Implications of recent findings for current cognitive models of familiar people recognition

Perceptual and semantic deficits in face recognition in semantic dementia

State of the art

Semantic dementia (SD) patients including semantic variant primary progressive aphasia (svPPA) and semantic behavioral variant frontotemporal dementia (sbvFTD) patients show semantic difficulties identifying faces and known people related to right anterior temporal lobe (ATL) atrophy. However, it remains unclear whether they also have perceptual deficits in face recognition.

Methodology

We selected 74 SD patients (54 with svPPA and predominant left ATL atrophy and 20 with sbvFTD and predominant right ATL atrophy) and 36 cognitively healthy controls (HC) from UCSF Memory and Aging Center. They underwent a perceptual face processing test (Benton facial recognition test-short version; BFRT-S), and semantic face processing tests (UCSF Famous people battery - Recognition, Naming, Semantic associations - pictures and words subtests), as well as structural magnetic resonance imaging (MRI). Neural correlates with the task's performance were conducted with a Voxel-based morphometry approach using CAT12.

Results

svPPA and sbvFTD patients were impaired on all semantic face processing tests, with sbvFTD patients performing significantly lower on the famous faces' recognition task in comparison to svPPA, and svPPA performing significantly lower on the naming task in comparison to sbvFTD. These tasks predominantly correlated with gray matter (GM) volumes in the right and left ATL, respectively. Compared to HC, both svPPA and sbvFTD patients showed preserved performance on the perceptual face processing test (BFRT-S), and performance on the BFRT-S negatively correlated with GM volume in the right posterior superior temporal sulcus (pSTS).

Conclusion

Our results suggest that early in the disease, with the atrophy mostly restricted to the anterior temporal regions, SD patients do not present with perceptual deficits. However, more severe SD cases with atrophy in right posterior temporal regions might show lower performance on face perception tests, in addition to the semantic face processing deficits. Early sparing of face perceptual deficits in SD patients, regardless of hemispheric lateralization, furthers our understanding of clinical phenomenology and therapeutical approaches of this complex disease.

Familiarity Is Key: Exploring the Effect of Familiarity on the Face-Voice Correlation

Recent research has examined the extent to which face and voice processing are associated by virtue of the fact that both tap into a common person perception system. However, existing findings do not yet fully clarify the role of familiarity in this association. Given this, two experiments are presented that examine face-voice correlations for unfamiliar stimuli (Experiment 1) and for familiar stimuli (Experiment 2). With care being taken to use tasks that avoid floor and ceiling effects and that use realistic speech-based voice clips, the results suggested a significant positive but small-sized correlation between face and voice processing when recognizing unfamiliar individuals. In contrast, the correlation when matching familiar individuals was significant and positive, but much larger. The results supported the existing literature suggesting that face and voice processing are aligned as constituents of an overarching person perception system. However, the difference in magnitude of their association here reinforced the view that familiar and unfamiliar stimuli are processed in different ways. This likely reflects the importance of a pre-existing mental representation and cross-talk within the neural architectures when processing familiar faces and voices, and yet the reliance on more superficial stimulus-based and modality-specific analysis when processing unfamiliar faces and voices.

A descriptive study on misidentifications of a person as a familiar person in an everyday situation

The purpose of this study is to show the characteristics of person misidentifications, that is, experiences in which persons are misidentified as known persons. A total of 121 participants were asked how many times they misidentified persons in the last year and details of a recent person misidentification were recorded through a traditional questionnaire. Additionally, they answered questions in a diary method questionnaire, about the details of person misidentification each time they experienced it, during the two-week survey period. The questionnaires revealed that the participants misidentified both known and unknown persons as familiar persons approximately six (traditional questionnaire) or 19 (diary method) times a year on average, regardless of whether they expected the persons to be there. They were more likely to misidentify a person as a familiar than as a less familiar person. It was also shown that the similarity of the faces of the person actually seen and the person they were mistaken for was not as high as the similarities of build and clothing. This study is expected to provide suggestions for models of person identification and enhance the research on errors.

COVID-19 and hospital restrictions: physical disconnection and digital re-connection in disorders of consciousness

Purpose: The coronavirus disease 2019 (COVID-19) pandemic forced hospitals to adopt tighter restrictions, the most impacting is no access to visitors. Disorder of consciousness (DOC) due to severe acquired brain injury is a condition needing neurorehabilitation and the role of relatives is essential, hence besides physical "disconnection" digital "re-connection" is crucial. We aimed to assess whether digital communication benefits in patients with DOC, considering the sensorial and emotional deprivation due to the COVID-19 emergency lock-down.Methods: For eleven consecutive patients with DOC admitted to our Intensive Neurorehabilitation Care (mean age: 45; females: 9), two observers registered neurobehavioral changes during a video-calls with their relatives. Heart-rate variability was measured before and during the calls. The video-call was performed by using two displays of different sizes: tablet (T-video-call) and large screen (LS-Video-call).Results: The video-calls impacted on the patients' vigilance and in the relationship with relatives. Moreover, positively impacted on their relatives. The current results showed significant greater impact on patients during the LS-video-call than when they are exposed to T-video-call.Conclusions: During the COVID-19 pandemic, besides the physical disconnection to stop the contagion spread, a "digital re-connection" is needed for all and especially for fragile population groups as patients with DOC.

The processing of intimately familiar and unfamiliar voices: Specific neural responses of speaker recognition and identification

Research has repeatedly shown that familiar and unfamiliar voices elicit different neural responses. But it has also been suggested that different neural correlates associate with the feeling of having heard a voice and knowing who the voice represents. The terminology used to designate these varying responses remains vague, creating a degree of confusion in the literature. Additionally, terms serving to designate tasks of voice discrimination, voice recognition, and speaker identification are often inconsistent creating further ambiguities. The present study used event-related potentials (ERPs) to clarify the difference between responses to 1) unknown voices, 2) trained-to-familiar voices as speech stimuli are repeatedly presented, and 3) intimately familiar voices. In an experiment, 13 participants listened to repeated utterances recorded from 12 speakers. Only one of the 12 voices was intimately familiar to a participant, whereas the remaining 11 voices were unfamiliar. The frequency of presentation of these 11 unfamiliar voices varied with only one being frequently presented (the trained-to-familiar voice). ERP analyses revealed different responses for intimately familiar and unfamiliar voices in two distinct time windows (P2 between 200-250 ms and a late positive component, LPC, between 450-850 ms post-onset) with late responses occurring only for intimately familiar voices. The LPC present sustained shifts, and short-time ERP components appear to reflect an early recognition stage. The trained voice equally elicited distinct responses, compared to rarely heard voices, but these occurred in a third time window (N250 between 300-350 ms post-onset). Overall, the timing of responses suggests that the processing of intimately familiar voices operates in two distinct steps of voice recognition, marked by a P2 on right centro-frontal sites, and speaker identification marked by an LPC component. The recognition of frequently heard voices entails an independent recognition process marked by a differential N250. Based on the present results and previous observations, it is proposed that there is a need to distinguish between processes of voice "recognition" and "identification". The present study also specifies test conditions serving to reveal this distinction in neural responses, one of which bears on the length of speech stimuli given the late responses associated with voice identification.

Neurophysiological evidence for crossmodal (face-name) person-identity representation in the human left ventral temporal cortex

Putting a name to a face is a highly common activity in our daily life that greatly enriches social interactions. Although this specific person-identity association becomes automatic with learning, it remains difficult and can easily be disrupted in normal circumstances or neurological conditions. To shed light on the neural basis of this important and yet poorly understood association between different input modalities in the human brain, we designed a crossmodal frequency-tagging paradigm coupled to brain activity recording via scalp and intracerebral electroencephalography. In Experiment 1, 12 participants were presented with variable pictures of faces and written names of a single famous identity at a 4-Hz frequency rate while performing an orthogonal task. Every 7 items, another famous identity appeared, either as a face or a name. Robust electrophysiological responses were found exactly at the frequency of identity change (i.e., 4 Hz / 7 = 0.571 Hz), suggesting a crossmodal neural response to person identity. In Experiment 2 with twenty participants, two control conditions with periodic changes of identity for faces or names only were added to estimate the contribution of unimodal neural activity to the putative crossmodal face-name responses. About 30% of the response occurring at the frequency of crossmodal identity change over the left occipito-temporal cortex could not be accounted for by the linear sum of unimodal responses. Finally, intracerebral recordings in the left ventral anterior temporal lobe (ATL) in 7 epileptic patients tested with this paradigm revealed a small number of "pure" crossmodal responses, i.e., with no response to changes of identity for faces or names only. Altogether, these observations provide evidence for integration of verbal and nonverbal person identity-specific information in the human brain, highlighting the contribution of the left ventral ATL in the automatic retrieval of face-name identity associations.

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.

Anatomical connections underlying personally-familiar face processing

Familiar face processing involves face specific regions (the core face system) as well as other non-specific areas related to processing of person-related information (the extended face system). The connections between core and extended face system areas must be critical for face recognition. Some studies have explored the connectivity pattern of unfamiliar face responding area, but none have explored those areas related to face familiarity processing in the extended system. To study these connections, diffusion weighted imaging with probabilistic tractography was used to estimate the white-matter pathways between core and extended system regions, which were defined from functional magnetic resonance imaging responses to personally-familiar faces. Strong white matter connections were found between occipitotemporal face areas (OFA/FFA) with superior temporal sulcus and insula suggesting the possible existence of direct anatomical connections from face-specific areas to frontal nodes that could underlay the processing of emotional information associated to familiar faces.

"Looks familiar, but I do not know who she is": The role of the anterior right temporal lobe in famous face recognition

Processing a famous face involves a cascade of steps including detecting the presence of a face, recognizing it as familiar, accessing semantic/biographical information about the person, and finally, if required, production of the proper name. Decades of neuropsychological and neuroimaging studies have identified a network of occipital and temporal brain regions ostensibly comprising the 'core' system for face processing. Recent research has also begun to elucidate upon an 'extended' network, including anterior temporal and frontal regions. However, there is disagreement about which brain areas are involved in each step, as many aspects of face processing occur automatically in healthy individuals and rarely dissociate in patients. Moreover, some common phenomena are not easily induced in an experimental setting, such as having a sense of familiarity without being able to recall who the person is. Patients with the semantic variant of Primary Progressive Aphasia (svPPA) often recognize a famous face as familiar, even when they cannot specifically recall the proper name or biographical details. In this study, we analyzed data from a large sample of 105 patients with neurodegenerative disorders, including 43 svPPA, to identify the neuroanatomical substrates of three different steps of famous face processing. Using voxel-based morphometry, we correlated whole-brain grey matter volumes with scores on three experimental tasks that targeted familiarity judgment, semantic/biographical information retrieval, and naming. Performance in naming and semantic association significantly correlates with grey matter volume in the left anterior temporal lobe, whereas familiarity judgment with integrity of the right anterior middle temporal gyrus. These findings shed light on the neuroanatomical substrates of key components of overt face processing, addressing issues of functional lateralization, and deepening our understanding of neural substrates of semantic knowledge.

Resting state functional connectivity and neural correlates of face-name encoding in patients with ischemic vascular lesions with and without the involvement of the left inferior frontal gyrus

Face-name association is a relevant ability for social interactions and involves the ventral and dorsolateral prefrontal cortices, particularly in the left hemisphere, bilateral hippocampal, fusiform gyrus and occipital regions. Previous studies demonstrated the primary role of the hippocampus for this ability in healthy subjects. However, no study has examined the participation of the left inferior frontal area, specially the left inferior frontal gyrus (LIFG) in patients with ischemic vascular lesions. In the present study we addressed this issue and investigated the neural correlates and resting state functional connectivity of face-name memory encoding in ischemic patients with LIFG or without lesions in the left IFG (nLIFG) and healthy controls (HC) using fMRI. The main results showed that the nLIFG group demonstrated efficient compensation related to encoding and performance on face-name learning and recognition memory task, in addition to similar brain areas activated during task performance compared to healthy controls. Some of these areas were more activated in nLIFG group, indicating a compensation mechanism. In contrast, the LIFG group showed worse behavior performance, and no signs of an efficient compensation mechanism. Functional connectivity analysis suggested that the left IFG region seems to be important for maintaining the connectivity of the right fusiform gyrus or, perhaps, lesion in this area is associated to maladaptive reorganization. Our findings highlight the relevant role of the left IFG in face-name learning and encoding, possibly as a primary region in addition to the bilateral hippocampal formation and fusiform gyrus.

Electrophysiological correlates of voice memory for young and old speakers in young and old listeners

Faces of one's own-age group are easier to recognize than other-age faces. Using behavioral measures and EEG, we studied whether an own-age bias (OAB) also exists in voice memory. Young (19 - 26 years) and old (60-75 years) participants studied young (18-25 years) and old (60-77 years) unfamiliar voices from short sentences. Subsequently, they classified studied and novel voices as "old" (i.e. studied) or "new", from the same sentences. Recognition performance was higher in young compared to old participants, and for old compared to young voices, with no OAB. At the same time, we found evidence for higher distinctiveness of old compared to young voices, both in terms of acoustic measures and subjective ratings (independent of rater age). Analyses of event-related brain potentials (ERPs) indicated more negative-going deflections (400-1000ms) for old compared to young voices in young participants. In old participants, we observed a reversed OLD/NEW memory effect, with overall more positive amplitudes for novel compared to studied old (but not young) voices (400-1000ms). Time-frequency analyses revealed less beta power (16-26Hz) for young compared to old voices at left anterior sites, and also reduced beta power for correctly recognized studied (compared to novel) voices at left posterior sites (300-900ms). These findings could suggest an engagement of cortical areas during stimulus-specific recollection from about 300ms, in a task that emphasized the analysis of individual acoustic features.

Famous people recognition through personal name: a normative study

In this normative study, we investigated famous people recognition through personal name, using as stimuli the names of the same 40 Italian famous persons whose faces and voices had been utilized for the normative study of the Famous People Recognition Battery. For each famous people, we assessed name familiarity, person identification (when the name had been considered as familiar), and false alarms. The investigation was carried out on 143 normal subjects who varied in age and education. Name familiarity and semantic scores were affected by educational level, whereas age influenced false alarms. A comparison between results obtained with names in this research and with faces and voices of the same famous people in our previous study showed that familiarity scores were higher for personal names than those for faces and voices, which obtained the worst scores. Person identification scores were not significantly different from names and from faces, but both these scores were significantly higher than the semantic scores obtained by voices. Taken together, these results are inconsistent with the influential interactive activation and competition model of person recognition.

Anosognosia, denial of illness and the right hemisphere dominance for emotions: Some historical and clinical notes

Poor disease awareness ('anosognosia') is often observed in patients with various disabilities caused by brain damage. The lack of disease awareness can be due to the disruption of specific cognitive mechanisms and the development of psychodynamic mechanisms of denial. The aim of this paper is to review how these phenomena were discovered and evolved over time and to consider the relationships between them and the right hemisphere dominance for emotions. It is not clear whether the term 'anosognosia' refers to a basic mechanism that can explain similar awareness defects in different behavioural domains or whether it must be viewed as a multifaceted phenomenon in which both the disruption of cognitive or sensorimotor mechanisms and the emergence of motivational factors can play different roles in various forms of disease unawareness and in different kinds of 'anosognosic' patients.

Drawing a distinction between familiar and unfamiliar voice processing: A review of neuropsychological, clinical and empirical findings

Thirty years on from their initial observation that familiar voice recognition is not the same as unfamiliar voice discrimination (van Lancker and Kreiman, 1987), the current paper reviews available evidence in support of a distinction between familiar and unfamiliar voice processing. Here, an extensive review of the literature is provided, drawing on evidence from four domains of interest: the neuropsychological study of healthy individuals, neuropsychological investigation of brain-damaged individuals, the exploration of voice recognition deficits in less commonly studied clinical conditions, and finally empirical data from healthy individuals. All evidence is assessed in terms of its contribution to the question of interest - is familiar voice processing distinct from unfamiliar voice processing. In this regard, the evidence provides compelling support for van Lancker and Kreiman's early observation. Two considerations result: First, the limits of research based on one or other type of voice stimulus are more clearly appreciated. Second, given the demonstration of a distinction between unfamiliar and familiar voice processing, a new wave of research is encouraged which examines the transition involved as a voice is learned.

"Hearing faces and seeing voices": Amodal coding of person identity in the human brain

Recognizing familiar individuals is achieved by the brain by combining cues from several sensory modalities, including the face of a person and her voice. Here we used functional magnetic resonance (fMRI) and a whole-brain, searchlight multi-voxel pattern analysis (MVPA) to search for areas in which local fMRI patterns could result in identity classification as a function of sensory modality. We found several areas supporting face or voice stimulus classification based on fMRI responses, consistent with previous reports; the classification maps overlapped across modalities in a single area of right posterior superior temporal sulcus (pSTS). Remarkably, we also found several cortical areas, mostly located along the middle temporal gyrus, in which local fMRI patterns resulted in identity “cross-classification”: vocal identity could be classified based on fMRI responses to the faces, or the reverse, or both. These findings are suggestive of a series of cortical identity representations increasingly abstracted from the input modality.

Face gender categorization and hemispheric asymmetries: Contrasting evidence from connected and disconnected brains

We investigated hemispheric asymmetries in categorization of face gender by means of a divided visual field paradigm, in which female and male faces were presented unilaterally for 150ms each. A group of 60 healthy participants (30 males) and a male split-brain patient (D.D.C.) were asked to categorize the gender of the stimuli. Healthy participants categorized male faces presented in the right visual field (RVF) better and faster than when presented in the left visual field (LVF), and female faces presented in the LVF than in the RVF, independently of the participants' sex. Surprisingly, the recognition rates of D.D.C. were at chance levels - and significantly lower than those of the healthy participants - for both female and male faces presented in the RVF, as well as for female faces presented in the LVF. His performance was higher than expected by chance - and did not differ from controls - only for male faces presented in the LVF. The residual right-hemispheric ability of the split-brain patient in categorizing male faces reveals an own-gender bias lateralized in the right hemisphere, in line with the rightward own-identity and own-age bias previously shown in split-brain patients. The gender-contingent hemispheric dominance found in healthy participants confirms the previously shown right-hemispheric superiority in recognizing female faces, and also reveals a left-hemispheric superiority in recognizing male faces, adding an important evidence of hemispheric imbalance in the field of face and gender perception.

Neuronal generator patterns at scalp elicited by lateralized aversive pictures reveal consecutive stages of motivated attention

Event-related potential (ERP) studies have provided evidence for an allocation of attentional resources to enhance perceptual processing of motivationally salient stimuli. Emotional modulation affects several consecutive components associated with stages of affective-cognitive processing, beginning as early as 100-200ms after stimulus onset. In agreement with the notion that the right parietotemporal region is critically involved during the perception of arousing affective stimuli, some ERP studies have reported asymmetric emotional ERP effects. However, it is difficult to separate emotional from non-emotional effects because differences in stimulus content unrelated to affective salience or task demands may also be associated with lateralized function or promote cognitive processing. Other concerns pertain to the operational definition and statistical independence of ERP component measures, their dependence on an EEG reference, and spatial smearing due to volume conduction, all of which impede the identification of distinct scalp activation patterns associated with affective processing. Building on prior research using a visual half-field paradigm with highly controlled emotional stimuli (pictures of cosmetic surgery patients showing disordered [negative] or healed [neutral] facial areas before or after treatment), 72-channel ERPs recorded from 152 individuals (ages 13-68years; 81 female) were transformed into reference-free current source density (CSD) waveforms and submitted to temporal principal components analysis (PCA) to identify their underlying neuronal generator patterns. Using both nonparametric randomization tests and repeated measures ANOVA, robust effects of emotional content were found over parietooccipital regions for CSD factors corresponding to N2 sink (212ms peak latency), P3 source (385ms) and a late centroparietal source (630ms), all indicative of greater positivity for negative than neutral stimuli. For the N2 sink, emotional effects were right-lateralized and modulated by hemifield, with larger amplitude and asymmetry for left hemifield (right hemisphere) presentations. For all three factors, more positive amplitudes at parietooccipital sites were associated with increased ratings of negative valence and greater arousal. Distributed inverse solutions of the CSD-PCA-based emotional effects implicated a sequence of maximal activations in right occipitotemporal cortex, bilateral posterior cingulate cortex, and bilateral inferior temporal cortex. These findings are consistent with hierarchical activations of the ventral visual pathway reflecting subsequent processing stages in response to motivationally salient stimuli.

More Than Meets the Eye: The Merging of Perceptual and Conceptual Knowledge in the Anterior Temporal Face Area

An emerging body of research has supported the existence of a small face sensitive region in the ventral anterior temporal lobe (ATL), referred to here as the "anterior temporal face area". The contribution of this region in the greater face-processing network remains poorly understood. The goal of the present study was to test the relative sensitivity of this region to perceptual as well as conceptual information about people and objects. We contrasted the sensitivity of this region to that of two highly-studied face-sensitive regions, the fusiform face area (FFA) and the occipital face area (OFA), as well as a control region in early visual cortex (EVC). Our findings revealed that multivoxel activity patterns in the anterior temporal face area contain information about facial identity, as well as conceptual attributes such as one's occupation. The sensitivity of this region to the conceptual attributes of people was greater than that of posterior face processing regions. In addition, the anterior temporal face area overlaps with voxels that contain information about the conceptual attributes of concrete objects, supporting a generalized role of the ventral ATLs in the identification and conceptual processing of multiple stimulus classes.