-
Cureus Sep 2023Prosopagnosia describes the inability to recognize others by their faces, which may be hereditary or acquired. Acquired cases result from intracranial lesions such as...
Prosopagnosia describes the inability to recognize others by their faces, which may be hereditary or acquired. Acquired cases result from intracranial lesions such as intracranial hemorrhage or ischemia. This case demonstrates acquired prosopagnosia secondary to an intracranial hemorrhage and thus exemplifies the importance of early symptom recognition for appropriate diagnosis and management. A 58-year-old female presented to the emergency department with a chief complaint of the worst headache of her life along with nausea and vomiting. She also reported that she was unable to recognize her children in photos and although she knew her husband was with her, she did not recognize his face. Physical examination revealed no focal motor deficits. Computed tomography angiography of the brain revealed intracerebral hemorrhage of the right occipital lobe. Acquired prosopagnosia can be the only presenting symptom of intracranial pathology. It is most commonly caused by intracranial hemorrhage, as shown in this case report. This demonstrates a unique symptom of posterior circulation strokes that are commonly misdiagnosed in the emergency department.
PubMed: 37842404
DOI: 10.7759/cureus.45128 -
Brain Sciences May 2024In non-clinical populations, facial features (eyes, nose, mouth) may vary in their contribution to face identity perception. Changes to whole faces are easier to detect...
In non-clinical populations, facial features (eyes, nose, mouth) may vary in their contribution to face identity perception. Changes to whole faces are easier to detect than changes to individual features, and eye changes are typically easier to detect than mouth changes, which in turn are easier to detect than nose changes. However, how this differs for people with face recognition difficulties (developmental prosopagnosia; DP) and for individuals with superior face recognition abilities (super-recognisers; SR) is not clear; although findings from previous studies have suggested differences, the nature of this difference is not understood. The aim of this study was to examine whether differences in the ability to detect feature changes in DPs and SRs were (a) quantitative, meaning that the pattern across feature changes remained the same but there was an overall upwards or downwards shift in performance, or (b) qualitative, meaning that the pattern across feature changes was different. Using a change detection task in which individual face features (eyes, nose, mouth) changed between sequentially presented faces, we found that while prosopagnosics showed a quantitative difference in performance with a downwards shift across all conditions, super-recognisers only showed qualitative differences: they were better able to detect when the face was the same and were marginally (but not non-significantly) worse at detecting when the eyes changed. Further, the only condition which distinguished between the three groups was the ability to identify when the same face was presented, with SRs being better than controls, and controls being better than DPs. Our findings suggest that, in feature-matching tasks, differences for DPs are due to them being overall worse at the task, while SRs use a qualitatively different strategy.
PubMed: 38928560
DOI: 10.3390/brainsci14060561 -
Cortex; a Journal Devoted To the Study... Sep 2023Cross-condition comparisons on neurodevelopmental conditions are central in neurodiversity research. In the realm of visual perception, the performance of participants...
Cross-condition comparisons on neurodevelopmental conditions are central in neurodiversity research. In the realm of visual perception, the performance of participants with different category-specific disorders such as developmental prosopagnosia (problems with faces) and dyslexia (problems with words) have contributed to understanding of perceptual processes involved in word and face recognition. Alterations in face and word recognition are present in several neurodiverse populations, and improved knowledge about their relationship may increase our understanding of this variability of impairment. The present study investigates organizing principles of visual object processing and their implications for developmental disorders of recognition. Some accounts suggest that distinct mechanisms are responsible for recognizing objects of different categories, while others propose that categories share or even compete for cortical resources. We took an individual differences approach to estimate the relationship between abilities in recognition. Neurotypical participants (N = 97 after outlier exclusion) performed a match-to-sample task with faces, houses, and pseudowords. Either individual features or feature configurations were manipulated. To estimate the separability of visual recognition mechanisms, we used representational similarity analysis (RSA) where correlational matrices for accuracy were compared to predicted data patterns. Recognition abilities separated into face recognition on one hand and house/pseudoword recognition on the other, indicating that face recognition may rely on relatively selective mechanisms in neurotypicals. We also found evidence for a general visual object recognition mechanism, while some combinations of category (faces, houses, words) and processing type (featural, configural) likely rely on additional mechanisms. Developmental conditions may therefore reflect combinations of impaired and intact aspects of specific and general visual object recognition mechanisms, where featural and configural processes for one object category separate from the featural or configural processing of another. More generally, RSA is a promising approach for advancing understanding of neurodiversity, including shared aspects and distinctions between neurodevelopmental conditions of visual recognition.
Topics: Humans; Pattern Recognition, Visual; Visual Perception; Recognition, Psychology; Facial Recognition; Dyslexia
PubMed: 37390594
DOI: 10.1016/j.cortex.2023.05.012 -
Cortex; a Journal Devoted To the Study... Mar 2024Despite severe everyday problems recognising faces, some individuals with developmental prosopagnosia (DP) can achieve typical accuracy scores on laboratory face...
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.
Topics: Humans; Prosopagnosia; Facial Recognition; Self Report; Surveys and Questionnaires; Reaction Time; Pattern Recognition, Visual
PubMed: 38330779
DOI: 10.1016/j.cortex.2023.12.011 -
Cortex; a Journal Devoted To the Study... Jul 2024Developmental prosopagnosia (DP) is associated with considerable perceptual heterogeneity, though the nature of this heterogeneity and whether there are discrete...
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.
Topics: Humans; Prosopagnosia; Female; Male; Adult; Facial Recognition; Middle Aged; Young Adult; Neuropsychological Tests; Recognition, Psychology; Pattern Recognition, Visual; Visual Perception; Adolescent
PubMed: 38744075
DOI: 10.1016/j.cortex.2024.03.011 -
Journal of Nippon Medical School =... Jun 2024Prosopagnosia is a cognitive disorder in which facial recognition is severely impaired despite normal vision and intelligence. Prosopagnosia was first reported in the...
Prosopagnosia is a cognitive disorder in which facial recognition is severely impaired despite normal vision and intelligence. Prosopagnosia was first reported in the 1800s, but its cause remains unclear. Although other neurological symptoms are often present, some patients have pure prosopagnosia. The bilateral occipital lobes are believed to be associated with symptoms. Recent brain imaging techniques have identified the right fusiform gyrus (rFG), located at the junction of the right occipital temporal lobe, as the affected region. In this report, we present a case of associative prosopagnosia with no concomitant symptoms in a 76-year-old man. Brain magnetic resonance imaging detected a subcortical hemorrhage in the right temporal lobe. Using tractography based on diffusion tensor imaging, we visualized atrophy of the right inferior longitudinal fasciculus (ILF). This is the first time tractography has been used to show a clear association between associative prosopagnosia and ILF damage projecting from the rFG.
PubMed: 38897948
DOI: 10.1272/jnms.JNMS.2025_92-202 -
Cortex; a Journal Devoted To the Study... Oct 2023People with aphantasia have a markedly impaired ability to form visual images in the mind's eye. Here, by testing people with and without aphantasia, we examine the...
People with aphantasia have a markedly impaired ability to form visual images in the mind's eye. Here, by testing people with and without aphantasia, we examine the relationship between visual imagery and face processing. We show that aphantasics have weaker face recognition than people with visual imagery, using both self-report (Prosopagnosia Index) and behavioural measures (Cambridge Face Memory Test). However, aphantasics nonetheless have a fully intact ability to construct facial composites from memory (i.e., composites produced using EFIT6 by aphantasics and imagers were rated as equally accurate in terms of their resemblance to a target face). Additionally, we show that aphantasics were less able than imagers to see the resemblance between composites and a target face, suggestive of potential issues with face matching (perception). Finally, we show that holistic and featural methods of composite construction using EFIT6 produce equally accurate composites. Our results suggest that face recognition, but not face composite construction, is facilitated by the ability to represent visual properties as 'pictures in the mind'. Our findings have implications for the study of aphantasia, and also for forensic settings, where face composite systems are commonly used to aid criminal investigations.
Topics: Humans; Facial Recognition; Imagery, Psychotherapy; Prosopagnosia; Recognition, Psychology; Self Report; Visual Perception
PubMed: 37597266
DOI: 10.1016/j.cortex.2023.06.015 -
Frontiers in Neurology 2023Frontotemporal lobe disorders (FTD) are amongst the most common brain neurodegenerative disorders. Their relatively covert, frequently subtle presentations and diverse...
BACKGROUND
Frontotemporal lobe disorders (FTD) are amongst the most common brain neurodegenerative disorders. Their relatively covert, frequently subtle presentations and diverse etiologies, pose major challenges in diagnosis and treatments. Recent studies have yielded insights that the etiology in the majority are due to environmental and sporadic causes, rather than genetic in origin.
AIMS
To retrospectively examine the cognitive and behavioral impairments in the veteran population to garner the range of differing syndrome presentations and etiological subcategories with a specific focus on frontotemporal lobe disorders.
METHODOLOGY
The design is a retrospective, observational registry, case series with the collection of epidemiological, clinical, cognitive, laboratory and radiological data on people with cognitive and behavioral disorders. Inclusion criteria for entry were veterans evaluated exclusively at Orlando VA Healthcare System, neurology section, receiving a diagnosis of FTD by standard criteria, during the observation period dated from July 2016 to March 2021. Frontotemporal disorders (FTD) were delineated into five clinical 5 subtypes. Demographic, cardiovascular risk factors, cognitive, behavioral neurological, neuroimaging data and presumed etiological categories, were collected for those with a diagnosis of frontotemporal disorder.
RESULTS
Of the 200 patients with FTD, further cognitive, behavioral neurological evaluation with standardized, metric testing was possible in 105 patients. Analysis of the etiological groups revealed significantly different younger age of the traumatic brain injury (TBI) and Gulf War Illness (GWI) veterans who also had higher Montreal Cognitive Assessment (MOCA) scores. The TBI group also had significantly more abnormalities of hypometabolism, noted on the PET brain scans. Behavioral neurological testing was notable for the findings that once a frontotemporal disorder had been diagnosed, the four different etiological groups consistently had abnormal FRSBE scores for the 3 principal frontal presentations of (i) abulia/apathy, (ii) disinhibition, and (iii) executive dysfunction as well as abnormal Frontal Behavioral Inventory (FBI) scores with no significant difference amongst the etiological groups. The most common sub-syndromes associated with frontotemporal syndromes were the Geschwind-Gastaut syndrome (GGS), Klüver-Bucy syndrome (KBS), involuntary emotional expression disorder (IEED), cerebellar cognitive affective syndrome (CCA), traumatic encephalopathy syndrome (TES) and prosopagnosia. Comparisons with the three principal frontal lobe syndrome clusters (abulia, disinhibition, executive dysfunction) revealed a significant association with abnormal disinhibition FRSBE T-scores with the GGS. The regression analysis supported the potential contribution of disinhibition behavior that related to this complex, relatively common behavioral syndrome in this series. The less common subsyndromes in particular, were notable, as they constituted the initial overriding, presenting symptoms and syndromes characterized into 16 separate conditions.
CONCLUSION
By deconstructing FTD into the multiple sub-syndromes and differing etiologies, this study may provide foundational insights, enabling a more targeted precision medicine approach for future studies, both in treating the sub-syndromes as well as the underlying etiological process.
PubMed: 38264092
DOI: 10.3389/fneur.2023.1305071 -
Clinical Pharmacology and Therapeutics Oct 2023Face recognition deficits occur in diseases such as prosopagnosia, autism, Alzheimer's disease, and dementias. The objective of this study was to evaluate whether...
Face recognition deficits occur in diseases such as prosopagnosia, autism, Alzheimer's disease, and dementias. The objective of this study was to evaluate whether degrading the architecture of artificial intelligence (AI) face recognition algorithms can model deficits in diseases. Two established face recognition models, convolutional-classification neural network (C-CNN) and Siamese network (SN), were trained on the FEI faces data set (~ 14 images/person for 200 persons). The trained networks were perturbed by reducing weights (weakening) and node count (lesioning) to emulate brain tissue dysfunction and lesions, respectively. Accuracy assessments were used as surrogates for face recognition deficits. The findings were compared with clinical outcomes from the Alzheimer's Disease Neuroimaging Initiative (ADNI) data set. Face recognition accuracy decreased gradually for weakening factors less than 0.55 for C-CNN, and 0.85 for SN. Rapid accuracy loss occurred at higher values. C-CNN accuracy was similarly affected by weakening any convolutional layer whereas SN accuracy was more sensitive to weakening of the first convolutional layer. SN accuracy declined gradually with a rapid drop when nearly all nodes were lesioned. C-CNN accuracy declined rapidly when as few as 10% of nodes were lesioned. CNN and SN were more sensitive to lesioning of the first convolutional layer. Overall, SN was more robust than C-CNN, and the findings from SN experiments were concordant with ADNI results. As predicted from modeling, brain network failure quotient was related to key clinical outcome measures for cognition and functioning. Perturbation of AI networks is a promising method for modeling disease progression effects on complex cognitive outcomes.
Topics: Humans; Artificial Intelligence; Alzheimer Disease; Neurodegenerative Diseases; Facial Recognition; Neural Networks, Computer
PubMed: 37394678
DOI: 10.1002/cpt.2987 -
Internal Medicine (Tokyo, Japan) Feb 2024A 73-year-old woman with posterior cortical atrophy (PCA) presented with progressive apperceptive visual agnosia, alexia, agraphia, ventral simultanagnosia,...
A 73-year-old woman with posterior cortical atrophy (PCA) presented with progressive apperceptive visual agnosia, alexia, agraphia, ventral simultanagnosia, prosopagnosia, and allocentric (stimulus-centered) left-sided hemispatial neglect. All of these symptoms were attributed to damage to the bilateral occipito-temporal cortices, consistent with ventral variant PCA. While the Pittsburgh compound B uptake was extensively distributed throughout the occipito-parietal (dorsal) and occipito-temporal (ventral) areas, the THK5351 (ligand binding to tau aggregates/astrocyte gliosis) accumulation was limited to the ventral area. These findings suggest that local accumulation of tau proteins and/or astrocyte gliosis over the occipito-temporal cortices can result in ventral variant PCA.
PubMed: 38369357
DOI: 10.2169/internalmedicine.2844-23