Detailed Exploration of Face-related Processing in Congenital Prosopagnosia: 1. Behavioral Findings

Improving the DSM-5 approach to cognitive impairment: Developmental prosopagnosia reveals the need for tailored diagnoses

The Diagnostic Statistical Manual of Mental Disorders (DSM-5) recommends diagnosing neurocognitive disorders (i.e., cognitive impairment) when a patient scores beyond - 1 SD below neurotypical norms on two tests. I review how this approach will fail due to cognitive tests' power limitations, validity issues, imperfect reliabilities, and biases, before summarizing their resulting negative consequences. As a proof of concept, I use developmental prosopagnosia, a condition characterized by difficulties recognizing faces, to show the DSM-5 only diagnoses 62-70% (n1 = 61, n2 = 165) versus 100% (n1 = 61) through symptoms alone. Pooling the DSM-5 missed cases confirmed the presence of group-level impairments on objective tests, which were further evidenced through meta-analyses, thus validating their highly atypical symptoms. These findings support a paradigm shift towards bespoke diagnostic approaches for distinct cognitive impairments, including a symptom-based method when validated effective. I reject dogmatic adherence to the DSM-5 approach to neurocognitive disorders, and underscore the importance of a data driven, transdiagnostic approach to understanding patients' subjective cognitive impairments. This will ultimately benefit patients, their families, clinicians, and scientific progress.

The heterogeneity of holistic processing profiles in developmental prosopagnosia: holistic processing is impaired but not absent

Although it is generally assumed that face recognition relies on holistic processing, whether face recognition deficits observed in Developmental Prosopagnosics (DPs) can be explained by impaired holistic processing is currently under debate. The mixed findings from past studies could be the consequence of DP's heterogeneous deficit nature and the use of different measures of holistic processing-the inversion, part-whole, and composite tasks-which showed a poor association among each other. The present study aimed to gain further insight into the role of holistic processing in DPs. Groups of DPs and neurotypicals completed three tests measuring holistic face processing and non-face objects (i.e., Navon task). At a group level, DPs showed (1) diminished, but not absent, inversion and part-whole effects, (2) comparable magnitudes of the composite face effect and (3) global precedence effect in the Navon task. However, single-case analyses showed that these holistic processing deficits in DPs are heterogeneous.

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.

Disentangling developmental prosopagnosia: A scoping review of terms, tools and topics

The goal of this preregistered scoping review is to create an overview of the research on developmental prosopagnosia (DP). Through analysis of all empirical studies of DP in adults, we investigate 1) how DP is conceptualized and defined, 2) how individuals are classified with DP and 3) which aspects of DP are investigated in the literature. We reviewed 224 peer-reviewed studies of DP. Our analysis of the literature reveals that while DP is predominantly defined as a lifelong face recognition impairment in the absence of acquired brain injury and intellectual/cognitive problems, there is far from consensus on the specifics of the definition with some studies emphasizing e.g., deficits in face perception, discrimination and/or matching as core characteristics of DP. These differences in DP definitions is further reflected in the vast heterogeneity in classification procedures. Only about half of the included studies explicitly state how they classify individuals with DP, and these studies adopt 40 different assessment tools. The two most frequently studied aspects of DP are the role of holistic processing and the specificity of face processing, and alongside a substantial body of neuroimaging studies of DP, this paints a picture of a research field whose scientific interests and aims are rooted in cognitive neuropsychology and neuroscience. We argue that these roots - alongside the heterogeneity in DP definition and classification - may have limited the scope and interest of DP research unnecessarily, and we point to new avenues of research for the field.

The neuropsychological evaluation of face identity recognition

Facial identity recognition (FIR) is arguably the ultimate form of recognition for the adult human brain. Even if the term prosopagnosia is reserved for exceptionally rare brain-damaged cases with a category-specific abrupt loss of FIR at adulthood, subjective and objective impairments or difficulties of FIR are common in the neuropsychological population. Here we provide a critical overview of the evaluation of FIR both for clinicians and researchers in neuropsychology. FIR impairments occur following many causes that should be identified objectively by both general and specific, behavioral and neural examinations. We refute the commonly used dissociation between perceptual and memory deficits/tests for FIR, since even a task involving the discrimination of unfamiliar face images presented side-by-side relies on cortical memories of faces in the right-lateralized ventral occipito-temporal cortex. Another frequently encountered confusion is between specific deficits of the FIR function and a more general impairment of semantic memory (of people), the latter being most often encountered following anterior temporal lobe damage. Many computerized tests aimed at evaluating FIR have appeared over the last two decades, as reviewed here. However, despite undeniable strengths, they often suffer from ecological limitations, difficulties of instruction, as well as a lack of consideration for processing speed and qualitative information. Taking into account these issues, a recently developed behavioral test with natural images manipulating face familiarity, stimulus inversion, and correct response times as a key variable appears promising. The measurement of electroencephalographic (EEG) activity in the frequency domain from fast periodic visual stimulation also appears as a particularly promising tool to complete and enhance the neuropsychological assessment of FIR.

Cognitive strengths in neurodevelopmental disorders, conditions and differences: A critical review

Neurodevelopmental disorders are traditionally characterised by a range of associated cognitive impairments in, for example, sensory processing, facial recognition, visual imagery, attention, and coordination. In this critical review, we propose a major reframing, highlighting the variety of unique cognitive strengths that people with neurodevelopmental differences can exhibit. These include enhanced visual perception, strong spatial, auditory, and semantic memory, superior empathy and theory of mind, along with higher levels of divergent thinking. Whilst we acknowledge the heterogeneity of cognitive profiles in neurodevelopmental conditions, we present a more encouraging and affirmative perspective of these groups, contrasting with the predominant, deficit-based position prevalent throughout both cognitive and neuropsychological research. In addition, we provide a theoretical basis and rationale for these cognitive strengths, arguing for the critical role of hereditability, behavioural adaptation, neuronal-recycling, and we draw on psychopharmacological and social explanations. We present a table of potential strengths across conditions and invite researchers to systematically investigate these in their future work. This should help reduce the stigma around neurodiversity, instead promoting greater social inclusion and significant societal benefits.

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.

Both identity and non-identity face perception tasks predict developmental prosopagnosia and face recognition ability

Developmental prosopagnosia (DP) is characterised by deficits in face identification. However, there is debate about whether these deficits are primarily perceptual, and whether they extend to other face processing tasks (e.g., identifying emotion, age, and gender; detecting faces in scenes). In this study, 30 participants with DP and 75 controls completed a battery of eight tasks assessing four domains of face perception (identity; emotion; age and gender; face detection). The DP group performed worse than the control group on both identity perception tasks, and one task from each other domain. Both identity perception tests uniquely predicted DP/control group membership, and performance on two measures of face memory. These findings suggest that deficits in DP may arise from issues with face perception. Some non-identity tasks also predicted DP/control group membership and face memory, even when face identity perception was accounted for. Gender perception and speed of face detection consistently predicted unique variance in group membership and face memory; several other tasks were only associated with some measures of face recognition ability. These findings indicate that face perception deficits in DP may extend beyond identity perception. However, the associations between tasks may also reflect subtle aspects of task demands or stimuli.

A new way of classifying developmental prosopagnosia: Balanced Integration Score

Despite severe everyday problems recognising faces, some individuals with developmental prosopagnosia (DP) can achieve typical accuracy scores on laboratory face recognition tests. To address this, studies sometimes also examine response times (RTs), which tend to be longer in DPs relative to control participants. In the present study, 24 potential (according to self-report) DPs and 110 age-matched controls completed the Cambridge Face and Bicycle Memory Tests, old new faces task, and a famous faces test. We used accuracy and the Balanced Integration Score (BIS), a measure that adjusts accuracy for RTs, to classify our sample at the group and individual levels. Subjective face recognition ability was assessed using the PI20 questionnaire and semi structured interviews. Fifteen DPs showed a major impairment using BIS compared with only five using accuracy alone. Logistic regression showed that a model incorporating the BIS measures was the most sensitive for classifying DP and showed highest area under the curve (AUC). Furthermore, larger between-group effect sizes were observed for a derived global (averaged) memory measure calculated using BIS versus accuracy alone. BIS is thus an extremely sensitive novel measure for attenuating speed-accuracy trade-offs that can otherwise mask impairment measured only by accuracy in DP.

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.

Familial Transmission of Developmental Prosopagnosia: New Case Reports from an Extended Family and Identical Twins

Existing evidence suggests that developmental prosopagnosia (DP) is a surprisingly prevalent condition, with some individuals describing lifelong difficulties with facial identity recognition. Together with case reports of multiple family members with the condition, this evidence suggests that DP is inherited in at least some instances. Here, we offer some novel case series that further support the heritability of the condition. First, we describe five adult siblings who presented to our lab with symptoms of DP. Second, for the first known time in the literature, we describe a pair of adult identical twins who contacted us in the belief that they both experience DP. The condition was confirmed in three of the five siblings (with minor symptoms observed in the remaining two) and in both twins. Supplementary assessments suggested that all individuals also experienced some degree of difficulty with facial identity perception, but that object recognition was preserved. These findings bolster the evidence supporting the heritability of DP and suggest that it can be a specific impairment in some cases.

Null effect of anodal and cathodal transcranial direct current stimulation (tDCS) on own- and other-race face recognition

Successful face recognition is important for social interactions and public security. Although some preliminary evidence suggests that anodal and cathodal transcranial direct current stimulation (tDCS) might modulate own- and other-race face identification, respectively, the findings are largely inconsistent. Hence, we examined the effect of both anodal and cathodal tDCS on the recognition of own- and other-race faces. Ninety participants first completed own- and other-race Cambridge Face Memory Test (CFMT) as baseline measurements. Next, they received either anodal tDCS, cathodal tDCS or sham stimulation and finally they completed alternative versions of the own- and other-race CFMT. No difference in performance, in terms of accuracy and reaction time, for own- and other-race face recognition between anodal tDCS, cathodal tDCS and sham stimulation was found. Our findings cast doubt upon the efficacy of tDCS to modulate performance in face identification tasks.

A new approach to diagnosing and researching developmental prosopagnosia: Excluded cases are impaired too

Developmental prosopagnosia is characterized by severe, lifelong difficulties when recognizing facial identity. Unfortunately, the most common diagnostic assessment (Cambridge Face Memory Test) misses 50-65% of individuals who believe that they have this condition. This results in such excluded cases' absence from scientific knowledge, effect sizes of impairment potentially overestimated, treatment efficacy underrated, and may elicit in them a negative experience of research. To estimate their symptomology and group-level impairments in face processing, we recruited a large cohort who believes that they have prosopagnosia. Matching prior reports, 56% did not meet criteria on the Cambridge Face Memory Test. However, the severity of their prosopagnosia symptoms and holistic perception deficits were comparable to those who did meet criteria. Excluded cases also exhibited face perception and memory impairments that were roughly one standard deviation below neurotypical norms, indicating the presence of objective problems. As the prosopagnosia index correctly classified virtually every case, we propose it should be the primary method for providing a diagnosis, prior to subtype categorization. We present researchers with a plan on how they can analyze these excluded prosopagnosia cases in their future work without negatively impacting their traditional findings. We anticipate such inclusion will enhance scientific knowledge, more accurately estimate effect sizes of impairments and treatments, and identify commonalities and distinctions between these different forms of prosopagnosia. Owing to their atypicalities in visual perception, we recommend that the prosopagnosia index should be used to screen out potential prosopagnosia cases from broader vision research.

Navon letters and composite faces: same or different processing mechanisms?

Navon letters and composite faces are two fascinating demonstrations of hierarchical organization in perception. Many researchers believe that the two types of stimuli and their associated tasks gauge comparable holistic mechanisms. This belief is so common that the two paradigms are now being applied in tandem to measure impaired holistic processing in prosopagnosic patients. But are Navon letters and composite faces processed in a similar fashion? In the present study we take a closer look at their apparent affinity. We gain novel insights into their underlying mechanisms by fitting parameters of the linear ballistic accumulator (LBA) model to empirical correct and incorrect response times (RTs). The results reveal major differences in processing between the two tasks. We conclude that despite the presence of a compelling surface similarity, Navon compound letters and composite faces tap into separate psychological processes.

Developmental emergence of holistic processing in word recognition

Holistic processing (HP) of faces refers to the obligatory, simultaneous processing of the parts and their relations, and it emerges over the course of development. HP is manifest in a decrement in the perception of inverted versus upright faces and a reduction in face processing ability when the relations between parts are perturbed. Here, adopting the HP framework for faces, we examined the developmental emergence of HP in another domain for which human adults have expertise, namely, visual word processing. Children, adolescents, and adults performed a lexical decision task and we used two established signatures of HP for faces: the advantage in perception of upright over inverted words and nonwords and the reduced sensitivity to increasing parts (word length). Relative to the other groups, children showed less of an advantage for upright versus inverted trials and lexical decision was more affected by increasing word length. Performance on these HP indices was strongly associated with age and with reading proficiency. Also, the emergence of HP for word perception was not simply a result of improved visual perception over the course of development as no group differences were observed on an object decision task. These results reveal the developmental emergence of HP for orthographic input, and reflect a further instance of experience-dependent tuning of visual perception. These results also add to existing findings on the commonalities of mechanisms of word and face recognition. RESEARCH HIGHLIGHTS: Children showed less of an advantage for upright versus inverted trials compared to adolescents and adults. Relative to the other groups, lexical decision in children was more affected by increasing word length. Performance on holistic processing (HP) indices was strongly associated with age and with reading proficiency. HP emergence for word perception was not due to improved visual perception over development as there were no group differences on an object decision task.

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.

Face specific inversion effects provide evidence for two subtypes of developmental prosopagnosia

Many studies have attempted to identify the perceptual underpinnings of developmental prosopagnosia (DP). The majority have focused on whether holistic and configural processing mechanisms are impaired in DP. However, previous work suggests that there is substantial heterogeneity in holistic and configural processing within the DP population; further, there is disagreement as to whether any deficits are face-specific or reflect a broader perceptual deficit. This study used a data-driven approach to examine whether there are systematic patterns of variability in DP that reflect different underpinning perceptual deficits. A group of individuals with DP (N = 37) completed a cognitive battery measuring holistic/configural and featural processing in faces and non-face objects. A two-stage cluster analysis on data from the Cambridge Face Perception Test identified two subgroups of DPs. Across several tasks, the first subgroup (N = 21) showed typical patterns of holistic/configural processing (measured via inversion effects); the second (N = 16) was characterised by reduced or abolished inversion effects compared to age-matched control participants (N = 91). The subgroups did not differ on tasks measuring upright face matching, object matching, non-face holistic processing, or composite effects. These findings indicate two separable pathways to face recognition impairment, one characterised by impaired configural processing and the other potentially by impaired featural processing. Comparisons to control participants provide some preliminary evidence that the deficit in featural processing may extend to some non-face stimuli. Our results demonstrate the utility of examining both the variability between and consistency across individuals with DP as a means of illuminating our understanding of face recognition in typical and atypical populations.

Severe developmental topographical disorientation associated with ADHD and dyscalculia: A case report

We report the clinical case of AB, a right-handed 19-year-old woman who presents severe developmental topographical disorientation, a relatively rare syndrome, leading to difficulties in navigating in familiar (and novel) environments. This symptomatology appears without acquired cerebral damage (MRI described as normal) nor more global cognitive disability (high degree of education achieved). An extensive assessment of spatial cognition with different aspects of underlying cognitive processes is first presented. Second, the patient's preserved cognitive abilities and her major difficulties in calculation, as well as her attention deficit, as seen in a detailed neuropsychological assessment, are reported. For the first time to our knowledge, we show that developmental topographical disorientation can be associated with other developmental cognitive disorders affecting number processing (dyscalculia) and attention (Attention Deficit-Hyperactivity Disorder (ADHD)). We discuss the links between these different cognitive processes in relation to visuo-spatial working memory and magnitude representation, which could represent common denominators for all these syndromes. This case report highlights the importance of thoroughly assessing potentially associated neurocognitive disorders in developmental topographical disorientation. In addition, it highlights the necessity to keep in mind the prevalence of spatial difficulties in the assessment of children and adolescents with other neurodevelopmental syndromes. Finally, this case study raises a new question about the nosology of developmental disorders affecting the visuo-spatial and spatial domains.

Not so fast! Response times in the computerized Benton Face Recognition Test may not reflect face recognition ability

Response times (RTs) are commonly used to assess cognitive abilities, though it is unclear whether face processing RTs predict recognition ability beyond accuracy. In the current study, we examined accuracy and RT on a widely used face matching assessment modified to collect meaningful RT data, the computerized Benton Facial Recognition Test (BFRT-c), and measured whether RTs predicted face recognition ability and developmental prosopagnosia (DP) vs. control group membership. 62 controls and 36 DPs performed the BFRT-c as well as validated measures of face recognition ability: the Cambridge Face Memory Test (CFMT) and a Famous Faces Memory Test (FFMT). In controls, BFRT-c accuracy robustly predicted CFMT (r = .49, p < .001), FFMT (r = .43, p < .001), and a CFMT-FFMT composite (r = .54, p < .001), whereas BFRT-c RT was not significantly associated with these measures (all r's  .21). We also found that BFRT-c accuracy significantly differed between DPs and controls, but RT failed to differentiate the groups.

An update of the Benton Facial Recognition Test

The Benton Facial Recognition Test (BFRT) is a paper-and-pen task that is traditionally used to assess face perception skills in neurological, clinical and psychiatric conditions. Despite criticisms of its stimuli, the task enjoys a simple procedure and is rapid to administer. Further, it has recently been computerised (BFRT-c), allowing reliable measurement of completion times and the need for online testing. Here, in response to calls for repeat screening for the accurate detection of face processing deficits, we present the BFRT-Revised (BFRT-r): a new version of the BFRT-c that maintains the task's basic paradigm, but employs new, higher-quality stimuli that reflect recent theoretical advances in the field. An initial validation study with typical participants indicated that the BFRT-r has good internal reliability and content validity. A second investigation indicated that while younger and older participants had comparable accuracy, completion times were longer in the latter, highlighting the need for age-matched norms. Administration of the BFRT-r and BFRT-c to 32 individuals with developmental prosopagnosia resulted in improved sensitivity in diagnostic screening for the BFRT-r compared to the BFRT-c. These findings are discussed in relation to current diagnostic screening protocols for face perception deficits. The BFRT-r is stored in an open repository and is freely available to other researchers.

Accurate but inefficient: Standard face identity matching tests fail to identify prosopagnosia

In recent years, the number of face identity matching tests in circulation has grown considerably and these are being increasingly utilized to study individual differences in face cognition. Although many of these tests were designed for testing typical observers, recent studies have begun to utilize general-purpose tests for studying specific, atypical populations (e.g., super-recognizers and individuals with prosopagnosia). In this study, we examined the capacity of four tests requiring binary face-matching decisions to study individual differences between healthy observers. Uniquely, we used performance of the patient PS (Rossion, 2018), a well-documented case of acquired prosopagnosia (AP), as a benchmark. Two main findings emerged: (i) PS could exhibit typical rates of accuracy in all tests; (ii) compared to age-matched controls and when considering both accuracy and speed to account for potential trade-offs, only the KFMT - but not the EFCT, PICT or GFMT - was able to detect PS's severe impairment. These findings reflect the importance of considering both accuracy and response times to measure individual differences in face matching, and the need for comparing tests in terms of their sensitivity, when used as a measure of human cognition and brain functioning.

Comparing the sensitivity of face matching assessments to detect face perception impairments

Numerous neurological, developmental, and psychiatric conditions demonstrate impaired face recognition, which can be socially debilitating. These impairments can be caused by either deficient face perception or face memory mechanisms. Though there are well-validated, sensitive measures of face memory impairments, it currently remains unclear which assessments best measure face perception impairments. A sensitive, validated face perception measure could help with diagnosing causes of face recognition deficits and be useful in characterizing individual differences in unimpaired populations. Here, we compared the computerized Benton Face Recognition Test (BFRT-c) and Cambridge Face Perception Test (CFPT) in their ability to differentiate developmental prosopagnosics (DPs, N = 30) and age-matched controls (N = 30). Participants completed the BFRT-c, CFPT, and two additional face perception assessments: the University of Southern California Face Perception Test (USCFPT) and a novel same/different face matching test (SDFMT). Participants were also evaluated on objective and subjective face recognition tasks including the Cambridge Face Memory Test, famous faces test, and Prosopagnosia Index-20. We performed a logistic regression with the perception tests predicting DP vs. control group membership and used multiple linear regressions to predict continuous objective and subjective face recognition memory. Our results show that the BFRT-c performed as well as, if not better than, the CFPT, and that both tests clearly outperformed the USCFPT and SDFMT. Further, exploratory analyses revealed that face lighting-change conditions better predicted DP group membership and face recognition abilities than viewpoint-change conditions. Together, these results support the combined use of the BFRT-c and CFPT to best assess face perception impairments.

Normal colour perception in developmental prosopagnosia

Developmental prosopagnosia (DP) is a selective neurodevelopmental condition defined by lifelong impairments in face recognition. Despite much research, the extent to which DP is associated with broader visual deficits beyond face processing is unclear. Here we investigate whether DP is accompanied by deficits in colour perception. We tested a large sample of 92 DP individuals and 92 sex/age-matched controls using the well-validated Ishihara and Farnsworth–Munsell 100-Hue tests to assess red–green colour deficiencies and hue discrimination abilities. Group-level analyses show comparable performance between DP and control individuals across both tests, and single-case analyses indicate that the prevalence of colour deficits is low and comparable to that in the general population. Our study clarifies that DP is not linked to colour perception deficits and constrains theories of DP that seek to account for a larger range of visual deficits beyond face recognition.

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.

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.

A short humorous intervention protects against subsequent psychological stress and attenuates cortisol levels without affecting attention

Presentation of humor simultaneously with a stressful event has been shown to dampen the psychological and physiological responses of stress. However, whether a relatively short humorous intervention can be utilized to prevent the subsequent stress processing is still underinvestigated. Furthermore, it is unknown, whether such a humor intervention changes stress processing at a cost of cognitive functioning. According to the broaden-and-build theory inducing positive emotions may subsequently impact cognitive performance. Here, we investigated whether humor protects against subsequent stressors by attenuating both, psychological and physiological stress levels and whether this affects cognitive performance. Participants watched either a humorous or a neutral movie, underwent stress induction and performed in a visual search task. Compared to the control group, psychological stress levels and salivary cortisol levels were lower in the humor group, yet no differences were found in response times and accuracy rates for the visual search task. Our results demonstrate that a short humorous intervention shields against subsequent psychological stress leaving cognitive performance intact, thus making it highly applicable to improve mental and physical health in everyday life situations.

Forest Before Trees: Letter Stimulus and Sex Modulate Global Precedence in Visual Perception

The global precedence effect (GPE), originally referring to processing hierarchical visual stimuli composed of letters, is characterised by both global advantage and global interference. We present herein a study of how this effect is modulated by the variables letter and sex. The Navon task, using the letters “H” and “S,” was administered to 78 males and 168 females (69 follicular women, 52 luteal women, and 47 hormonal contraceptive users). No interaction occurred between the letter and sex variables, but significant main effects arose from each of these. Reaction times (RTs) revealed that the letter “H” was identified more rapidly in the congruent condition both in the global and the local task, and the letter “S” in the incongruent condition for the local task. Also, although RTs showed a GPE in both males and females, males displayed shorter reaction times in both global and local tasks. Furthermore, luteal women showed higher d’ index (discrimination sensitivity) in the congruent condition for the local task than both follicular women and hormonal contraceptive users, as well as longer exploration time of the irrelevant level during the global task than males. We conclude that, according to the linear periodicity law, the GPE is enhanced for compound letters with straight vs. curved strokes, whereas it is stronger in males than in females. Relevantly, luteal phase of the menstrual cycle seems to tilt women to rely on finer grained information, thus exhibiting an analytical processing style in global/local visual processing.

Different and common brain signals of altered neurocognitive mechanisms for unfamiliar face processing in acquired and developmental prosopagnosia

Neuropsychological studies have shown that prosopagnosic individuals perceive face structure in an atypical way. This might preclude the formation of appropriate face representations and, consequently, hamper effective recognition. The present ERP study, in combination with Bayesian source reconstruction, investigates how information related to both external (E) and internal (I) features was processed by E.C. and I.P., suffering from acquired and developmental prosopagnosia, respectively. They carried out a face-feature matching task with new faces. E.C. showed poor performance and remarkable lack of early face-sensitive P1, N170 and P2 responses on right (damaged) posterior cortex. Although she presented the expected mismatch effect to target faces in the E-I sequence, it was of shorter duration than in Controls, and involved left parietal, right frontocentral and dorsofrontal regions, suggestive of reduced neural circuitry to process face configurations. In turn, I.P. performed efficiently but with a remarkable bias to give "match" responses. His face-sensitive potentials P1-N170 were comparable to those from Controls, however, he showed no subsequent P2 response and a mismatch effect only in the I-E sequence, reflecting activation confined to those regions that sustain typically the initial stages of face processing. Relevantly, neither of the prosopagnosics exhibited conspicuous P3 responses to features acting as primes, indicating that diagnostic information for constructing face representations could not be sufficiently attended nor deeply encoded. Our findings suggest a different locus for altered neurocognitive mechanisms in the face network in participants with different types of prosopagnosia, but common indicators of a deficient allocation of attentional resources for further recognition.

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

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

Normative data for two challenging tests of face matching under ecological conditions

Background

Unfamiliar face processing is an ability that varies considerably between individuals. Numerous studies have aimed to identify its underlying determinants using controlled experimental procedures. While such tests can isolate variables that influence face processing, they usually involve somewhat unrealistic situations and optimized face images as stimulus material. As a consequence, the extent to which the performance observed under laboratory settings is informative for predicting real-life proficiency remains unclear.

Results

We present normative data for two ecologically valid but underused tests of face matching: the Yearbook Test (YBT) and the Facial Identity Card Sorting Test (FICST). The YBT (n = 252) measures identity matching across substantial age-related changes in facial appearance, while the FICST (n = 218) assesses the ability to process unfamiliar facial identity despite superficial image variations. To determine the predictive value of both tests, a subsample of our cohort (n = 181) also completed a commonly used test of face recognition and two tests of face perception (the long form of the Cambridge Face Memory Test (CFMT+), the Expertise in Facial Comparison Test (EFCT) and the Person Identification Challenge Test (PICT)).

Conclusions

Focusing on the top performers identified independently per test, we made two important observations: 1) YBT and FICST performance can predict CFMT+ scores and vice versa; and 2) EFCT and PICT scores neither reliably predict superior performance in ecologically meaningful and challenging tests of face matching, nor in the most commonly used test of face recognition. These findings emphasize the necessity for using challenging and ecologically relevant, and thus highly sensitive, tasks of unfamiliar face processing to identify high-performing individuals in the normal population.

The domain-specificity of face matching impairments in 40 cases of developmental prosopagnosia

A prevailing debate in the psychological literature concerns the domain-specificity of the face recognition system, where evidence from typical and neurological participants has been interpreted as evidence that faces are "special". Although several studies have investigated the same question in cases of developmental prosopagnosia, the vast majority of this evidence has recently been discounted due to methodological concerns. This leaves an uncomfortable void in the literature, restricting our understanding of the typical and atypical development of the face recognition system. The current study addressed this issue in 40 individuals with developmental prosopagnosia, completing a sequential same/different face and biological (hands) and non-biological (houses) object matching task, with upright and inverted conditions. Findings support domain-specific accounts of face-processing for both hands and houses: while significant correlations emerged between all the object categories, no condition correlated with performance in the upright faces condition. Further, a categorical analysis demonstrated that, when face matching was impaired, object matching skills were classically dissociated in six out of 15 individuals (four for both categories). These findings provide evidence about domain-specificity in developmental disorders of face recognition, and present a theoretically-driven means of partitioning developmental prosopagnosia.

Over time, the right results will emerge

Scientific research involves going beyond the well-trodden and well-tested ideas and theories that form the core of scientific knowledge. During the time scientists are working things out, some results will be right, and others will be wrong. Over time, the right results will emerge. Lisa Randall (Frank B. Baird, Jr. Professor of Science, Physics Department, Harvard University) We are grateful to all the commentators for the important and thoughtful comments raised in response to the Geskin and Behrmann (G & B) literature survey. The issues raised in the introduction to this Special Issue and in these commentaries not only address and challenge aspects of the G & B literature review, but contribute perspectives and extensions that go well beyond the scope of the review. As is evident from G & B and from the 13 commentaries, many aspects of congenital prosopagnosia (CP) remain controversial. Adopting the language of the quote above, the intention of the G & B survey, along with the commentaries and this response, is to establish a collaborative process from which the right results (and right theory) will emerge in time. We are grateful to the editor of this Special Issue, Dr. Brad Mahon, for his support and for facilitating this collaborative exchange in Cognitive Neuropsychology.

The hidden identity of faces: a case of lifelong prosopagnosia

BACKGROUND

Not being able to recognize a person's face is a highly debilitating condition from which people with developmental prosopagnosia (DP) suffer their entire life. Here we describe the case of J, a 30 year old woman who reports being unable to recognize her parents, her husband, or herself in the mirror.

CASE PRESENTATION

We set out to assess the severity of J's prosopagnosia using tests with unfamiliar as well as familiar faces and investigated whether impaired configural processing explains her deficit. To assess the specificity of the impairment, we tested J's performance when evaluating emotions, intentions, and the attractiveness and likability of faces. Detailed testing revealed typical brain activity patterns for faces and normal object recognition skills, and no evidence of any brain injury. However, compared to a group of matched controls, J showed severe deficits in learning new faces, and in recognizing familiar faces when only inner features were available. Her recognition of uncropped faces with blurred features was within the normal range, indicating preserved configural processing when peripheral features are available. J was also unimpaired when evaluating intentions and emotions in faces. In line with healthy controls, J rated more average faces as more attractive. However, she was the only one to rate them as less likable, indicating a preference for more distinctive and easier to recognize faces.

CONCLUSIONS

Taken together, the results illustrate both the severity and the specificity of DP in a single case. While DP is a heterogeneous disorder, an inability to integrate the inner features of the face into a whole might be the best explanation for the difficulties many individuals with prosopagnosia experience.

Perception of musical pitch in developmental prosopagnosia

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

Self-face and self-body advantages in congenital prosopagnosia: evidence for a common mechanism

Prosopagnosia is a disorder leading to difficulties in recognizing faces. However, recent evidence suggests that individuals with congenital prosopagnosia can achieve considerable accuracy when they have to recognize their own faces (self-face advantage). Yet, whether this advantage is face-specific or not is still unclear. Here, we aimed to investigate whether individuals with congenial prosopagnosia show a self-advantage also in recognizing other self body-parts and, if so, whether the advantage for the body parts differs from the one characterizing the self-face. Eight individuals with congenital prosopagnosia and 22 controls underwent a delayed matching task in which they were required to recognize faces, hands and feet belonging to the self or to others. Controls showed a similar self-advantage for all the stimuli tested; by contrast, individuals with congenital prosopagnosia showed a larger self-advantage with faces compared to hands and feet, mainly driven by their deficit with others' faces. In both groups the self-advantages for the different body parts were strongly and significantly correlated. Our data suggest that the self-face advantage showed by individuals with congenital prosopagnosia is not face-specific and that the same mechanism could be responsible for both the self-face and self body-part advantages.

Tests of whole upright face processing in prosopagnosia: A literature review

Prosopagnosia refers to an acquired or developmental deficit in face recognition. This neuropsychological impairment has received increasing attention over the last decade, in particular because of an increased scientific interest in developmental prosopagnosia. Studies investigating prosopagnosia have used a variety of different clinical and experimental tests to assess face processing abilities. With such a large variety of assessment methods available, test selection can be challenging. Some previous works have aimed to provide an overview of tests used to diagnose prosopagnosia. However, no overview that is based on a structured review of the literature is available. We review the literature to identify tests that have been used to assess the processing of whole upright faces in acquired and developmental prosopagnosia over the last five years (2013-2017). We not only review tests that have been used for diagnostic purposes, but also tests that have been used for experimental purposes. Tests are categorised according to i) their experimental designs and, ii) the stage of face processing that they assess. On this basis, we discuss considerations regarding test designs for future studies. A visual illustration providing a structured overview of paradigms available for testing the processing of whole upright faces is provided. This visual illustration can be used to inform test selection when designing a study and to apply a structured approach to interpreting findings from the literature. The different approaches to assessment of face processing in prosopagnosia have been necessary and fruitful in generating data and hypotheses about the cause of face processing deficits. However, impairments at different levels of face processing have often been interpreted as reflecting a deficit in the recognition stage of face processing. Based on the data now available on prosopagnosia, we advocate for a more structured approach to assessment, which may facilitate a better understanding of the key deficits in prosopagnosia and of the level(s) of face processing that are impaired.

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

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

White matter pathways and social cognition

There is a growing consensus that social cognition and behavior emerge from interactions across distributed regions of the "social brain". Researchers have traditionally focused their attention on functional response properties of these gray matter networks and neglected the vital role of white matter connections in establishing such networks and their functions. In this article, we conduct a comprehensive review of prior research on structural connectivity in social neuroscience and highlight the importance of this literature in clarifying brain mechanisms of social cognition. We pay particular attention to three key social processes: face processing, embodied cognition, and theory of mind, and their respective underlying neural networks. To fully identify and characterize the anatomical architecture of these networks, we further implement probabilistic tractography on a large sample of diffusion-weighted imaging data. The combination of an in-depth literature review and the empirical investigation gives us an unprecedented, well-defined landscape of white matter pathways underlying major social brain networks. Finally, we discuss current problems in the field, outline suggestions for best practice in diffusion-imaging data collection and analysis, and offer new directions for future research.

Developmental prosopagnosics have widespread selectivity reductions across category-selective visual cortex

Developmental prosopagnosia (DP) is a neurodevelopmental disorder characterized by severe deficits with facial identity recognition. It is unclear which cortical areas contribute to face processing deficits in DP, and no previous studies have investigated whether other category-selective areas function normally in DP. To address these issues, we scanned 22 DPs and 27 controls using a dynamic localizer consisting of video clips of faces, scenes, bodies, objects, and scrambled objects. We then analyzed category selectivity, a measure of the tuning of a cortical area to a particular visual category. DPs exhibited reduced face selectivity in all 12 face areas, and the reductions were significant in three posterior and two anterior areas. DPs and controls showed similar responses to faces in other category-selective areas, which suggests the DPs' behavioral deficits with faces result from problems restricted to the face network. DPs also had pronounced scene-selectivity reductions in four of six scene-selective areas and marginal body-selectivity reductions in two of four body-selective areas. Our results demonstrate that DPs have widespread deficits throughout the face network, and they are inconsistent with a leading account of DP which proposes that posterior face-selective areas are normal in DP. The selectivity reductions in other category-selective areas indicate many DPs have deficits spread across high-level visual cortex.

The contribution of facial dynamics to subtle expression recognition in typical viewers and developmental visual agnosia

Facial expressions are inherently dynamic cues that develop and change over time, unfolding their affective signal. Although facial dynamics are assumed important for emotion recognition, testing often involves intense and stereotypical expressions and little is known about the role of temporal information in the recognition of subtle, non-stereotypical expressions. In Experiment 1 we demonstrate that facial dynamics are critical for recognizing subtle and non-stereotypical facial expressions, but not for recognizing intense and stereotypical displays of emotion. In Experiment 2 we further examined whether the facilitative effect of motion can lead to improved emotion recognition in LG, an individual with developmental visual agnosia and prosopagnosia, who has poor emotion recognition when tested with static facial expressions. LG's emotion recognition improved when subtle, non-stereotypical faces were dynamic rather than static. However, compared to controls, his relative gain from temporal information was diminished. Furthermore, LG's eye-tracking data demonstrated atypical visual scanning of the dynamic faces, consisting of longer fixations and lower fixation rates for the dynamic-subtle facial expressions, comparing to the dynamic-intense facial expressions. We suggest that deciphering subtle dynamic expressions strongly relies on integrating broad facial regions across time, rather than focusing on local emotional cues, skills which are impaired in developmental visual agnosia.

Delayed processing of global shape information in developmental prosopagnosia

There is accumulating evidence suggesting that a central deficit in developmental prosopagnosia (DP), a disorder characterized by profound and lifelong difficulties with face recognition, concerns impaired holistic processing. Some of this evidence comes from studies using Navon’s paradigm where individuals with DP show a greater local or reduced global bias compared with controls. However, it has not been established what gives rise to this altered processing bias. Is it a reduced global precedence effect, changes in susceptibility to interference effects or both? By analyzing the performance of 10 individuals with DP in Navon’s paradigm we find evidence of a reduced global precedence effect: The DPs are slower than controls to process global but not local shape information. Importantly, and in contrast to previous studies, we demonstrate that the DPs perform normally in a comprehensive test of visual attention, showing normal: visual short-term memory capacity, speed of visual processing, efficiency of top-down selectivity, and allocation of attentional resources. Hence, we conclude that the reduced global precedence effect reflects a perceptual rather than an attentional deficit. We further show that this reduced global precedence effect correlates both with the DPs’ face recognition abilities, as well as their ability to recognize degraded (non-face) objects. We suggest that the DPs’ impaired performance in all three domains (Navon, face and object recognition) may be related to the same dysfunction; delayed derivation of global relative to local shape information.

Congenital prosopagnosia without object agnosia? A literature review

A longstanding controversy concerns the functional organization of high-level vision, and the extent to which the recognition of different classes of visual stimuli engages a single system or multiple independent systems. We examine this in the context of congenital prosopagnosia (CP), a neurodevelopmental disorder in which individuals, without a history of brain damage, are impaired at face recognition. This paper reviews all CP cases from 1976 to 2016, and explores the evidence for the association or dissociation of face and object recognition. Of the 238 CP cases with data permitting a satisfactory evaluation, 80.3% evinced an association between impaired face and object recognition whereas 19.7% evinced a dissociation. We evaluate the strength of the evidence and correlate the face and object recognition behaviour. We consider the implications for theories of functional organization of the visual system, and offer suggestions for further adjudication of the relationship between face and object recognition.

Hemispheric Organization in Disorders of Development

A recent theoretical account posits that, during the acquisition of word recognition in childhood, the pressure to couple visual and language representations in the left hemisphere (LH) results in competition with the LH representation of faces, which consequently become largely, albeit not exclusively, lateralized to the right hemisphere (RH). We explore predictions from this hypothesis using a hemifield behavioral paradigm with words and faces as stimuli, with concurrent ERP measurement, in a group of adults with developmental dyslexia (DD) or with congenital prosopagnosia (CP), and matched control participants. Behaviorally, the DD group exhibited clear deficits in both word and face processing relative to controls, while the CP group showed a specific deficit in face processing only. This pattern was mirrored in the ERP data too. The DD group evinced neither the normal ERP pattern of RH dominance for faces nor the LH dominance for words. In contrast, the CP group showed the typical ERP superiority for words in the LH but did not show the typical RH superiority for faces. These findings are consistent with the hypothesis that the typical hemispheric organization for words can develop in the absence of typical hemispheric organization for faces but not vice versa, supporting the account of interactive perceptual development.