happy, neutral) vs. houses between participants with CP (N = 21) and with normal face perception (N = 21). The results suggest that CP observers process emotions in faces automatically but rely more on local features than controls. The inversion of faces, which is supposed to disturb holistic processing, affected controls in a more pronounced way than participants with CP. In experiment 2, we introduced the Thatcher effect in BR by inverting the eye and mouth regions of the presented faces in the hope of further increasing the effect of face inversion. However, our expectations were not borne out by the results. Critically, both experiments showed that inversion effects were more pronounced in controls than in CP, suggesting that holistic face processing is less relevant in CP. We find BR to be a useful implicit test for assessing visual processing specificities in neurological participants.

Prosopagnosia: face blindness and its association with neurological disorders

Loss of facial recognition or prosopagnosia has been well-recognized for over a century. It has been categorized as developmental or acquired depending on whether the onset is in early childhood or beyond, and acquired cases can have degenerative or non-degenerative aetiologies. Prosopagnosia has been linked to involvement of the fusiform gyri, mainly in the right hemisphere. The literature on prosopagnosia comprises case reports and small case series. We aim to assess demographic, clinical and imaging characteristics and neurological and neuropathological disorders associated with a diagnosis of prosopagnosia in a large cohort. Patients were categorized as developmental versus acquired; those with acquired prosopagnosia were further subdivided into degenerative versus non-degenerative, based on neurological aetiology. We assessed regional involvement on [18F] fluorodeoxyglucose-PET and MRI of the right and left frontal, temporal, parietal and occipital lobes. The Intake and Referral Center at the Mayo Clinic identified 487 patients with possible prosopagnosia, of which 336 met study criteria for probable or definite prosopagnosia. Ten patients, 80.0% male, had developmental prosopagnosia including one with Niemann-Pick type C and another with a forkhead box G1 gene mutation. Of the 326 with acquired prosopagnosia, 235 (72.1%) were categorized as degenerative, 91 (27.9%) as non-degenerative. The most common degenerative diagnoses were posterior cortical atrophy, primary prosopagnosia syndrome, Alzheimer's disease dementia and semantic dementia, with each diagnosis accounting for >10% of this group. The most common non-degenerative diagnoses were infarcts (ischaemic and haemorrhagic), epilepsy-related and primary brain tumours, each accounting for >10%. We identified a group of patients with non-degenerative transient prosopagnosia in which facial recognition loss improved or resolved over time. These patients had migraine-related prosopagnosia, posterior reversible encephalopathy syndrome, delirium, hypoxic encephalopathy and ischaemic infarcts. On [18F] fluorodeoxyglucose-PET, the temporal lobes proved to be the most frequently affected regions in 117 patients with degenerative prosopagnosia, while in 82 patients with non-degenerative prosopagnosia, MRI revealed the right temporal and right occipital lobes as most affected by a focal lesion. The most common pathological findings in those with degenerative prosopagnosia were frontotemporal lobar degeneration with hippocampal sclerosis and mixed Alzheimer's and Lewy body disease pathology. In this large case series of patients diagnosed with prosopagnosia, we observed that facial recognition loss occurs across a wide range of acquired degenerative and non-degenerative neurological disorders, most commonly in males with developmental prosopagnosia. The right temporal and occipital lobes, and connecting fusiform gyrus, are key areas. Multiple different pathologies cause degenerative prosopagnosia.

Longitudinal development of category representations in ventral temporal cortex predicts word and face recognition

Regions in ventral temporal cortex that are involved in visual recognition of categories like words and faces undergo differential development during childhood. However, categories are also represented in distributed responses across high-level visual cortex. How distributed category representations develop and if this development relates to behavioral changes in recognition remains largely unknown. Here, we used functional magnetic resonance imaging to longitudinally measure the development of distributed responses across ventral temporal cortex to 10 categories in school-age children over several years. Our results reveal both strengthening and weakening of category representations with age, which was mainly driven by changes across category-selective voxels. Representations became particularly more distinct for words in the left hemisphere and for faces bilaterally. Critically, distinctiveness for words and faces across category-selective voxels in left and right lateral ventral temporal cortex, respectively, predicted individual children's word and face recognition performance. These results suggest that the development of distributed representations in ventral temporal cortex has behavioral ramifications and advance our understanding of prolonged cortical development during childhood.

The Neural Correlates of Developmental Prosopagnosia: Twenty-Five Years on

Faces play a crucial role in social interactions. Developmental prosopagnosia (DP) refers to the lifelong difficulty in recognizing faces despite the absence of obvious signs of brain lesions. In recent decades, the neural substrate of this condition has been extensively investigated. While early neuroimaging studies did not reveal significant functional and structural abnormalities in the brains of individuals with developmental prosopagnosia (DPs), recent evidence identifies abnormalities at multiple levels within DPs' face-processing networks. The current work aims to provide an overview of the convergent and contrasting findings by examining twenty-five years of neuroimaging literature on the anatomo-functional correlates of DP. We included 55 original papers, including 63 studies that compared the brain structure (MRI) and activity (fMRI, EEG, MEG) of healthy control participants and DPs. Despite variations in methods, procedures, outcomes, sample selection, and study design, this scoping review suggests that morphological, functional, and electrophysiological features characterize DPs' brains, primarily within the ventral visual stream. Particularly, the functional and anatomical connectivity between the Fusiform Face Area and the other face-sensitive regions seems strongly impaired. The cognitive and clinical implications as well as the limitations of these findings are discussed in light of the available knowledge and challenges in the context of DP.

Using representational similarity analysis to reveal category and process specificity in visual object recognition

Cross-condition comparisons on neurodevelopmental conditions are central in neurodiversity research. In the realm of visual perception, the performance of participants with different category-specific disorders such as developmental prosopagnosia (problems with faces) and dyslexia (problems with words) have contributed to understanding of perceptual processes involved in word and face recognition. Alterations in face and word recognition are present in several neurodiverse populations, and improved knowledge about their relationship may increase our understanding of this variability of impairment. The present study investigates organizing principles of visual object processing and their implications for developmental disorders of recognition. Some accounts suggest that distinct mechanisms are responsible for recognizing objects of different categories, while others propose that categories share or even compete for cortical resources. We took an individual differences approach to estimate the relationship between abilities in recognition. Neurotypical participants (N = 97 after outlier exclusion) performed a match-to-sample task with faces, houses, and pseudowords. Either individual features or feature configurations were manipulated. To estimate the separability of visual recognition mechanisms, we used representational similarity analysis (RSA) where correlational matrices for accuracy were compared to predicted data patterns. Recognition abilities separated into face recognition on one hand and house/pseudoword recognition on the other, indicating that face recognition may rely on relatively selective mechanisms in neurotypicals. We also found evidence for a general visual object recognition mechanism, while some combinations of category (faces, houses, words) and processing type (featural, configural) likely rely on additional mechanisms. Developmental conditions may therefore reflect combinations of impaired and intact aspects of specific and general visual object recognition mechanisms, where featural and configural processes for one object category separate from the featural or configural processing of another. More generally, RSA is a promising approach for advancing understanding of neurodiversity, including shared aspects and distinctions between neurodevelopmental conditions of visual recognition.

Dissociations between face identity and face expression processing in developmental prosopagnosia

Individuals with developmental prosopagnosia (DPs) experience severe and lifelong deficits recognising faces, but whether their deficits are selective to the processing of face identity or extend to the processing of face expression remains unclear. Clarifying this issue is important for understanding DP impairments and advancing theories of face processing. We compared identity and expression processing in a large sample of DPs (N = 124) using three different matching tasks that each assessed identity and expression processing with identical experimental formats. We ran each task in upright and inverted orientations and we measured inversion effects to assess the integrity of upright-specific face processes. We report three main results. First, DPs showed large deficits at discriminating identity but only subtle deficits at discriminating expression. Second, DPs showed a reduced inversion effect for identity but a normal inversion effect for expression. Third, DPs' performance on the expression tasks were linked to autism traits, but their performance on the identity tasks were not. These results constitute several dissociations between identity and expression processing in DP, and they are consistent with the view that the core impairment in DP is highly selective to identity.

Selecting police super-recognisers

People vary in their ability to recognise faces. These individual differences are consistent over time, heritable and associated with brain anatomy. This implies that face identity processing can be improved in applied settings by selecting high performers-'super-recognisers' (SRs)-but these selection processes are rarely available for scientific scrutiny. Here we report an 'end-to-end' selection process used to establish an SR 'unit' in a large police force. Australian police officers (n = 1600) completed 3 standardised face identification tests and we recruited 38 SRs from this cohort to complete 10 follow-up tests. As a group, SRs were 20% better than controls in lab-based tests of face memory and matching, and equalled or surpassed accuracy of forensic specialists that currently perform face identification tasks for police. Individually, SR accuracy was variable but this problem was mitigated by adopting strict selection criteria. SRs' superior abilities transferred only partially to body identity decisions where the face was not visible, and they were no better than controls at deciding which visual scene that faces had initially been encountered in. Notwithstanding these important qualifications, we conclude that super-recognisers are an effective solution to improving face identity processing in applied settings.

Recognition of animal faces is impaired in developmental prosopagnosia

An on-going debate in psychology and neuroscience concerns the way faces and objects are represented. Domain-specific theories suggest that faces are processed via a specialised mechanism, separate from objects. Developmental prosopagnosia (DP) is a neurodevelopmental disorder in which there is a deficit in the ability to recognize conspecific (human) faces. It is unclear, however, whether prosopagnosia also affects recognition of heterospecific (animal) faces. To address this question, we compared recognition performance with human and animal faces in neurotypical controls and participants with DP. We found that DPs showed deficits in the recognition of both human and animal faces compared to neurotypical controls. In contrast to, we found no group-level deficit in the recognition of animate or inanimate non-face objects in DPs. Using an individual-level approach, we demonstrate that in 60% of cases in which face recognition is impaired, there is a concurrent deficit with animal faces. Together, these results show that DPs have a general deficit in the recognition of faces that encompass a range of configural and morphological structures.

Do subtle cultural differences sculpt face pareidolia?

Face tuning to non-face images such as shadows or grilled toasts is termed face pareidolia. Face-pareidolia images represent a valuable tool for investigation of social cognition in mental disorders. Here we examined (i) whether, and, if so, how face pareidolia is affected by subtle cultural differences; and (ii) whether this impact is modulated by gender. With this purpose in mind, females and males from Northern Italy were administered a set of Face-n-Thing images, photographs of objects such as houses or waves to a varying degree resembling a face. Participants were presented with pareidolia images with canonical upright orientation and display inversion that heavily affects face pareidolia. In a two-alternative forced-choice paradigm, beholders had to indicate whether each image resembled a face. The outcome was compared with the findings obtained in the Southwest of Germany. With upright orientation, neither cultural background nor gender affected face pareidolia. As expected, display inversion generally mired face pareidolia. Yet, while display inversion led to a drastic reduction of face impression in German males as compared to females, in Italians, no gender differences were found. In a nutshell, subtle cultural differences do not sculpt face pareidolia, but instead affect face impression in a gender-specific way under unusual viewing conditions. Clarification of the origins of these effects requires tailored brain imaging work. Implications for transcultural psychiatry, in particular, for schizophrenia research, are highlighted and discussed.

Self-reported face recognition abilities moderately predict face-learning skills: Evidence from Italian samples

Face Recognition Ability (FRA) varies widely throughout the population. Previous research highlights a positive relationship between self-perceived and objectively measured FRA in the healthy population, suggesting that people do have insight into their FRA. Given that this relationship has not been investigated in Italian samples yet, the main aim of the present work was to develop an Italian translation of the Prosopagnosia Index-20 (PI-20), a self-report measure of FRA, to investigate the relationship between PI-20 performances and an objective assessment given by the Cambridge Face Memory Test Long Form (CFMT+) in the Italian population. A sample of 553 participants filled in the PI-20 Italian version 1 or 2 (PI-20_GE or PI-20_BA) and completed the CFMT+. Results showed a negative correlation between both versions of the Italian PI-20 and CFMT+ scores, meaning that the more self-evaluations were negative, the worse they objectively performed. The same results applied to the extreme limits of the distribution (i.e., 10% of the highest and lowest PI-20 scores). Furthermore, both age and administration order of the tests were predictor variables of CFMT+ scores. Overall, our results suggest that people possess insight, although relatively limited, into their FRA.

The Danish Version of the 20-Item Prosopagnosia Index (PI20): Translation, Validation and a Link to Face Perception

Developmental prosopagnosia (DP) is a neurodevelopmental condition characterized by face recognition problems. Psychometrically sound self-report measures of face recognition problems are important tools in classification of DP. A widely used measure of such problems is the 20-item prosopagnosia index (PI20). Here, we present a Danish translation of the PI20 (PI20_DK). We administered the PI20_DK alongside three objective measures of face and object processing performance to 119 participants to validate the PI20_DK. Further, we assess the underlying factor structure of the PI20_DK. Finally, as the first study in the field, we investigate the association between self-reported face recognition ability and face perception performance. The project was preregistered prior to data collection. The results suggest excellent convergent validity, discriminant validity and internal consistency for the PI20_DK. A confirmatory factor analysis, however, indicates a suboptimal fit of the PI20_DK to a one factor solution. An investigation of the association between the PI20_DK and face perception suggests that the poor fit may reflect that the PI20_DK measures problems with face recognition in general and not specifically face memory problems.

Preference for horizontal information in faces predicts typical variations in face recognition but is not impaired in developmental prosopagnosia

Face recognition is strongly influenced by the processing of orientation structure in the face image. Faces are much easier to recognize when they are filtered to include only horizontally oriented information compared with vertically oriented information. Here, we investigate whether preferences for horizontal information in faces are related to face recognition abilities in a typical sample (Experiment 1), and whether such preferences are lacking in people with developmental prosopagnosia (DP; Experiment 2). Experiment 1 shows that preferences for horizontal face information are linked to face recognition abilities in a typical sample, with weak evidence of face-selective contributions. Experiment 2 shows that preferences for horizontal face information are comparable in control and DP groups. Our study suggests that preferences for horizontal face information are related to variations in face recognition abilities in the typical range, and that these preferences are not aberrant in DP.

Multiple-stage impairments of unfamiliar face learning in developmental prosopagnosia: Evidence from fMRI repetition suppression and multi-voxel pattern stability

Individuals with developmental prosopagnosia (DP) are characterized by severe face recognition deficits, yet it remains unknown how they are hindered in the process of unfamiliar face learning. Here we tracked the changes of neural activation during unfamiliar face repetition in DP with fMRI to reveal their neural deficits in learning unfamiliar faces. At the perceptual level, we found that the bilateral fusiform face area (FFA) in individuals with DP showed attenuated repetition suppression for faces, suggesting an inefficient perceptual analysis for learned faces. At the mnemonic level, individuals with DP showed decreased multi-voxel pattern stability for repeated faces in bilateral medial temporal lobe (MTL), suggesting an unstable mnemonic representation for learned faces. In addition, resting-state functional connectivity between the FFA and MTL was also disrupted in individuals with DP. Finally, the MTL's unstable mnemonic representation was associated with the impaired face recognition performance in DP. In sum, our study provides evidence that individuals with DP showed multi-stage neural deficits in unfamiliar face learning and sheds new light on how unfamiliar faces are learned in normal population.

New evidence of impaired expression recognition in developmental prosopagnosia

Developmental prosopagnosia (DP) is a neurodevelopmental condition characterized by lifelong face recognition difficulties. To date, it remains unclear whether or not individuals with DP experience impaired recognition of facial expressions. It has been proposed that DPs may have sufficient perceptual ability to correctly interpret facial expressions when tasks are relatively easy (e.g., the stimuli are unambiguous and viewing conditions are optimal), but exhibit subtle impairments when tested under more challenging conditions. In the present study, we sought to take advantage of the COVID-19 pandemic to test this view. It is well-established that the surgical-type masks worn during the pandemic hinder the recognition and interpretation of facial emotion in typical participants. Relative to typical participants, we hypothesized that DPs may be disproportionately impaired when asked to interpret the facial emotion of people wearing face masks. We compared the ability of 34 DPs and 60 age-matched typical controls to recognize facial emotions i) when the whole face is visible, and ii) when the lower portion of the face is covered with a surgical mask. When expression stimuli were viewed without a mask, the DPs and typical controls exhibited similar levels of performance. However, when expression stimuli were shown with a mask, the DPs showed signs of subtle expression recognition deficits. The DPs were particularly prone to mislabeling masked expressions of happiness as emotion neutral. These results add to a growing body of evidence that under some conditions, DPs do exhibit subtle deficits of expression recognition.

The influence of familiarity on memory for faces and mask wearing

During the COVID-19 pandemic, the wearing of face masks became mandatory in public areas or at workplaces in many countries. While offering protection, the coverage of large parts of our face (nose, mouth and chin) may have consequences for face recognition. This seems especially important in the context of contact tracing which can require memory of familiar and unfamiliar contacts and whether they were wearing a mask. In this study, we tested how well participants perform at remembering faces and whether they wore a mask, and if this depends on familiarity. Our results show that: (a) Participants remembered familiar faces better than unfamiliar ones, regardless of mask wearing. (b) Participants remembered unmasked faces better than masked faces, regardless of familiarity. (c) Participants were significantly worse at remembering whether an unfamiliar face was wearing a mask or not-even if they indicated remembering the face. (d) Participants showed a bias to indicate no memory of unfamiliar faces. (e) Participants showed a bias to indicate that unfamiliar faces wore a mask, even if they did not. In sum, it was harder to remember both, the identity of unfamiliar faces and whether they wore a mask. These findings have practical relevance for contact tracing and epidemic control.

Impaired grouping of ambient facial images in autism

Ambient facial images depict individuals from a variety of viewing angles, with a range of poses and expressions, under different lighting conditions. Exposure to ambient images is thought to help observers form robust representations of the individuals depicted. Previous results suggest that autistic people may derive less benefit from exposure to this exemplar variation than non-autistic people. To date, however, it remains unclear why. One possibility is that autistic individuals possess atypical perceptual learning mechanisms. Alternatively, however, the learning mechanisms may be intact, but receive low-quality perceptual input from face encoding processes. To examine this second possibility, we investigated whether autistic people are less able to group ambient images of unfamiliar individuals based on their identity. Participants were asked to identify which of four ambient images depicted an oddball identity. Each trial assessed the grouping of different facial identities, thereby preventing face learning across trials. As such, the task assessed participants’ ability to group ambient images of unfamiliar people. In two experiments we found that matched non-autistic controls correctly identified the oddball identities more often than our autistic participants. These results imply that poor face learning from variation by autistic individuals may well be attributable to low-quality perceptual input, not aberrant learning mechanisms.

Is It Just Face Blindness? Exploring Developmental Comorbidity in Individuals with Self-Reported Developmental Prosopagnosia

Developmental prosopagnosia (DP)—or ‘face blindness’—refers to life-long problems with facial recognition in the absence of brain injury. We know that neurodevelopmental disorders tend to co-occur, and this study aims to explore if individuals with self-reported DP also report indications of other neurodevelopmental disorders, deficits, or conditions (developmental comorbidity). In total, 115 individuals with self-reported DP participated in this online cross-sectional survey. Face recognition impairment was measured with a validated self-report instrument. Indications of difficulties with navigation, math, reading, or spelling were measured with a tailored questionnaire using items from published sources. Additional diagnoses were measured with direct questions. We also included open-ended questions about cognitive strengths and difficulties. Results: Overall, 57% reported at minimum one developmental comorbidity of interest, with most reflecting specific cognitive impairment (e.g., in memory or object recognition) rather than diagnostic categories (e.g., ADHD, dyslexia). Interestingly, many participants reported cognitive skills or strengths within the same domains that others reported impairment, indicating a diverse pattern of cognitive strengths and difficulties in this sample. The frequency and diversity of self-reported developmental comorbidity suggests that face recognition could be important to consider in future investigations of neurodevelopmental comorbidity patterns.

EXPRESS: Distinct abilities associated with matching same identity faces vs. discriminating different faces: Evidence from individual differences in prosopagnosics and controls

Previous face matching studies provide evidence that matching same identity faces (match trials) and discriminating different face identities (non-match trials) rely on distinct processes. For example, instructional studies geared towards improving face matching in applied settings have often found selective improvements in match or non-match trials only. Additionally, a small study found that developmental prosopagnosics (DPs) have specific deficits in making match but not non-match judgments. In the current study, we sought to replicate this finding in DPs and examine how individual differences across DPs and controls in match vs. non-match performance relate to featural vs. holistic processing abilities. 43 DPs and 27 controls matched face images shown from similar front views or with varied lighting or viewpoint. Participants also performed tasks measuring featural (eyes/mouth) and holistic processing (part-whole task). We found that DPs showed worse overall matching performance than controls and that their relative match vs. non-match deficit depended on image variation condition, indicating that DPs do not consistently show match- or non-match-specific deficits. When examining the association between holistic and featural processing abilities and match vs. non-match trials in the entire group of DPs and controls, we found a very clear dissociation: Match trials significantly correlated with eye processing ability (r=.48) but not holistic processing (r=.11), whereas non-match trials significantly correlated with holistic processing (r=.32) but not eye processing (r=.03). This suggests that matching same identity faces relies more on eye processing while discriminating different faces relies more on holistic processing.

Domain-specific connectivity drives the organization of object knowledge in the brain

The goal of this chapter is to review neuropsychological and functional MRI findings that inform a theory of the causes of functional specialization for semantic categories within occipito-temporal cortex-the ventral visual processing pathway. The occipito-temporal pathway supports visual object processing and recognition. The theoretical framework that drives this review considers visual object recognition through the lens of how "downstream" systems interact with the outputs of visual recognition processes. Those downstream processes include conceptual interpretation, grasping and object use, navigating and orienting in an environment, physical reasoning about the world, and inferring future actions and the inner mental states of agents. The core argument of this chapter is that innately constrained connectivity between occipito-temporal areas and other regions of the brain is the basis for the emergence of neural specificity for a limited number of semantic domains in the brain.

Neurocognitive effects of a training program for poor face recognizers using shape and texture caricatures: A pilot investigation

Recent research suggested disproportional usage of shape information by people with poor face recognition, although texture information appears to be more important for familiar face recognition. Here, we tested a training program with faces that were selectively caricatured in either shape or texture parameters. Forty-eight young adults with poor face recognition skills (1 SD below the mean in at least 2/3 face processing tests: CFMT, GFMT, BFFT) were pseudo-randomly assigned to either one of two training groups or a control group (n = 16 each). Training comprised six sessions over three weeks. Per session, participants studied ten unfamiliar facial identities whose shape or texture characteristics were caricatured. Before and after training (or waiting in the control group), all participants completed EEG experiments on face learning and famous face recognition, and behavioral face processing tests. Results showed small but specific training-induced improvements: Whereas shape training improved face matching (training tasks, and to some extent GFMT), texture training elicited marked improvements in face learning (CFMT). Moreover, for the texture training group the N170 ERP was enhanced for novel faces post-training, suggesting training-induced changes in early markers of face processing. Although further research is necessary, this suggests that parameter-specific caricature training is a promising way to improve performance in people with poor face recognition skills.

Cortical recycling in high-level visual cortex during childhood development

Human ventral temporal cortex contains category-selective regions that respond preferentially to ecologically relevant categories such as faces, bodies, places and words and that are causally involved in the perception of these categories. How do these regions develop during childhood? We used functional magnetic resonance imaging to measure longitudinal development of category selectivity in school-age children over 1 to 5 years. We discovered that, from young childhood to the teens, face- and word-selective regions in ventral temporal cortex expand and become more category selective, but limb-selective regions shrink and lose their preference for limbs. Critically, as a child develops, increases in face and word selectivity are directly linked to decreases in limb selectivity, revealing that during childhood, limb selectivity in ventral temporal cortex is repurposed into word and face selectivity. These data provide evidence for cortical recycling during childhood development. This has important implications for understanding typical as well as atypical brain development and necessitates a rethinking of how cortical function develops during childhood.

Why is the literature on first impressions so focused on White faces?

We spontaneously attribute to strangers a wide variety of character traits based on their facial appearance. While these first impressions have little or no basis in reality, they exert a strong influence over our behaviour. Cognitive scientists have revealed a great deal about first impressions from faces including their factor structure, the cues on which they are based, the neurocognitive mechanisms responsible, and their developmental trajectory. In this field, authors frequently strive to remove as much ethnic variability from stimulus sets as possible. Typically, this convention means that participants are asked to judge the likely traits of White faces only. In the present article, we consider four possible reasons for the lack of facial diversity in this literature and find that it is unjustified. Next, we illustrate how the focus on White faces has undermined scientific efforts to understand first impressions from faces and argue that it reinforces socially regressive ideas about 'race' and status. We go on to articulate our concern that opportunities may be lost to leverage the knowledge derived from the study of first impressions against the dire consequences of prejudice and discrimination. Finally, we highlight some promising developments in the field.

Developmental prosopagnosics and super recognizers rely on the same facial features used by individuals with normal face recognition abilities for face identification

Face recognition depends on the ability of the face processing system to extract facial features that define the identity of a face. In a recent study we discovered that altering a subset of facial features changed the identity of the face, indicating that they are critical for face identification. Changing another set of features did not change the identity of a face, indicating that they are not critical for face identification. In the current study, we assessed whether developmental prosopagnosics (DPs) and super recognizers (SRs) also rely more heavily on these critical features than non-critical features for face identification. To that end, we presented to DPs and SRs faces in which either the critical or the non-critical features were manipulated. In Study 1, we presented SRs with a famous face recognition task. We found that overall SRs recognized famous faces that differ in either critical or non-critical features better than controls. Similar to controls, changes in critical features had a larger effect on SRs' face recognition than changes in non-critical features. In Study 2, we presented an identity matching task to DPs and SRs. Similar to controls, DPs and SRs perceived faces that differed in critical features as more different than faces that differed in non-critical features. Taken together, our results indicate that SRs and DPs use the same critical features for face identification as normal individuals. These findings emphasize the fundamental role of this subset of features for face identification.

Professional Versus Self-Applied Makeup: Do Makeup Artists Add Value?

While a number of studies have investigated the effects of makeup on how people are perceived, the vast majority have used professionally applied makeup. Here, we tested the hypothesis that professional makeup is more effective than self-applied makeup. We photographed the same target women under controlled conditions wearing no makeup, makeup they applied themselves, and makeup applied by professional makeup artists. Participants rated the faces as appearing more attractive, more feminine, and as having higher status when wearing professional makeup than self-applied makeup. Secondarily, we found that participants perceived the professional makeup as appearing heavier and less natural looking than the self-applied makeup. This work shows that professional makeup is more effective than self-applied makeup and begins to elucidate the nature of makeup artistry. We discuss these findings with respect to personal decoration and physical attractiveness, as well as the notion of artists as experts.

Separate and Shared Neural Basis of Face Memory and Face Perception in Developmental Prosopagnosia

Developmental prosopagnosia (DP), also known as face blindness, is a cognitive disorder with a severe deficit in recognizing faces. However, the heterogeneous nature of DP leads to a longstanding debate on which stages the deficit occurs, face perception (e.g., matching two consecutively presented faces) or face memory (e.g., matching a face to memorized faces). Here, we used the individual difference approach with functional magnetic resonance imaging to explore the neural substrates of DPs' face perception and face memory that may illuminate DPs' heterogeneity. Specifically, we measured the behavioral performance of face perception and face memory in a large sample of individuals suffering DP (N = 64) and then associated the behavioral performance with their face-selective neural responses in the core face network (CFN) and the extended face network (EFN), respectively. Behaviorally, we found that DP individuals were impaired in both face perception and face memory; however, there was only a weak correlation between the performances of two tasks. Consistent with this observation, the neural correlate of DPs' performance in face memory task was localized in the bilateral fusiform face area, whereas DPs' performance in face perception task was correlated with the face selectivity in the right posterior superior temporal sulcus, suggesting that the neural substrates in the CFN for face memory and face perception were separate in DP. In contrast, shared neural substrates of deficits in face perception and face memory tasks were identified in the EFN, including the right precuneus and the right orbitofrontal cortex. In summary, our study provides one of the first empirical evidence that the separate and shared neural substrates of face perception and face memory were identified in the CFN and EFN, respectively, which may help illuminating DP's heterogeneous nature.

The Oxford Face Matching Test: A non-biased test of the full range of individual differences in face perception

Tests of face processing are typically designed to identify individuals performing outside of the typical range; either prosopagnosic individuals who exhibit poor face processing ability, or super recognisers, who have superior face processing abilities. Here we describe the development of the Oxford Face Matching Test (OFMT), designed to identify individual differences in face processing across the full range of performance, from prosopagnosia, through the range of typical performance, to super recognisers. Such a test requires items of varying difficulty, but establishing difficulty is problematic when particular populations (e.g., prosopagnosics, individuals with autism spectrum disorder) may use atypical strategies to process faces. If item difficulty is calibrated on neurotypical individuals, then the test may be poorly calibrated for atypical groups, and vice versa. To obtain items of varying difficulty, we used facial recognition algorithms to obtain face pair similarity ratings that are not biased towards specific populations. These face pairs were used as stimuli in the OFMT, and participants were required to judge whether the face images depicted the same individual or different individuals. Across five studies the OFMT was shown to be sensitive to individual differences in the typical population, and in groups of both prosopagnosic individuals and super recognisers. The test-retest reliability of the task was at least equivalent to the Cambridge Face Memory Test and the Glasgow Face Matching Test. Furthermore, results reveal, at least at the group level, that both face perception and face memory are poor in those with prosopagnosia, and are good in super recognisers.

Spatial Integration in Normal Face Processing and Its Breakdown in Congenital Prosopagnosia

Congenital prosopagnosia (CP), a life-long impairment in face processing that occurs in the absence of any apparent brain damage, provides a unique model in which to explore the psychological and neural bases of normal face processing. The goal of this review is to offer a theoretical and conceptual framework that may account for the underlying cognitive and neural deficits in CP. This framework may also provide a novel perspective in which to reconcile some conflicting results that permits the expansion of the research in this field in new directions. The crux of this framework lies in linking the known behavioral and neural underpinnings of face processing and their impairments in CP to a model incorporating grid cell-like activity in the entorhinal cortex. Moreover, it stresses the involvement of active, spatial scanning of the environment with eye movements and implicates their critical role in face encoding and recognition. To begin with, we describe the main behavioral and neural characteristics of CP, and then lay down the building blocks of our proposed model, referring to the existing literature supporting this new framework. We then propose testable predictions and conclude with open questions for future research stemming from this model. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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.

The COVID-19 pandemic masks the way people perceive faces

The unprecedented efforts to minimize the effects of the COVID-19 pandemic introduce a new arena for human face recognition in which faces are partially occluded with masks. Here, we tested the extent to which face masks change the way faces are perceived. To this end, we evaluated face processing abilities for masked and unmasked faces in a large online sample of adult observers (n = 496) using an adapted version of the Cambridge Face Memory Test, a validated measure of face perception abilities in humans. As expected, a substantial decrease in performance was found for masked faces. Importantly, the inclusion of masks also led to a qualitative change in the way masked faces are perceived. In particular, holistic processing, the hallmark of face perception, was disrupted for faces with masks, as suggested by a reduced inversion effect. Similar changes were found whether masks were included during the study or the test phases of the experiment. Together, we provide novel evidence for quantitative and qualitative alterations in the processing of masked faces that could have significant effects on daily activities and social interactions.

Normal recognition of famous voices in developmental prosopagnosia

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

Evidence for normal novel object recognition abilities in developmental prosopagnosia

The issue of the face specificity of recognition deficits in developmental prosopagnosia (DP) is fundamental to the organization of high-level visual memory and has been increasingly debated in recent years. Previous DP investigations have found some evidence of object recognition impairments, but have almost exclusively used familiar objects (e.g. cars), where performance may depend on acquired object-specific experience and related visual expertise. An object recognition test not influenced by experience could provide a better, less contaminated measure of DPs' object recognition abilities. To investigate this, in the current study we tested 30 DPs and 30 matched controls on a novel object memory test (NOMT Ziggerins) and the Cambridge Face Memory Test (CFMT). DPs with severe impairment on the CFMT showed no differences in accuracy or reaction times compared with controls on the NOMT. We found similar results when comparing DPs with a larger sample of 274 web-based controls. Additional individual analyses demonstrated that the rate of object recognition impairment in DPs did not differ from the rate of impairment in either control group. Together, these results demonstrate unimpaired object recognition in DPs for a class of novel objects that serves as a powerful index for broader novel object recognition capacity.

Holistic processing of facial identity in developmental prosopagnosia

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

Multi-Item Discriminability Pattern to Faces in Developmental Prosopagnosia Reveals Distinct Mechanisms of Face Processing

Previous studies have shown that individuals with developmental prosopagnosia (DP) show specific deficits in face processing. However, the mechanism underlying the deficits remains largely unknown. One hypothesis suggests that DP shares the same mechanism as normal population, though their faces processing is disproportionally impaired. An alternative hypothesis emphasizes a qualitatively different mechanism of DP processing faces. To test these hypotheses, we instructed DP and normal individuals to perceive faces and objects. Instead of calculating accuracy averaging across stimulus items, we used the discrimination accuracy for each item to construct a multi-item discriminability pattern. We found DP's discriminability pattern was less similar to that of normal individuals when perceiving faces than perceiving objects, suggesting that DP has qualitatively different mechanism in representing faces. A functional magnetic resonance imaging study was conducted to reveal the neural basis and found that multi-voxel activation patterns for faces in the right fusiform face area and occipital face area of DP were deviated away from the mean activation pattern of normal individuals. Further, the face representation was more heterogeneous in DP, suggesting that deficits of DP may come from multiple sources. In short, our study provides the first direct evidence that DP processes faces qualitatively different from normal population.

The discrimination of facial sex in developmental prosopagnosia

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

Looking beyond the face area: lesion network mapping of prosopagnosia

Damage to the right fusiform face area can disrupt the ability to recognize faces, a classic example of how damage to a specialized brain region can disrupt a specialized brain function. However, similar symptoms can arise from damage to other brain regions, and face recognition is now thought to depend on a distributed brain network. The extent of this network and which regions are critical for facial recognition remains unclear. Here, we derive this network empirically based on lesion locations causing clinically significant impairments in facial recognition. Cases of acquired prosopagnosia were identified through a systematic literature search and lesion locations were mapped to a common brain atlas. The network of brain regions connected to each lesion location was identified using resting state functional connectivity from healthy participants (n = 1000), a technique termed lesion network mapping. Lesion networks were overlapped to identify connections common to lesions causing prosopagnosia. Reproducibility was assessed using split-half replication. Specificity was assessed through comparison with non-specific control lesions (n = 135) and with control lesions associated with symptoms other than prosopagnosia (n = 155). Finally, we tested whether our facial recognition network derived from clinically evident cases of prosopagnosia could predict subclinical facial agnosia in an independent lesion cohort (n = 31). Our systematic literature search identified 44 lesions causing prosopagnosia, only 29 of which intersected the right fusiform face area. However, all 44 lesion locations fell within a single brain network defined by connectivity to the right fusiform face area. Less consistent connectivity was found to other face-selective regions. Surprisingly, all 44 lesion locations were also functionally connected, through negative correlation, with regions in the left frontal cortex. This connectivity pattern was highly reproducible and specific to lesions causing prosopagnosia. Positive connectivity to the right fusiform face area and negative connectivity to left frontal regions were independent predictors of prosopagnosia and predicted subclinical facial agnosia in an independent lesion cohort. We conclude that lesions causing prosopagnosia localize to a single functionally connected brain network defined by connectivity to the right fusiform face area and to left frontal regions. Implications of these findings for models of facial recognition deficits are discussed.

Cross-cultural analysis of attention disengagement times supports the dissociation of faces and patterns in the infant brain

Infants are slower to disengage from faces than non-face patterns when distracted by novel competing stimuli. While this perceptual predilection for faces is well documented, its universality and mechanisms in relation to other aspects of attention are poorly understood. We analysed attention disengagement times for faces and non-face patterns in a large sample of 6-to 9-month-old infants (N = 637), pooled from eye tracking studies in socioculturally diverse settings (Finland, Malawi, South Africa). Disengagement times were classified into distinct groups of quick and delayed/censored responses by unsupervised clustering. Delayed disengagement was frequent for faces (52.1% of trials), but almost negligible for patterns (3.9% of trials) in all populations. The magnitude of this attentional bias varied by individuals, whereas the impact of situational factors and facial expression was small. Individual variations in disengagement from faces were moderately stable within testing sessions and independent from variations in disengagement times for patterns. These results point to a fundamental dissociation of face and pattern processing in infants and demonstrate that the bias for faces can be robust against distractors and habituation. The results raise the possibility that attention to faces varies as an independent, early-emerging social trait in populations.