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Prosopagnosia: A clinical, psychological, and anatomical study of three patients
Abstract
Three patients with prosopagnosia are described of whom two had right occipital lesions. An analysis of visual and perceptual functions demonstrated a defect in perceptual classification which appeared to be stimulus-specific. A special mechanism for facial recognition is postulated, and the importance of the right sided posterior lesion is stressed.
... In their classic study of 22 cases of facial agnosia, Hecaen and Angelergues (1962) concluded on clinical grounds that 16 had right hemisphere lesions, 4 had bilateral disease, and only 2 had left-hemisphere lesions. More recently, Whitely and Warrington (1977) have described three patients with facial agnosia. One had bilateral occipital infarctions and two had right occipital lobe disease, the site of the lesions having been verified by computed tomography. ...
... Among the 42 prosopagnosic cases analyzed by Meadows (1974), 38 (90%) were found to have field defects. To these cases may be added the patient of Lhermitte et al. (1972), who had a visual field defect, the three patients described by Whitely and Warrington (1977), all of whom had field defects, and the traumatic case with full visual fields reported by Levin and Peters (1976). The relative frequency of visual field defect in .patients ...
Knowledge of the neuropsychological mechanisms underlying facial recognition has come from both experimental study of normal Ss and clinical investigation of patients who show defects in facial perception or memory. A basic difference exists between the identification of the faces of familiar persons and the discrimination of unfamiliar faces. Defects in these 2 forms of facial recognition have different anatomical correlates, and a patient with brain disease may show one type of impairment and not the other. The right hemisphere appears to play a primary role in mediating both forms of facial recognition. However, there is evidence to indicate that left-hemisphere mechanisms are also involved in facial perception and memory and that the relative contribution of each hemisphere to the process may vary among individuals. (50 ref)
... The second, more significant reason for using faces as stimuli was to test whether memories for faces are susceptible to impairment. Some researchers have interpreted studies on prosopagnosia, face inversion, and people's impressive ability to recognize large numbers of faces as support for the position that face recognition involves a special processing system (e.g., Whiteley & Warrington, 1977;Yin, 1969Yin, , 1970. One derivation from this position is the idea that memories for faces might not be affected by impairment that plagues memories for other stimuli (see Davies & Christie, 1982;Davies, Shepherd, & Ellis, 1979). ...
... These findings have obvious practical significance regarding eyewit-ness memory. Also, they clearly refute the idea that memories for faces are somehow unique in their resistance to retroactive interference (see Davies et al., 1979;Davies & Christie, 1982), and they do not bode well for the claim that face recognition involves a special processing system (Whiteley & Warrington, 1977;Yin, 1969Yin, ,1970. ...
Four experiments investigated whether and how interpolated faces cause impairment to memories for related target faces. Participants viewed target faces and then saw a presentation of interpolated faces that were related to some of the targets. Modified tests, which offered target and novel faces as recognition alternatives, detected impairment effects after short retention intervals but not after 48-hr intervals, indicating that spontaneous recovery had occurred. For the interpolated presentations, some participants were misled to believe that the faces were the same as the targets, and others were informed that they were similar but different. The impairment and recovery effects were not moderated by participants' beliefs about the interpolated faces. The recovery effects suggest that interpolated faces affected the retrieval but not the storage of memories for targets, even for participants who were successfully misled about the interpolated faces.
... Prior to CT imaging, debate persisted about whether involvement of both hemispheres was necessary or whether just a right-hemisphere focal lesion was sufficient. [3][4][5][6][7][8] Increased use of head CT scans in neurological diseases revealed that an isolated righthemisphere lesion was sufficient to account for loss of facial recognition. [9][10][11][12] Over the next few decades, De-Renzi and colleagues 13 proposed that there are two different types of prosopagnosia, an apperceptive type and an associative (amnestic) type, while Warrington and colleagues 14,15 showed that facial-recognition loss differed from the loss of ability to discriminate between faces and that facial recognition can be specific to human faces. ...
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 etiologies. 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 etiology. 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 categorised 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 (ischemic and hemorrhagic), 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 ischemic 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.
... Therefore, prosopagnosia and prosopometamorphopsia need to be carefully distinguished from each other. Neither should prosopometamorphopsia be confused with face adaptation (i.e., the finding that faces can be perceived slightly differently due to prior exposure to other faces; Webster & MacLeod, 2011). Finally, it should be distinguished from the flashed face distortion effect (also known as multiple-faces configuration), an experimentally induced illusion that involves a marked distortion of facial features when normal faces are presented in rapid succession to the peripheral visual field (Simas, Rocha, Sedycias, do Amaral, & de Menezes, 2008;Tangen, Murphy, & Tompson, 2011). ...
Prosopometamorphopsia is an extremely rare disorder of visual perception characterised by facial distortions. We here review 81 cases (eight new ones and 73 cases published over the past century) to shed light on the perception of face gestalts. Our analysis indicates that the brain systems underlying the perception of face gestalts have genuine network properties, in the sense that they are widely disseminated and built such that spatially normal perception of faces can be maintained even when large parts of the network are compromised. We found that bilateral facial distortions were primarily associated with right-sided and bilateral occipital lesions, and unilateral facial distortions with lesions ipsilateral to the distorted hemifield or to the splenium of the corpus callosum. We also found tentative evidence for the involvement of the left frontal regions in the fusing of vertical hemi-images of faces, and of right parietal regions in the fusing of horizontal hemi-images. Evidence supporting the remarkable adaptability of the network comes from the relatively high recovery rates that we found, from the ipsilateral hemifield predominance of hemi-prosopometamorphopsia, and from a phenomenon called cerebral asthenopia (heightened visual fatigability) which points to the dynamic nature of compensatory mechanisms maintaining normal face perception, even in chronic cases of prosopometamorphopsia. Finally, our analysis suggests that specialised networks for the representation of face gestalts in familiar-versus-unfamiliar faces and for own-versus-other face may be present, although this is in need of further study.
... Although Quaglino recognised the cerebral origin of the disorder, the impact of his paper on the scientific community was practically nil and Prosopagnosia had to wait until almost a century (Bodamer, 1947) to be identified as a distinct type of agnosia. Since the 1940s, more than a hundred case reports of prosopagnosia have been published (Bomstein and Kidron, 1959;Bomstein et al, 1969;Damasio, 1985;Davidoff, 1988;De Renzi, 1986;Dumont et al, 1981;Landis et al, 1986b;Levine, 1978;Meadows, 1974;Pevzner et al, 1962;Rendot and Tzavaras, 1969;Whiteley and Warrington, 1977). The increased interest in prosopagnosia may partly relate to its implication on the organisation of the visual recognition and memory systems (Damasio et al, 1990). ...
In this thesis, Position Emission Tomography (PET) was used to investigate how the human brain identifies the faces and proper names of famous people. The first experiment illustrated that identifying known individuals from either their faces or their proper names, activated a widespread neural system in the left hemisphere extending from the anterior temporal to the posterior temporo-parietal regions. To investigate the specificity of these responses for famous people, two further PET studies were performed in which famous faces were compared to other categories of objects (animals, man-made objects, body parts, maps and colours) presented as pictures and famous proper names were compared to names of common objects. Both studies revealed that a specific region in the left anterior temporal lobe was more active for famous faces and proper names than for objects, suggesting a segregation of the neural substrates necessary for retrieving semantic attributes about known people. Alternatively, the preferential response of the anterior temporal cortex for famous people could be explained by greater demands on semantic retrieval processes when the semantic attributes of a stimulus are unique but the visual features are shared by many other members of the same category. To test this hypothesis, the brain response to famous buildings and landmarks was investigated since they are linked, like famous faces, to unique semantic information. Indeed, the anterior temporal lobe was activated by famous buildings as well as famous faces. These studies on normal subjects therefore suggested that the anterior temporal lobe is implicated in retrieval of specific semantic information about unique items. However, in normal language processing, identification and naming occur together highly automatically and it is difficult to disentangle them. A patient with a severe deficit in naming (anomia) famous faces was therefore studied. The patient was able to access semantic but not lexical information and showed a normal anterior temporal cortex response. Taken together, the results of both normal and patient studies suggest that the left anterior temporal cortex is involved in: i) Retrieving specific semantic information about known people regardless of the modality of presentation of the stimuli, i.e. both from faces and proper names; ii) Identification of other categories of unique items, such as famous buildings and landmarks; and iii) Identification more than naming.
... He commented that he saw everything as shades between black and white." (Whiteley & Warrington, 1977) (Green & Lessell, 1977) (Ishii, Kita, Nagura, Bandoh & Yamanouchi, 1992) (Damasio, et al., 1980) (Brazis, Biller & Fine, 1981) Case 1 : No recovery within 9 months. what is its cause. ...
Practical and theoretical approaches were applied to try to unravel the relationship of the anatomical processing sites to the relative timing of processing and perception. Psychophysical, imaging and theoretical studies led to the overall conclusion that simultaneously presented attributes that are perceived at the same time are processed at the same site, and ones that are perceived at different times are processed at different sites. This is referred to as to the theory of perceptual sites. Functional magnetic resonance imaging (fMRI) experiments charted the organisation of the human colour centre (the V4-complex), and found it to be more complex than previously believed. It has two subdivisions, V4 and V4α, of which V4 is retinotopically organised, while V4α is not. The extent and organisation of the colour centre revealed in this study may account for the variability and severity of the syndrome of achromatopsia (acquired cortical colour blindness). Application of an independent components analysis (ICA) to fMRI data showed that these two subdivisions are coactive and can be isolated together from the remaining brain activity. It was further shown that, because cortical areas enjoy substantial autonomy, they differ in their activation time courses, such that ICA can dissect the brain computationally into its functional units, creating what we call chronoarchitectonic maps. The above evidence, when viewed in context of previous experimental and clinical studies, leads us to propose the following: First, that the activity in different visual areas reaches conscious perceptual endpoints at different times; leading to the supposition that consciousness is not unitary but consists of many microconsciousnesses. Second, that since activity at each processing site can become perceptually explicit, there is no terminal perceptual stage in the visual brain; leading to the conclusion that activity at each site of the visual brain can be integrated with activity at any other site, and to the theory of multistage integration.
... The utility of clinical observations to aid in anatomical localizsation cannot be underestimated. 'The anatomical basis of prosopagnosia' 1 is a concept that has intrigued neurologists and neuropsychologists since the first descriptions of prosopagnosia in the 19th century by Quaglino and subsequently by the giants of early neurology Hughlings Jackson and Charcot. 2 3 The JNNP has a long history of publishing manuscripts discussing this phenomenon that have included case reports by illustrious authors such as Elizabeth Warrington 4 and also historical notes 2 detailing Lewis Carroll's humpty dumpty in Through the looking-glass, and what Alice found there (1872), as an early report of prosopagnosia. John Meadows in his comprehensive review published in 1974 1 has been cited more than 400 times, which speaks to the enduring interest in this disorder. ...
... In addition, cortical thickness of the 541 right fusiform in MDD cases with comorbid generalised anxiety was even more 542 reduced ( Canu et al., 2015). The right fusiform gyrus has a central role in face 543 perception ( Haxby et al., 2000), in neurological case reports of prosopagnosis 544 (face blindness) ( Whiteley and Warrington, 1977;Damasio et al., 1990;Derenzi 545 et al., 1994), behavioural studies ( Rhodes, 1993) and imaging studies ( McCarthy 546 et al., 1997;Haxby et al., 2000). Lower right fusiform grey matter density was 547 observed in developmental prosopagnosis ( Garrido et al., 2009) and in 548 congenital prosopagnosia ( Behrmann et al., 2007). ...
Here we aimed to identify cortical endophenotypes for anxiety-depression. Our data-driven approach used vertex-wise genetic correlations (estimated from a twin sample: 157 monozygotic and 194 dizygotic twin pairs) to parcellate cortical thickness (CT) and surface area (SA) into genetically homogeneous regions (Chen et al., 2013). In an overlapping twin and sibling sample (n = 834; aged 15-29, 66% female), in those with anxiety-depression Somatic and Psychological Health Report (SPHERE) scores (Hickie et al., 2001) above median, we found a reduction of SA in an occipito-temporal cluster, which comprised part of the right lingual, fusiform and parahippocampal gyrii. A similar reduction was observed in the Human Connectome Project (HCP) sample (n = 890, age 22-37, 56.5% female) in those with Adult Self Report (ASR) DSM-oriented scores (Achenbach et al., 2005) in the 25-95% quantiles. A post hoc vertex-wise analysis identified the right lingual and, to a lesser extent the fusiform gyrus. Overall, the surface reduction explained by the anxiety-depression scores was modest (r = -0.10, 3rd order spline, and r = -0.040, 1st order spline in the HCP). The discordant results in the top 5% of the anxiety-depression scores may be explained by differences in recruitment between the studies. However, we could not conclude whether this cortical region was an endophenotype for anxiety-depression as the genetic correlations did not reach significance, which we attribute to the modest effect size (post hoc statistical power <10%).
... Individuals with face perception deficits such as prosopagnosia, the inability to recognize faces, demonstrate impairments in behavioral face recognition tasks while performing normally on behavioral tasks of emotional expression recognition [13][14][15][16][17][18]. Additionally, individuals with these deficits demonstrate a marked decrease in the amplitude of the ERP most associated with face perception, the temporal-occipital N170. ...
... Left lateralization in visual and auditory word recognition has been demonstrated in a number of studies that specifically activated semantic and phonological processes (Petersen et al., 1988(Petersen et al., , 1990Wise et al., 1991;Demonet et al., 1992;Howard et al., 1992;Price et al., 1994Price et al., , 1996 as well as prelexical letter-string processing . Right lateralization in face recognition is also consistent with the findings of previous imaging or electrophysiological studies (Ojemann et al., 1992;Sergent et al., 1992;Allison et al., 1994a;Puce et al., 1996;Kanwisher et al., 1997) and clinical studies demonstrating significant impairment of facial recognition in patients with right hemisphere lesions (Whiteley and Warrington, 1977;De Renzi, 1986;Rosler et al., 1997). A particularly interesting activation with this lateralization pattern occurred in the orbitofrontal cortex; it was activated on the left side in novel word recognition and symmetrically activated on the right side in novel face recognition (see the transaxial slices in Fig. 1). ...
For the purpose of identifying the relatively specific brain regions related to word and face recognition memory on the one hand and the regions common to both on the other, regional cerebral blood flow associated with different cognitive tasks for recognition memory was examined using [H215O]PET in healthy volunteers. The tasks consisted of recognizing two types of stimuli (faces and words) in two conditions (novel and familiar), and two baseline tasks (reading words and gender classification). The statistical analyses used to identify the specific regions consisted of three subtractions: novel words minus novel faces, familiar words minus familiar faces, and reading words minus gender classification. These analyses revealed relative differences in the brain circuitry used for recognizing words and for recognizing faces within a defined level of familiarity. In order to find the regions common to both face and word recognition, overlapping areas in four subtractions (novel words minus reading words, novel faces minus gender classification, familiar words minus reading words, and familiar faces minus gender classification) were identified. The results showed that the activation sites in word recognition tended to be lateralized to the left hemisphere and distributed as numerous small loci, and particularly included the posterior portion of the left middle and inferior temporal gyri. These regions may be related to lexical retrieval during written word recognition. In contrast, the activated regions for face recognition tended to be lateralized to the right hemisphere and located in a large aggregated area, including the right lingual and fusiform gyri. These findings suggest that strikingly different neural pathways are engaged during recognition memory for words and for faces, in which a critical role in discrimination is played by semantic cueing and perceptual loading, respectively. In addition, the investigation of the regions common to word and face recognition indicates that the anterior and posterior cingulate have dissociable functions in recognition memory that vary with familiarity, and that the cerebellum may serve as the co-ordinator of all four types of recognition memory processes.
... In support of face modularity are those reports of prosopagnosic subjects who can still identify personal belongings (122), individual animals (52, 123), specific places (39, 52), cars (52, 124, 125), flowers (39), vegetables (124,126), and eyeglasses (127). In support of the expertise hypothesis are reports of prosopagnosic subjects who cannot identify types ('subordinate categories') of cars, food, or coins, or specific unique exemplars of buildings, handwriting, or personal clothing (17,48,128,129). ...
Detection of faces in visual scenes has received extensive attention in machine vision, but limited research has addressed face detection in humans. Here we assess face detection in six participants with acquired prosopagnosia resulting from a variety of lesions to better understand the processes and neural areas contributing to face detection and the relation of detection to other stages of face recognition. All six participants showed severe impairments on tests of facial identity recognition, confirming prosopagnosia, and participants were also extensively tested for perceptual discrimination of faces. We used structural MRI to delineate the lesions and functional MRI to show the status of the core regions of the face-processing network (OFA, FFA, STS). Two tasks requiring visual search for the presence of a face among distractor stimuli assessed detection in the patients and 12 age-matched controls. Two participants, R-AT2 and B-AT1, performed normally on both tasks. These patients had anterior temporal lesions that did not affect their core face-processing network. Two participants, R-AT1 and R-IOT4, had severe detection impairments while the performance of R-IOT1 and B-AT/IOT1 was borderline. These four subjects all showed difficulty on perceptual tasks requiring discrimination of facial identity. Except for R-AT1, all subjects had lesions to right inferior occipitotemporal cortex, with loss of the FFA and OFA in R-IOT1 and B-AT/IOT1 and loss of the FFA alone in R-IOT4. Furthermore, DTI analysis in R-AT1 suggested reduced fractional anisotropy in the region of the FFA and OFA. The association between detection and identity perception suggests that these abilities may be supported by the same processes. Impairment in these abilities correlates with damage to the core face-processing network in the right hemisphere. Face detection deficits in R-IOT4 despite preservation of the right and left OFA indicates that these regions are not sufficient on their own to support detection.
... In support of face modularity are those reports of prosopagnosic subjects who can still identify personal belongings (122), individual animals (52,123), specific places (39,52), cars (52,124,125), flowers (39), vegetables (124,126), and eyeglasses (127). In support of the expertise hypothesis are reports of prosopagnosic subjects who cannot identify types ('subordinate categories') of cars, food, or coins, or specific unique exemplars of buildings, handwriting, or personal clothing (17,48,128,129). ...
... La presencia simultánea de defectos perceptivos (cuadranopsias y hemianopsias) en el hemicampo visual izquierdo y de trastornos relacionados con el reconocimiento de caras ha sido uno de los datos clínicos considerados para plantear que las regiones posteriores del hemisferio derecho podrían desempeñar un papel casi exclusivo en el reconocimiento de caras [8][9][10]. De acuerdo con este supuesto, las lesiones unilaterales del hemisferio derecho deberían ser suficientes para provocar la aparición de este trastorno, lo cual se ha corroborado mediante estudios radiológicos de pacientes con distintos tipos de prosopagnosia [11][12][13][14][15][16][17]. ...
Agradecimientos. Este trabajo forma parte del proyecto de investigación DGES PB95-0246. 2000, REVISTA DE NEUROLOGÍA INTRODUCCIÓN El procesamiento neural de la información facial tiene una especial relevancia durante las relaciones interindividuales. La cara como estímulo visual caracteriza la identidad de una persona y refleja la comunicación de distintas emociones [1]. Desde un punto de vista ontogenético, debe subrayarse la preferencia visual del lactante por el rostro humano en comparación con otros estímulos. También es conocido que, desde los primeros días de vida, el niño es capaz de imitar y discriminar los movimientos faciales de un adulto [2-4] y que, alrededor de los cinco primeros meses, demuestra reconocer el rostro de las personas más allegadas [5]. Tomados desde una pers-pectiva psicobiológica, estos datos nos permiten suponer la existen-cia de mecanismos neurales especializados en el procesamiento de caras. De acuerdo con la tesis anterior, en este artículo revisamos los datos aportados por la neuropsicología clínica y la investigación realizada en primates no humanos. Distintos datos ponen en evi-dencia, en el primer caso, la ocurrencia de daños cerebrales que conllevan trastornos relacionados particularmente con el recono-cimiento de rostros familiares y, en el segundo, la existencia de circuitos neurales que responden selectivamente a caras en rela-ción con otras categorías de estímulos. Comenzamos con el análisis, en primer lugar, de los datos apor-tados por la neuropsicología clínica sobre especialización funcional hemisférica en el procesamiento de caras. A continuación, revisa-mos los conocimientos actuales sobre las áreas intrahemisféricas específicas que parecen ser el soporte neural de la percepción y el reconocimiento de caras, y nos basamos también en los datos pro-Bases neurales de la percepción y el reconocimiento de caras E.I. Olivares, J. Iglesias NEURAL BASES OF PERCEPTION AND RECOGNITION OF FACES Summary. Objective. To analyze the neural bases of perception and the recognition of faces. First of all we consider the concept of functional hemisphere specialization; then we look at the results obtained with regard to the neuroanatomy of processing faces and finally refer to the disorders of recognition of faces in humans. For this we review the clinical evidence obtained from the neuropsychological studies of prosopagnostic patients and the data derived from psychophysiological experiments done using intracranial recordings of nonhuman primates. Development. The agreement between the results analysed allows us conclude that in both cerebral hemispheres there are neural mechanisms specialized in the perception and recognition of faces, and in particular the ventral and posterior regions of the occipito-temporal cortex play a decisive part in these processes. Similarly experimental findings in nonhuman primates permits explanation of the neural nature of certain neuropsychological disorders seen in man, such as the case of the dissociation between disorders of the recognition of facial identity and disorders of recognition of emotional expression, and also dissociation between the difficulty in recognizing familiar faces and difficulty in recognizing non-familiar faces. Conclusion. The use of modern neuroimaging techniques and electrophysiological studies using evoked potentials are necessary for greater understanding of these and other disorders related to processing facial information. [REV NEUROL 2000; 30: 946-52] [http://www.revneurol.com/3010/i100946.pdf] venientes del estudio de pacientes neuropsicológicos. Para todo ello es necesario destacar la importancia del estudio de pacientes proso-pagnósicos, esto es, individuos que, consecutivamente a un daño cerebral, pierden la habilidad de reconocer rostros familiares [6,7]. Posteriormente, aportamos una visión 'microscópica' a partir de los datos derivados de los registros electrofisiológicos de cier-tas poblaciones neuronales de primates no humanos. La caracte-rización de esta actividad neuronal nos permitirá, por último, comprender la causa de ciertos trastornos relacionados con el procesamiento de caras en el hombre.
... Usually, the damage in the occipito-temporal area, either bilateral (e.g., Bruyer et a, 1983;Damasio et al, 1982;Ettlin et al, 1992;Meadows, 1974) or right (e.g. Benton, 1990;De Renzi, 1986a;Landis et al, 1986Landis et al, , 1988Whiteley & Warrington, 1977) have been associated with disturbances in face recognition. It is usually assumed that a bilateral occipitotemporal network mediates face perception (Minnebusch et al., 2009); when this network is disrupted, face recognition defects are observed. ...
... Clinical evidence for face-selective regions in humans comes from cases of prosopagnosia, a difficulty in recognizing faces of familiar persons that is associated with damage to the inferior occipitotemporal region (Meadows, 1974;Whiteley and Warrington, 1977;Damasio, 1985;Sergent and Poncet, 1990). Object recognition, in contrast, is not typically impaired in prosopagnosic patients (De Renzi, 1986). ...
Numerous magnetoencephalographic (MEG) investigations of the functional organization of the human visual system have been conducted since 1968. MEG can provide sensitive temporal information about sensory and cognitive functions, on the order of milliseconds, and can provide good spatial resolution as well. Early MEG investigations of the visual system attempted to corroborate findings between noninvasive MEG measures and invasive studies in monkeys, because much of the knowledge of the visual system had been gained from these anatomical, lesional, and electrophysiological studies. Invasive studies reveal a number of different areas in the monkey brain that contain different representations of the visual field and which process information in slightly different ways. The MEG studies reviewed in this chapter represent the steps toward the general goal of a noninvasive delineation of visual information-processing pathways in the human brain. Despite reliable reports of gamma band activation in cats and monkeys, it has been more difficult to visualize this activity in humans using MEG. Mental imagery draws on much of the same neural machinery as perception in the same modality, and can engage mechanisms in memory, emotion, and motor control.
... The early reports have been mixed. Some subjects cannot identify types of car, food, or coin, or specific exemplars of buildings, handwriting, or personal clothing (Lhermitte et al., 1972;Whiteley and Warrington, 1977;Damasio et al., 1982;de Haan and Campbell, 1991), while others can identify personal belongings (de Renzi, 1986), individual animals (Bruyer et al., 1983;McNeil and Warrington, 1993), specific places (Bruyer et al., 1983;Evans et al., 1995), cars (Bruyer et al., 1983;Henke et al., 1998), flowers (Evans DISORDERS OF HIGHER VISUAL PROCESSING et al., 1995), vegetables (Henke et al., 1998;Riddoch et al., 2008), and eyeglasses (Farah et al., 1995). ...
Purpose of review:
This article reviews the various types of visual dysfunction that can result from lesions of the cerebral regions beyond the striate cortex.
Recent findings:
Patients with dyschromatopsia can exhibit problems with color constancy. The apperceptive form of prosopagnosia is associated with damage to posterior occipital and fusiform gyri, and an associative/amnestic form is linked to damage to more anterior temporal regions. Pure alexia can be accompanied by a surface dysgraphia. New word-length effect criteria distinguish pure alexia from hemianopic dyslexia. Subtler problems with perception of numbers and faces can be seen in patients with pure alexia as well. Also, a developmental form of topographic disorientation, which is due to problems with forming cognitive maps of the environment, has been discovered. In Balint syndrome, added features of decreased flexibility of attention in simultanagnosia include local and global capture. Balint syndrome can affect not just localization in space, but also in time, as manifest in sequence agnosia.
Summary:
Lesions at intermediate levels of a processing hierarchy can cause difficulty with color perception or motion perception. At a higher level, ventral lesions of the occipitotemporal lobes can lead to a variety of problems with object recognition. Dorsal lesions of the occipitoparietal lobes can cause difficulty with spatial localization and guidance.
... A review of the neuropsychological literature individuated the right occipitotemporal cortex as the most common location of the lesion in prosopagnosic patients (Meadows, 1974). Convergent evidence in support of the view that damage to the occipitotemporal cortex leads to prosopagnosia was reported in several studies (Whiteley and Warrington, 1977;Damasio et al., 1982;Malone et al., 1982). ...
Every day we encounter dozens of people, and in order to interact with them appropriately we need to recognize their identity. The face is a crucial source of information to recognize a person’s identity. However, recognizing the identity of a face is challenging because it requires distinguishing between very similar images (e.g., the front views of two different faces) while categorizing very different images (e.g., a front view and a profile) as the same person. Neuroimaging has the whole-brain coverage needed to investigate where representations of face identity are encoded, but it is limited in terms of spatial and temporal resolution. In this article, we review recent neuroimaging research that attempted to investigate the representation of face identity, the challenges it faces, and the proposed solutions, to conclude that given the current state of the evidence the right anterior temporal lobe is the most promising candidate region for the representation of face identity.
... Both the OFA and the FFA have been implicated in the processing of invariant aspects of faces for identity perception (Haxby et al., 2000;Gobbini & Haxby, 2007). Identity recognition is normal in some cases of prosopometamorphopsia (Bodamer, 1947;Nijboer et al., 2008), but impaired in others (Whiteley & Warrington, 1977;Heutink, Brouwer, Kums, Young, & Bouma, 2012). Interestingly, although her face recognition is normal, AS reports that her distortions are more severe for familiar than for unfamiliar faces. ...
Prosopometamorphopsia is a disorder of face perception in which faces appear distorted to the perceiver. The neural basis of prosopometamorphopsia is unclear, but may involve abnormal activity in face-selective areas in the ventral occipito-temporal pathway. Here we present the case of AS, a 44-year-old woman who reports persistent perceptual distortions of faces with no known cause. AS was presented with facial images and rated the magnitude of her distortions while activity in her core face areas and other areas in the ventral visual pathway was measured using functional magnetic resonance imaging. The magnitude of her distortions was positively correlated with signal changes in the right occipital face area (OFA) and right fusiform face area (FFA), as well as right V1-V3, and right lateral occipital cortex (LOC). There was also a trend for a significant correlation with signal in the left OFA and right inferior frontal gyrus (IFG), but not in the right or left superior temporal sulcus (STS). These results suggest that AS' prosopometamorphopsia reflects anomalous activity in face-processing network, particularly in the ventral occipitotemporal cortex.
Prosopometamorphopsia (PMO) is a striking condition of visual perception in which facial features appear distorted, for example drooping, swelling, or twisting. Although numerous cases have been reported, few of those investigations have carried out formal testing motivated by theories of face perception. However, because PMO involves conscious visual distortions to faces which participants can report, it can be used to probe fundamental questions about face representations. Here we review cases of PMO that address theoretical questions in visual neuroscience including face specificity, inverted face processing, the importance of the vertical midline, dissociable representations for each half of the face, hemispheric specialization, the relationship between face recognition and conscious face perception, and the reference frames that face representations are embedded within. Finally, we list and touch upon eighteen open questions that make clear how much is left to learn about PMO and the potential it has to provide important advances in face perception.
Frontotemporal dementia (FTD) is a cruel disease, robbing patients of core human characteristics and wreaking havoc with relationships. Clinical and scientific interest in FTD and related disorders continues to grow rapidly, with major advances having occurred since this book's last publication. New clinical diagnostic criteria were published in 2011; new pathological discoveries have led to new diagnostic criteria; and major genetic discoveries have been made. This new edition covers these developments, providing the leading resource on FTD, PPA, PSP, CBD, FTD-ALS, and related disorders, now written by a more internationally representative group of authors than before. Providing an in-depth and expert synthesis of the status of our knowledge of FTD and related syndromes, the content includes chapters reviewing clinical, neuropsychiatric, neuropsychological, imaging, and other features of FTD and multidisciplinary approaches to patient management. Essential reading for specialist and generalist neurologists, psychiatrists, geriatricians, neuropsychologists, neuropathologists, and basic scientists in relevant fields.
The importance of different perspective views for the recognition of model heads was studied. In experiment 1 subjects were instructed to learn the appearance of six heads placed individually on a turntable free to rotate through 360°. Subjects did not distribute their time evenly but focussed their inspection on particular views (the full face view and a view close to the profile). Despite differential inspection of these two views during the learning phase, the face, half profile, and profile views were recognized with equal efficiency in a subsequent recognition task with static views. Experiment 2 used the inspection paradigm to investigate view preference during the recognition of heads from memory. In this experiment subjects were asked to learn the appearance of three heads each seen rotating at an even speed. In a subsequent retrieval task the subjects actively inspected six model heads on the turntable and were asked to differentiate the three heads previously seen rotating from three novel heads. The pattern of inspection in this retrieval task was equivalent to that in experiment 1. Results suggest that during the encoding into memory subjects construct descriptions of specific prototypical views of the head and that descriptions of these same views are preferentially utilised during recognition.
Examination tools such as functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) have enabled extensive research in neuroanatomy in normal subjects and in individuals with congenital or acquired prosopagnosia. Greater awareness is necessary for early diagnosis and treatment.
Three different aspects of prosopagnosia are covered below.
In part one, neuroanatomical findings responsible for face recognition and identification in healthy subjects are described, highlighting the core and extended neural network of the extrastriate visual cortex. The three main areas in the core system are: the fusiform face area (FFA), the occipital face area (OFA), and posterior superior temporal sulcus (pSTS).
In part two, the essential clinical and diagnostic features of developmental (congenital) prosopagnosia (DP) are described. DP remains life-long during life. This prosopagnosia is often hereditary. Its prevalence is 2.5% among Caucasians.
Of interest to ophthalmologists are functional changes in individuals with DP. Subjects with DP exhibit normal visual acuity and visual fields.
Part three covers acquired prosopagnosia (AP), a defect in face recognition following focal brain damage, caused by various brain diseases: it is usually due to bilateral or unilateral occipitotemporal lesions or anterior temporal damage. A better functioning right hemisphere in patients with unilateral brain damage as the cause of AP should be considered. Neuro-ophthalmological deficits have often been diagnosed, i. e., visual field defects in 82%, color vision disturbances (achromatopsia or dyschromatopsia) in 23.3%. Of special interest to ophthalmologists are the findings in subjects’ gaze behavior. There is evidence that averted-gaze and mutual gaze-activated areas differ from those involved in face processing.
This thesis is an examination of the memory problems that are considered pathological of frontal lobe dysfunction in humans. It is divided in to three main sections. The first section concentrates on the findings from the experimental literature, and includes the development of two measures sensitive to frontal lobe involvement. These tests were validated on a group of 152 patients with localised cerebral lesions, and were used in order to discover the role of executive functions in patients' performance on traditional neuropsychological memory tests. The second section puts forward the notion that executive functions and prospective memory are intimately linked, and describes the investigation of three single case studies who showed organisational problems in everyday life. It is proposed that one of the core problems shown by such patients is a deficit in prospective memory functions. The last section presents the development of a model of the role of the frontal lobes in human memory with particular reference to confabulation. The model is based upon empirical evidence from a study of how normal subjects recall autobiographical events.
This chapter recounts the history of early studies of familiar voice recognition
This paper reviews the anatomy and pathophysiology of the visual agnosias, pure alexia, visual hallucinations, tortopia and akinetopsia.
This thesis concerns theoretical and empirical issues in face processing and facial trait perception. First, I present evidence that challenges two hypotheses proposed as alternatives to face specificity, namely the individuation and the expertise hypotheses. Inconsistent with the individuation hypothesis, an extensive investigation of a new case of acquired prosopagnosia (Herschel) revealed normal exemplar recognition memory for a wide variety of objects, and normal ability to discriminate between highly similar items within a novel object category. Inconsistent with the expertise hypothesis, Herschel and Florence, a second acquired prosopagnosic, showed normal learning profiles and response times putative of successful expertise acquisition in an eight-day training procedure with novel objects, demonstrating that faces are processed by specialised mechanisms not used for objects-of-expertise. Second, testing four patients with acquired prosopagnosia, I demonstrate that perceptual mechanisms underlying trait judgments are dissociable from those implicated in recognising identity. Furthermore, I show that perception of facial aggressiveness does not depend on mechanisms for facial sex recognition, and that normal facial trustworthiness judgments are likely to occur without intact recognition of facial expressions, therefore challenging the overgeneralisation theory in facial trait perception. Third, I present a series of experiments with healthy participants to characterise various properties of facial trait perception. Specifically, I examine: i) the role of facial width-to-height ratio in perceived trustworthiness; ii) the accuracy of facial trustworthiness judgments; iii) the interaction between facial trustworthiness and reputation; and iv) the interaction between face impressions and voice impressions. Overall, the findings of the present thesis have important implications for the nature of the mechanisms underlying facial identity processing, the organisation of facial trait perception and its relationship to other face perception abilities, as well as the physical, ecological, and multimodal aspects of facial trait perception.
The development of orientation-sensitivity, or tuning, and the spatial-frequency tuning of neurones that we have so far considered may be regarded as modes of analysis of the spatial features of an object in space, leading ultimately to the recognition of shape and texture. Stereoscopic perception adds a third dimension to this analysis, so that we may now proceed to a consideration of the responses of cortical neurones to this feature.
The neuronal mechanisms of binocular vision presuppose sophisticated anatomical connections stemming from the fact that binocular cells in the visual cortex receive information from the two eyes' corresponding receptive fields. This chapter discusses by using positron emission tomography (PET) with an experimental paradigm related to the detection of horizontal disparity in Julesz type stereograms, the areas in the human brain that are specifically engaged in binocular disparity detection mediated by the detection of shape. The data clearly indicates that the analysis and processing of stereoptic disparity information takes place in the polar striate cortex and the neighbouring peristriate cortices. To analyze the involvement of the striate cortex in stereovision, the location and size of the activated regions was determined in 1 cm thick mesial parasagittal brain slices left and right of the midline. The regions activated by disparity detection on the mesial surface of the striate well correspond to the topographic representation of the centre of the visual field up to 5°.
The primary degenerative dementias are associated with loss of neurones, which may be seen as cerebral atrophy visible on structural (computed tomography (CT) or magnetic resonance (MR)) scans or at neuropathological examination. Such atrophy is usually said to be generalized, particularly in cases of Alzheimer’s disease, but a number of cases of localized cerebral atrophy have been described. Pick’s disease is the most widely recognized cause of focal cortical degeneration, usually associated with language disturbance, but more recently there have been reports of a variety of presentations of localized cortical degenerative disease. While some patients with focal onset of cortical degeneration go on to develop a more generalized dementing illness (Wechsler et al., 1982; Pogacar and Williams, 1984), this may not necessarily occur, or may be greatly delayed. For example, of the six patients described by Mesulam (1982) with a progressive aphasia due to left fronto-temporal cortical atrophy one had apparently normal nonverbal intellectual skills at 11 years after presentation, despite complete loss of all language abilities. In addition to progressive aphasia, patients with progressive apraxia or agnosia (de Renzi, 1986a), progressive visual disturbance (Benson et al., 1988), progressive prosopagnosia (Tyrrell et al., 1990), progressive loss of speech with orofacial dyspraxia (Tyrrell et al., 1991) and progressive apraxia with gait disturbance (Rossor et al., 1993) have been described.
Bodamer (1947) invented the term Prosopagnosia to describe the isolated inability to recognise people by their face. Patients are usually able to judge a face to be a face, and some of them may even be able to discriminate and match face photographs normally (Benton & Van Allen, 1968). The major symptom is the failure to recognise familiar faces in real life and in reproduction (photographs, television etc.). In some cases, patients may not even recognise their own face (Bauer & Rubens, 1985). Prosopagnosic patients may be able to identify people despite this disability. They can learn to rely on paraphernalia such as clothing, gait, hair style, height and distinguishing birthmarks and on identification cues from other modalities, like voice and perfume.
There are many different types of neuron organized into many different anatomical structures in the mammal brain. Many of these structures are connected together, sometimes by multiple routes, and often indirectly via other structures. Neuron physiology involves large numbers of different chemicals interacting by many complex pathways.
Like the frontal, temporal, and parietal lobes, which respond to and process information from a number of modalities, the occipital lobe contains neurons that, although predominantly concerned with the analysis of visual stimuli (i.e., areas 17, 18, and 19), respond to vestibular, acoustic, or somesthetic input as well (Jung, 1961).
The temporal lobes are usually associated with the processing of auditory stimuli; indeed, the primary and association auditory areas are localized within the superior temporal gyms. Nevertheless, the temporal lobe also receives extensive projections from the somesthetic and visual association areas 18 and 19 (Jones & Powell, 1970; Seltzer and Pandya, 1978); receives and processes gustatory, visceral, and olfactory sensations; harbors the amygdala and hippocampus within its inferior depths; and contains a considerable number of neurons that are heavily involved in the performance of complex visual integrative activities, including visual closure and the recognition of specific meaningful forms. Indeed, it has been argued that the temporal lobe evolved from visual cortex (Diamond, 1943), and it is apparent based on a variety of neurophysiological, neuroanatomical, and behavioral studies that the middle, inferior, and posterior—superior temporal lobe are indeed cortical visual areas.
Over the course of evolution, each half of the brain has developed its own unique strategy for perceiving, processing, and expressing information as well as specialized neuroanatomical interconnections that assist in mediating these functions. Indeed, the human brain is organized such that two potentially independent mental systems coexist, literally side by side. (cf. Gazzaniga & LeDoux, 1978; Joseph, 1982, 1988a,b; Levy, 1983; Sperry, 1966, 1982).
Background: Face imagery can access facial memories without the use of perceptual stimuli. Current data on the relation of imagery to the perceptual function and neuroanatomy of prosopagnosic patients are mixed, and little is known about the type of facial information patients can access through imagery. Objective: The authors wished to determine 1) which lesions abolished face imagery in prosopagnosia, 2) if deficits in perceiving facial structure were paralleled by similar deficits in imagery, and 3) if covert recognition of faces correlated with the degree of residual imagery for faces. Methods: The authors tested nine prosopagnosic patients who had been tested previously for perception of facial configuration and covert recognition of famous faces. The authors constructed a battery of 37 questions that asked subjects to imagine the faces of two celebrities and to choose which one had a certain facial property. Half were questions about facial features and half were about overall facial shape. Results: Imagery was abolished only by anterior temporal lesions. Imagery for facial shape but not features was degraded by lesions of the right hemisphere's fusiform face area, which severely impaired perception of facial configuration. Feature imagery was degraded only when there was associated left occipito-temporal damage. Covert recognition was found when either configural perception or imagery was severely damaged, but not when both were abnormal. In patients with impaired configural perception, covert recognition correlated with feature imagery, suggesting that feature-based processing may drive residual covert abilities in these patients. Conclusion: Although anterior temporal cortex may be the site of facial memory stores, these data also support hypotheses that perceptual areas like the fusiform face area have parallel contributions to mental imagery. The data on covert recognition are consistent with a view that it is the residue of a partially damaged face-recognition network. Covert recognition may reflect the degree of damage across components of a network rather than mark a specific form of prosopagnosia or a dissociated pathway.
The specialized role of the posterior right hemisphere in visual perception was first advanced by John Hughlings Jackson in 1864. Twelve years later, Jackson (1876/1958) described a patient whose course of illness confirmed his speculations about the lateralization of higher visual function. The clinical onset of illness in Jackson’s patient was marked by a sudden episode of spatial disorientation. Although the patient had resided in the same neighborhood for 30 years, she could not find her way to a nearby park that she had visited frequently. Jackson observed that his patient suffered from what he called “imperception”: the inability to recognize objects, persons, and places. Within months, the patient developed a left hemiplegia and rapidly deteriorated to coma and death. Autopsy revealed a large tumor in the posterior right hemipshere, with two smaller tumors in close proximity.
Previous studies have reported that some neurons in the inferior temporal (IT) cortex respond selectively to highly specific complex objects. In the present study, we conducted the first systematic survey of the responses of IT neurons to both simple stimuli, such as edges and bars, and highly complex stimuli, such as models of flowers, snakes, hands, and faces. If a neuron responded to any of these stimuli, we attempted to isolate the critical stimulus features underlying the response. We found that many of the responsive neurons responded well to virtually every stimulus tested. The remaining, stimulus-selective cells were often selective along the dimensions of shape, color, or texture of a stimulus, and this selectivity was maintained throughout a large receptive field. Although most IT neurons do not appear to be "detectors" for complex objects, we did find a separate population of cells that responded selectively to faces. The responses of these cells were dependent on the configuration of specific face features, and their selectivity was maintained over changes in stimulus size and position. A particularly high incidence of such cells was found deep in the superior temporal sulcus. These results indicate that there may be specialized mechanisms for the analysis of faces in IT cortex.
Chapter 1: Introduction.
Part 1: Perception of identity and emotion.
Chapter 2: The Facial Expression Action Stimulus Test. A test battery for the assessment of face memory, face and object perception, configuration processing and facial expression recognition.
Chapter 3: Configuration perception, face memory and face context effects in developmental prosopagnosia.
Chapter 4: Facial identity and emotional expression recognition in developmental prosopagnosia.
Chapter 5: Recognition and integration of facial and bodily expressions in acquired prosopagnosia.
Part 2: Emotional social interactions between two or more people
Chapter 6: The Body Action Coding System I. Muscle activations during the perception and expression of emotion.
Chapter 7: The Body Action Coding System II. Muscle activations during the perception and expression of emotion.
Chapter 8: From personal fear to mass panic: The neurological basis of crowd perception.
Chapter 9: Discussion
Central visual1 and oculomotor2 disorders are present in some 20%-40% of patients in neurological rehabilitation centres.3 Gianutsos reported that 50% of the patients in a head trauma rehabilitation centre show visual system disorders not assessed before although most of the patients were chronic and had been treated in other hospitals previously.4 In a large sample of 314 patients with postchiasmatic visual field disorders from a rehabilitation department 70% had a parafoveal visual field sparing of 5° or less. Of these patients, 50%-70% subjectively reported and objectively showed chronic reading and visual exploration deficits.5 Furthermore, visual field disorders are associated with an adverse prognosis in outcome studies according to life table analysis6 and impair the success of vocational rehabilitation.4 7 Spatial-perceptual deficits may delay the rehabilitation progress in physiotherapy,8 9 lead to complications due to repeated accidents,10 and correlate highly with deficits in activities of daily living (dressing, transfers, or manoeuvring a wheelchair.11-16
In the presence of limited financial resources in health policy it might be argued that central visual disorders do not require treatment as they do not affect outcome adversely. Although nothing supports this opinion there is some evidence to the contrary. Cutting inpatient stroke rehabilitation to a maximum of 60 days (in Italy) led to a deterioration in neuropsychological and activities of daily living in patients with stroke, especially those with right hemispheric lesions.17 Hence, withdrawing neuropsychological treatment deteriorates functional performance and creates new costs. Whereas the systematic treatment of language, speech, and motor disorders is traditionally viewed as unequivocally necessary the possible influence of visual-sensory and oculomotor disorders on the patient's outcome is still neglected in neurorehabilitation. This review summarises therapeutic approaches for acquired central visual disorders. It is split into five parts. After an introduction …
Faces provide an extremely important visual medium in the social interactions of primate species generally (Redican, 1975; Ekman and Oster, 1978). It may not be surprising, therefore, that in the primate brain neural mechanisms should exist which are specialized to process the complex visual patterns of faces. Such a view is, however, controversial (Ellis, 1975). This paper will discuss recent neurophysiological findings which bear upon this issue. A substantial number of neurons in a specific region of the temporal lobe of macaque monkey brains have been found to be particularly responsive to the sight of faces (Perrett et al., 979, 1982; Bruce et al., 1981). A second line of evidence which bears upon the issue of face specific processing comes from clinical studies of brain damaged human patients who suffer a disability in their perception and recognition of faces. This clinical literature has been reviewed elsewhere (Meadows, 1974; Hecean and Albert, 1978; Benton, 1980; Damasio et al., 1981) and will be only briefly covered here.
General presentation of the disorder Prosopagnosia is classically defined as an inability to recognize faces of people known to the patient on the basis of visual perception, despite the absence of low-level visual impairments, or cognitive alterations such as mental confusion or amnesia, with a preserved ability to recognize people through other cues: voice or other visual traits such as gait, size, clothes, or even facial features (moustache, scar, blemish) or accessories (ear-rings, eyeglasses). Prosopagnosics also have access to semantic knowledge concerning people. According to Grüsser and Landis (1991), this condition seems to have been first described by Wigan (1844), in a book in which he expressed his views on the interaction of the two cerebral hemispheres. Wigan stated (pp. 128–9): A gentleman of middle age, or a little past that period, lamented to me his utter inability to remember faces. He would converse with a person for an hour, but after an interval of a day could not recognise him again. Even friends, with whom he had been engaged in business transactions, he was unconscious of ever having seen (…) it was not till he heard the voice, that he could recognise men with whom he had constant intercourse (…) When I inquire more fully into the matter, I found that there was no defect in vision, except that his eyes were weak, and that any long continued employment of them gave him pain (…). He was quite determined to conceal it, if possible, and it was impossible to convince him that it did not depend solely on the eyes.
Recognizing the sex of conspecifics is important: Expending one’s attentions Q or one’s seed Q on the wrong parity of partner could put one at a competitive disadvantage. While some animals use pheromones to recognize sex, in humans this task is primarily visual: “Many socially living animals ... recognize each other as members of the same species, as individuals, and as social partners by means of visual signals and communicate their mood and intentions by the same sensory modality. In many primate species the individual structure of the face is the most important visual characteristic of each group member” (Grusser, Selke, & Zynda 1985). A core issue is how sex is recognized from face; yet until recently this received little attention.
Clinical evidence is presented which links the anterior inferior part of the occipital lobe with colour perception in man. A review of the literature suggests that bilateral lesions at this site may cause persisting impairment of colour perception (achromatopsia) with preservation of primary visual function. This is discussed in relation to relevant experiments in animals. Achromatopsia is commonly associated with prosopagnosia (inability to recognize familiar faces) and impaired topographical memory, but published reports suggest that these three disorders may be dissociated from one another and they therefore appear to be functionally distinct.
The purpose of this research was to compare several tests requiring the recognition of unknown faces for their power to discriminate among different groups of patients with unilateral cerebral lesions. These groups were: 1) right brain-damaged patients without visual field defects (N = 31); 2) right brain-damaged patients with visual field defects (N = 19); 3) left brain-damaged patients without visual field defects (N = 50); 4) left brain-damaged patients with visual field defects (N = 14).
"62 PATIENTS WITH UNILATERAL CORTICAL LESIONS WERE GIVEN 2 TESTS OF FACIAL RECOGNITION, WHICH REQUIRED RECOGNITION OF WELL-KNOWN FACES AND RECOGNITION FROM IMMEDIATE MEMORY OF PREVIOUSLY UNKNOWN FACES. THE RIGHT HEMISPHERE GROUP WAS IMPAIRED RELATIVE TO THE LEFT HEMISPHERE GROUP ON BOTH TESTS. IN NEITHER GROUP WAS THERE A SIGNIFICANT CORRELATION BETWEEN THE SCORES ON THE 2 TASKS, INDICATING THAT THE TASKS WERE TESTS OF SEPARATE AND DISTINCT FUNCTIONS. THE RESULTS ARE DISCUSSED IN TERMS OF THE CLINICAL SYNDROME, PROSOPAGNOSIA. IT IS SUGGESTED THAT PROSOPAGNOSIA MAY BE A CONSTITUENT OF AN AMNESIC SYNDROME." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A series of visual identification tests was presented to 51 subjets with unilateral cortical lesions (25 left-sided, 26 right-sided) and to 30 controls. The test material included photographs and designs of human faces, meaningless line patterns, shadow patterns, and photographs of different objects in the same category (e.g. cups). The results confirm those of previous studies showing the predominant role of right hemispheric lesions in deficits of recognition of the human face. In addition, they demonstrate this same predominance whether the faces were presented as photographs or as simple designs. No correlation was found between the results of the tests of facial recognition, taken as a group, and those of the tests of identification of similar objects, of meaningless patterns, and of shadow patterns representing a complex perceptive task, also taken as a group. Based on these results, a hypothesis of the existence of an autonomous defect of human facial recognition is discussed.
A consecutive series of sixty-five patients with unilateral cortical lesions was given three tests of visual recognition and one of immediate visual retention, together with the W.A.I.S. The right parietal group showed a deficit on all tests of visual perception. Test stimuli, which were both verbal and familiar, were graded in difficulty on a perceptual dimension, and discriminated between right and left hemisphere lesions. Evidence for some degree of differentiation of function within the right hemisphere is presented. The test of visual retention was associated with constructional impairment in the right hemisphere group, but not in the left hemisphere group. The relationship between perceptual disorders following right hemisphere lesions and visual object agnosia is discussed.
Two cases of prosopagnosia (failure to recognize faces) are presented, together with the autopsy findings. Only 7 other cases of prosopagnosia caused by pathologically verified occlusive vascular lesions have been described. All the patients had significant bilateral lesions of the cerebral hemispheres, at least one being in the medial-ventral occipital region. In our patients the bilateral lesions were grossly symmetrical in the distribution of the posterior cerebral arteries but with somewhat more extensive involvement on one side. In all reported cases one or both fusiform gyri were destroyed, and there were variably sized lesions in the pericalcarine structures. These findings suggest that the fusiform gyrus functions as a visual association area for the recognition of specific faces.
The authors describe a case of prosopagnosia which appeared a month after right occipital lobectomy. Results obtained by means of various tests devised to analyse this perception disorder have produced the following conclusions: 1) results of pairing tests which require a high level of perceptive differentiation are successful but after abnormally long delays; 2) in spite of this success, faces--even the patient's own--are not recognized; 3) this disorder extends to affect every task requiring recognition of the individual nature of a stimulus; 4) this individuality has the peculiarity of being based on visual patterns which it is impossible, or almost impossible, to express verbally; 5) the part played by defective visual representation in the brain is discussed; 6) a posterior lesion of the minor hemisphere is a prerequisite of prosopagnosia; 7) these facts, in conjunction with the findings in cases of inter-hemispheric disconnection lead one to think that the minor hemisphere, in right-handed subjects, plays a major part in the development and treatment of highly differentiated visual patterns which it is impossible, or almost impossible, to express verbally.
Evidence is presented that patients with prosopagnosia have right anterior inferior occipital lesions in the region of the occipital temporal junction. Many if not all cases have an additional lesion in the left hemisphere; this is often but apparently not always symmetrical with the right hemisphere lesion. This evidence is discussed in relation to the anatomical connections of these regions and the results of experiments in animals.
Clinical evidence is presented which links the anterior inferior part of the occipital lobe with color perception in man. A review of the literature suggests that bilateral lesions at this site may cause persisting impairment of color perception (achromatopsia) with preservation of primary visual function. This is discussed in relation to relevant experiments in animals. Achromatopsia is commonly associated with prosopagnosia (inability to recognize familiar faces) and impaired topographical memory, but published reports suggest that these three disorders may be dissociated from one another and they therefore appear to be functionally distinct.
Visual discrimination of size, shade, shape and position was assessed in a group of 65 patients with unilateral cerebral lesions. Although on the spatial task of position discrimination the right posterior group was impaired, discrimination of size, shade and shape were not significantly worse in the right posterior group than in the other patient groups. The relevance of these findings to disorders of visual recognition is discussed.
Visual recognition of pictorial material was investigated in a group of 74 patients with localised cerebral lesions. Four tasks of visual perception, figure/ ground, fragmented drawings, enlarged drawings, and photographs of objects from an unconventional view, were administered. An unimpaired performance of the right posterior group on the figure/ground task contrasted with a marked deficit on the unconventional view objects task. It was demonstrated that there is a favoured view for efficiency of object recognition. The findings provide evidence that gestalt formation is intact whereas perceptual classification is impaired in patients with right posterior lesions. The implications of this interpretation of the data for theories of object recognition are discussed.
The relations between prosopagnosia and the ability to discriminate unfamiliar faces are reviewed and the performance of a prosopagnosic patient on a facial discrimination test as well as on other tasks requiring the processing and integration of visual information is described. The finding that this patient showed essentially normal ability to discriminate unfamiliar faces supports the contention that prosopagnosia cannot be solely explained in terms of a general visuoperceptive impairment. The present state of our understanding of the disabilities underlying both prosopagnosia and defective discrimination of unfamiliar faces is discussed.
Tasks of perceptual matching, including three types of visual stimulus (slope of line, position of dot and size of gap in contour) were devised. Seventy-four patients with unilateral cortical lesions were tested. The right parietal group was impaired on the perceptual matching tasks. There was no association between performance on perceptual matching tasks and tachistoscopic threshold measurements or a test of picture recognition. The relationship between perceptual matching and performance on other more complex visual tasks is discussed.
Patients with right posterior cerebral injuries did more poorly than patients with other unilateral injuries and normal control subjects in recognizing different faces. When the faces were presented upside-down, however, those with the other unilateral injuries did worse than the right posterior group and the normal controls. This dissociation between upright and inverted presentations was not found with pictures of another common object, houses of similar architecture. The results support the notion that, among the disorders caused by right posterior injuries, there does exist a material-specific deficit in recognizing faces.
A test requiring the identification of unfamiliar faces was developed and given to groups of patients with lesions of the left or the right hemisphere as well as to a large group of control patients. Performance level in the control group showed a slight decline with age but was not related to education or sex. The mean performance levels of both brain-damaged groups were significantly inferior to that of the control group. In addition, however, the mean performance level of the patients with right hemisphere lesions was significantly inferior to that of the patients with left hemisphere lesions and grossly defective performances were made mainly by patients with right hemisphere lesions. Performance level was not related to the presence of visual field defect, the presence of aphasia, type of lesion or intrahemispheric locus of lesion. A number of considerations suggested that the observed interhemispheric difference in performance was not related to a possible difference in the extent of lesion in the two groups.
"And what is the nature of this knowledge or recollection? I mean to ask, Whether a person, who having seen or heard or in any way perceived anything, knows not only that, but has a conception of something else which is the subject, not of the same but of some other kind of knowledge, may not be fairly said to recollect that of which he has the conception?"And when the recollection is derived from like things, then another consideration is sure to arise, which is, Whether the likeness in any degree falls short or not of that which is recollected?" "The Philosophy of Plato" Phaedo (the Jowett translation).
Difficulty in the recognition of faces as a symptom in patients with cerebral disease is not a new observation. It was first described by Charcot¹ in 1883 and by Wilbrand² in 1892. Case reports alluding to the phenomenon were later published by Millian,³ Hoff and Pötzl⁴ and Donini.⁵ However, it was Bodamer⁶ who definitively described the deficit in 1947 on the basis of 3 personally observed cases, and who proposed the name "prosopagnosia" for this special type of visual agnosia. Realizing that "prosopagnosia" is often merely one aspect of the clinical picture of severe object or form agnosia, Bodamer took pains to emphasize that this is not always the case and that recognition of faces may be preserved in patients with object agnosia. In this connection, he cited the cases of Lissauer⁷ and Nielsen.⁸ Ajuriaguerra and one of us (H.H.) recently observed
A further effort was made to determine the effects of right anterior temporal lobectomy in man on visual perception and visual memory. Groups of patients with cortical resections from right or left temporal, frontal, or parietal regions were required to recognize photographs of faces within a larger array, after having been shown the faces previously. Three variations of this task were used: in the first, the interval between initial presentation and recognition test was filled with an irrelevant visual task. In the second, the delay remained but the interpolated task was omitted. In the third, there was only minimal delay ("immediate recognition"). On the first two tasks, patients with right temporal-lobe lesions had marked deficits compared with all other groups, but on the third task (minimal delay) no clearcut group differences were seen, because the normal control group did worse than with delay. Normal subjects (unlike patients with right temporal-lobe excisions) apparently use the delay period to consolidate and possibly recode their visual impressions. In the context of other tasks sensitive to right temporal-lobe lesions, the findings suggest a mild impairment in the perception of complex patterns after right anterior temporal lobectomy, and a much more severe one in the retention of the perceived material.
Two choice recognition memory for 3 classes of information (words, unknown faces, and representational paintings) was assessed in 4 severely amnesic patients and 3 control groups. A clear cut and severe deficit of recognition memory for words, faces and paintings was demonstrated. A direct comparison of retention for these 3 classes of information is not meaningful as the individual task difficulty is constrained by the similarity of the distractor items. However, no evidence for a material specific deficit was found in these amnesic patients.
amnesie et troubles du language par lesion temporale gauche chez un sujet gaucher
- Prosopagnosie
Prosopagnosie, amnesie et troubles du language par
lesion temporale gauche chez un sujet gaucher. Encephale, 62, 382-394.
- S Pevzner
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