Developmental prosopagnosia (DP) is characterized by severe facial recognition deficits, though it is currently debated whether only face-specific neural mechanisms are disrupted. A recent fMRI study found widespread decreases in category-selective (e.g., scene, body) regions in DPs (Jiahui et al., 2019), suggesting disruption may not be face-specific. To further evaluate neural deficits in DP, we scanned 23 DPs and 23 controls in task-based fMRI (dynamic localizer of faces/scenes/objects/bodies) and resting-state fMRI. In the task-based fMRI, DPs exhibited reduced face-selectivity across ventral face areas (anterior temporal lobe-ATL, fusiform face area-FFA, and occipital face area-OFA). This category-selectivity reduction was not found for scenes, bodies or objects in their respective regions, suggesting that the deficit of DP is limited to faces. Moreover, only the face area selectivity correlated with face recognition ability (average face-selectivity across OFA/FFA r= .37, p<.05), whereas scene, body, and objects area selectivity did not (all p’s>.4). This shows that our measure of face-selectivity reflects behavioral performance on face identification. In the resting-state fMRI, DPs showed reduced functional connectivity (FC) across most region pairs within the face network. While FC within the body network showed some mild reduction, this reduction was not observed for FC within the scene or object network. Moreover, only the FC in the face network correlated with face recognition ability (average face-network FC r=.46, p<.001), while scene, body, and objects area FC did not (all p’s>.13). This suggests that only resting connectivity between face regions is related to face recognition ability. Interestingly, we do not find a significant correlation between face-selectivity and face-network FCs, indicating they explain independent variance in face-recognition ability. Together, the fMRI selectivity and FC results, as well as their association with behavioral performance across all examined categories, suggests that DPs’ functional neural deficits are largely limited to the faces.
The issue of the face specificity of recognition deficits in developmental prosopagnosia (DP) is fundamental to the organization of high-level visual memory and has been increasingly debated in recent years. Previous DP investigations have found some evidence of object recognition impairments, but have almost exclusively used familiar objects (e.g. cars), where performance may depend on acquired object-specific experience and related visual expertise. An object recognition test not influenced by experience could provide a better, less contaminated measure of DPs' object recognition abilities. To investigate this, in the current study we tested 30 DPs and 30 matched controls on a novel object memory test (NOMT Ziggerins) and the Cambridge Face Memory Test (CFMT). DPs with severe impairment on the CFMT showed no differences in accuracy or reaction times compared with controls on the NOMT. We found similar results when comparing DPs with a larger sample of 274 web-based controls. Additional individual analyses demonstrated that the rate of object recognition impairment in DPs did not differ from the rate of impairment in either control group. Together, these results demonstrate unimpaired object recognition in DPs for a class of novel objects that serves as a powerful index for broader novel object recognition capacity.
Converging lines of research suggests that many developmental prosopagnosics (DPs) have impairments beyond face perception, but currently no framework exists to characterize these impaired mechanisms. One potential extra-perceptual deficit is that DPs encode/retrieve faces in a distinct manner from controls that does not sufficiently support individuation. To test this possibility, 30 DPs and 30 matched controls performed an old/new face recognition task while providing confidence ratings, to which a model-based ROC analysis was applied. DPs had significantly reduced recollection compared to controls, driven by fewer ‘high-confidence target’ responses, but intact familiarity. Recollection and face perception ability uniquely predicted objective and subjective prosopagnosia symptoms, together explaining 51% and 56% of the variance, respectively. These results suggest that a specific deficit in face recollection in DP may represent a core aspect of the difficulty in confidently identifying an individual by their face.
Are gender differences in face recognition influenced by familiarity and socio-cultural factors? Previous studies have reported gender differences in processing unfamiliar faces, consistently finding a female advantage and a female own-gender bias. However, researchers have recently highlighted that unfamiliar faces are processed less efficiently than familiar faces, which have more robust, invariant representations. To-date, no study has examined whether gender differences exist for familiar face recognition. The current study addressed this by using a famous faces task in a large, web-based sample of > 2000 participants across different countries. We also sought to examine if differences varied by socio-cultural gender equality within countries. When examining raw accuracy as well when controlling for fame, the results demonstrated that there were no participant gender differences in overall famous face accuracy, in contrast to studies of unfamiliar faces. There was also a consistent own-gender bias in male but not female participants. In countries with low gender equality, including the USA, females showed significantly better recognition of famous female faces compared to male participants, whereas this difference was abolished in high gender equality countries. Together, this suggests that gender differences in recognizing unfamiliar faces can be attenuated when there is enough face learning and that sociocultural gender equality can drive gender differences in familiar face recognition.
Clinicians and researchers have widely believed that face processing cannot be improved in prosopagnosia. Though more than a dozen reported studies have attempted to enhance face processing in prosopagnosics over the last 50 years, evidence for effective treatment approaches has only begun to emerge. Here, we review the current literature on spontaneous recovery in acquired prosopagnosia (AP), as well as treatment attempts in acquired and developmental prosopagnosia (DP), differentiating between compensatory and remedial approaches. We find that for AP, rather than remedial methods, strategic compensatory training such as verbalizing distinctive facial features has shown to be the most effective approach (despite limited evidence of generalization). In children with DP, compensatory training has also shown some effectiveness. In adults with DP, two recent larger-scale studies, one using remedial training and another administering oxytocin, have demonstrated group-level improvements and evidence of generalization. These results suggest that DPs, perhaps because of their more intact face processing infrastructure, may benefit more from treatments targeting face processing than APs.
Prosopagnosia has largely been regarded as an untreatable disorder. However, recent case studies using cognitive training have shown that it is possible to enhance face recognition abilities in individuals with developmental prosopagnosia. Our goal was to determine if this approach could be effective in a larger population of developmental prosopagnosics. We trained 24 developmental prosopagnosics using a 3-week online face-training program targeting holistic face processing. Twelve subjects with developmental prosopagnosia were assessed before and after training, and the other 12 were assessed before and after a waiting period, they then performed the training, and were then assessed again. The assessments included measures of front-view face discrimination, face discrimination with view-point changes, measures of holistic face processing, and a 5-day diary to quantify potential real-world improvements. Compared with the waiting period, developmental prosopagnosics showed moderate but significant overall training-related improvements on measures of front-view face discrimination. Those who reached the more difficult levels of training (‘better’ trainees) showed the strongest improvements in front-view face discrimination and showed significantly increased holistic face processing to the point of being similar to that of unimpaired control subjects. Despite challenges in characterizing developmental prosopagnosics’ everyday face recognition and potential biases in self-report, results also showed modest but consistent self-reported diary improvements. In summary, we demonstrate that by using cognitive training that targets holistic processing, it is possible to enhance face perception across a group of developmental prosopagnosics and further suggest that those who improved the most on the training task received the greatest benefits.
Although holistic processing is thought to underlie normal face recognition ability, widely discrepant reports have recently emerged about this link in an individual differences context. Progress in this domain may have been impeded by the widespread use of subtraction scores, which lack validity due to their contamination with control condition variance. Regressing, rather than subtracting, a control condition from a condition of interest corrects this validity problem by statistically removing all control condition variance, thereby producing a specific measure that is uncorrelated with the control measure. Using 43 participants, we measured the relationships amongst the Cambridge Face Memory Test (CFMT) and two holistic processing measures, the composite task (CT) and the part-whole task (PW). For the holistic processing measures (CT and PW), we contrasted the results for regressing vs. subtracting the control conditions (parts for PW; misaligned congruency effect for CT) from the conditions of interest (wholes for PW; aligned congruency effect for CT). The regression-based holistic processing measures correlated with each other and with CFMT, supporting the idea of a unitary holistic processing mechanism that is involved in skilled face recognition. Subtraction scores yielded weaker correlations, especially for the PW. Together, the regression-based holistic processing measures predicted more than twice the amount of variance in CFMT (R2 = .21) than their respective subtraction measures (R2 = .10). We conclude that holistic processing is robustly linked to skilled face recognition. In addition to confirming this theoretically significant link, these results provide a case in point for the inappropriateness of subtraction scores when requiring a specific individual differences measure that removes the variance of a control task.