Memory for unfamiliar faces differentiates mild cognitive impairment from normal aging

Neural correlates of impaired learning and recognition of novel faces in mild cognitive impairment

OBJECTIVE

Face memory impairment significantly affects social interactions and daily functioning in individuals with mild cognitive impairment (MCI). While deficits in recognizing familiar faces among individuals with MCI have been reported, their ability to learn and recognize unfamiliar faces remains unclear. This study examined the behavioral performance and event-related potentials (ERPs) of unfamiliar face memorization and recognition in MCI.

METHODS

Fifteen individuals with MCI and 15 healthy controls learned and recognized 90 unfamiliar neutral faces. Their performance accuracy and cortical ERPs were compared between the two groups across the learning and recognition phases.

RESULTS

Individuals with MCI had lower accuracy in identifying newly learned faces than healthy controls. Moreover, individuals with MCI had reduced occipitotemporal N170 and central vertex positive potential responses during both the learning and recognition phases, suggesting impaired initial face processing and attentional resources allocation. Also, individuals with MCI had reduced central N200 and frontal P300 responses during the recognition phase, suggesting impaired later-stage face recognition and attention engagement.

CONCLUSION

These findings provide neurobehavioral evidence for impaired learning and recognition of unfamiliar faces in individuals with MCI.

SIGNIFICANCE

Individuals with MCI may have face memory deficits in both early-stage face processing and later-stage recognition .

Eye movement patterns during viewing face images with neutral expressions in patients with early-stage Alzheimer's disease and amnestic mild cognitive impairment

BACKGROUND

Alzheimer's disease (AD) neuropathology affects the brain regions responsible for visuospatial skills. Accumulating evidence points to visual difficulties involving face processing in AD and amnestic mild cognitive impairment (aMCI). No study has so far examined eye movement patterns when viewing faces with neutral expressions in patients with AD.

AIM

The objective of this study aimed to examine the eye movements of patients with early-stage AD, aMCI, and healthy controls (HC) during viewing face images.

MATERIALS&METHODS

Thirty-one AD, 37 aMCI, and 33 HC were included in the study. Eye movements in facial stimuli were recorded with the EyeLink 1000 Plus eye-tracker.

RESULTS

Our findings showed that AD patients looked less at the eye area of interest than the nose and mouth areas of interest compared to aMCI and HC. Regardless of the group, all participants looked at the eye and nose areas of interest more and longer in the mouth area of interest. In addition, the first fixation duration to the eye area of interest of all participants was shorter than that of the nose and mouth.

DISCUSSION

Consistent with our study, studies in healthy adults revealed eye movement patterns that focused more on the eyes and nose. AD patients are unable to pay attention to the salient parts of faces, tending to focus instead on the non-informative parts.

CONCLUSION

Our study is the first to reveal eye movement differences in face processing in AD.

Early detection of cognitive disturbances in mild cognitive impairment: a systematic review of observational studies

Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high-level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.

Eastern observers cannot inhibit their gaze to eye and nose regions in face perception

It has been found that Western observers cannot inhibit their gaze to the eye region, even if they are told to avoid doing so when they observe face stimuli because of the importance of the eye region. However, studies indicate that the nose region is more important for face processing among Eastern observers. We used the "don't look" paradigm with Eastern observers, in which participants were told to avoid fixating on a specific region (eye, nose, and mouth). The results extend previous findings as both the eye and nose regions attracted their gaze. Interestingly, the fixation behaviors differed for the eyes and nose in terms of the time-dependent view, in which reflexive saccades to the eye with a persistent fixation to the nose were observed. The nose regions could have stronger attractiveness than previously thought.

Recognition of Famous and Unfamiliar Faces among Patients Suffering from Amnesia Mild Cognitive Impairment (AMCI) and Alzheimer's Disease

Objective: Memory assessment for the early diagnosis of cortical dementia is a complicated process which depends on important factors such as facial recognition and naming. These factors could be considered to carry a predictive power to detect neurodegenerative disorders. The present study aimed to study and compare naming or recognizing famous faces with the recognition of newly learned faces among patients with Amnesia Mild Cognitive Impairment (AMCI) and Alzheimer's disease. Method : To collect data, 60 AMCI patients, 62 patients suffering from Alzheimer's disease, and 63 cognitively healthy individuals were assessed using Wechsler Memory Scale-III Faces test (WMS-III faces) and Famous Faces test. Results: The results of one-way ANOVA indicated that the patients suffering from AMCI and Alzheimer's disease scored significantly worse than the control group on naming (p < 0.001), recognition (p < 0.001) section of the Famous Faces test, and immediate or delayed recognition on the WMS-III Faces test (p < 0.001). Also, the obtained results showed that the patients groups received lower scores on WMS-III Faces compared to the Famous Faces test. Conclusion: The results of this study suggested that the unfamiliar and Famous Faces tests allow the quantification of patients' face recognition and name recall abilities which, in turn, makes it possible to make more accurate predictions about cases of dementia. These tests can be used for clinical and research purposes to screen those who may be prone to dementia and need further neuropsychological assessment.

Face-specific memory deficits and changes in eye scanning patterns among patients with amnestic mild cognitive impairment

Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer's disease (AD). Previous studies have shown functional and structural degradation of the fusiform face area, which is a core region for face processing, in addition to medial temporal lobe degradation. We predicted that patients with aMCI exhibit a loss of face processing and/or face memory, accompanied by abnormal eye scanning patterns, since patients who have deficits in face perception (i.e. prosopagnosia) exhibit such tendencies. Eighteen patients with aMCI and age-matched healthy controls were tested for perception and short-term memory of visually presented faces and houses while their gaze was recorded. Patients with aMCI showed a decline in memory, compared with control observers, for faces, but not for houses. Patients looked more at the mouth of faces, compared with control observers. We demonstrate here the loss of short-term face memory in aMCI with abnormal scanning patterns that might reflect the cerebral abnormality found in patients with aMCI.

Evoked Potentials and Memory/Cognition Tests Validate Brain Atrophy as Measured by 3T MRI (NeuroQuant) in Cognitively Impaired Patients

To our knowledge, this is the largest study evaluating relationships between 3T Magnetic Resonance Imaging (MRI) and P300 and memory/cognitive tests in the literature. The 3T MRI using NeuroQuant has an increased resolution 15 times that of 1.5T MRI. Utilizing NeuroQuant 3T MRI as a diagnostic tool in primary care, subjects (N=169; 19–90 years) displayed increased areas of anatomical atrophy: 34.62% hippocampal atrophy (N=54), 57.14% central atrophy (N=88), and 44.52% temporal atrophy (N=69). A majority of these patients exhibited overlap in measured areas of atrophy and were cognitively impaired. These results positively correlated with decreased P300 values and WMS-III (WMS-III) scores differentially across various brain loci. Delayed latency (p=0.0740) was marginally associated with temporal atrophy; reduced fractional anisotropy (FA) in frontal lobes correlated with aging, delayed P300 latency, and decreased visual and working memory (p=0.0115). Aging and delayed P300 latency correlated with lower FA. The correlation between working memory and reduced FA in frontal lobes is marginally significant (p=0.0787). In the centrum semiovale (CS), reduced FA correlated with visual memory (p=0.0622). Lower demyelination correlated with higher P300 amplitude (p=0.0002). Compared to males, females have higher demyelination (p=0.0064). Along these lines, the higher the P300 amplitude, the lower the bilateral atrophy (p=0.0165). Hippocampal atrophy correlated with increased auditory memory and gender, especially in males (p=0.0087). In considering temporal lobe atrophy correlations: delayed P300 latency and high temporal atrophy (p=0.0740); high auditory memory and low temporal atrophy (p=0.0417); and high working memory and low temporal atrophy (p=0.0166). Central atrophy correlated with aging and immediate memory (p=0.0294): the higher the immediate memory, the lower the central atrophy. Generally, the validation of brain atrophy by P300 and WMS-III could lead to cost-effective methods utilizable in primary care medicine following further confirmation.