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Prosopagnosia
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Prosopagnosia is often defined in encyclopedias as a problem with identifying faces—specifically human faces (e.g., Foster & Drago, 2011). However, when you look a bit deeper, there is disagreement over exactly where the boundaries of the recognition problems are. People with acquired prosopagnosia have reported losing their abilities to recognize other categories besides human faces. These reports include a farmer losing the ability to tell apart the cows on their farm, and a bird-watcher losing the ability to differentiate between bird species (Bornstein et al., 1969). Other problematic categories for people with prosopagnosia have included buildings, chairs, fruit and other food, cars, coins, handwriting, clothing, symbols such as ampersands and musical clefs, and other animals (Barton, 2011; Damasio et al., 1982; Meadows, 1974). My own research has found some evidence that a person with prosopagnosia had problems telling apart individual sheep when looking at their extra-fuzzy faces (Toftness, 2019). Overall, many people with prosopagnosia also seem to have some type of more general visual agnosia (see Visual Object Agnosia such that it is not just human faces that give them recognition issues.
Cortical Visual Loss
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Most patients with prosopagnosia are aware of their problem, though some cases with childhood onset or the developmental variant may not be (179–181). They report that to identify people they rely more on voices or non-facial visual cues such as a person's gait or mannerisms. They use distinctive local cues in faces such as odd glasses, hairstyles or scars, and can be misled if someone gets a new haircut. They use the context of an encounter: if they know which five people they will meet at work they can use this knowledge to improve their chances of identifying a person, though they will fail to recognize them in a random encounter on the street (179, 180, 182). These struggles can lead to social avoidance, dysphoria and occupational disability in some but not all patients (183, 184).
Neurologic Diagnosis
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Prosopagnosia describes the inability to recognize familiar faces, but where the subject may recognize people otherwise through cues such as a distinctive voice or gait. It is most commonly associated with bilateral inferior occipitotemporal lesions, usually with an accompanying superior visual field defect but may also occur in the context of an anterior right temporal lobe atrophy syndrome. It can be tested by face recognition of local politicians and celebrities from a magazine or by more formal test protocols.
Posterior cortical atrophy: clinical, neuroimaging, and neuropathological features
Published in Expert Review of Neurotherapeutics, 2023
John Best, Marianne Chapleau, Gil D. Rabinovici
Some of the most frequent early symptoms are related to driving, especially loss of confidence driving at night or numerous minor accidents. Individuals frequently describe difficulty judging distances or determining where objects are in space (spatial agnosia). Recent studies have demonstrated altered visual and tactile interpretation of verticality, which may play a role in both navigation and ambulation difficulties in PCA [27]. Patients describe difficulty finding an object on a messy table or room. Although higher-order visual dysfunction is more common, individuals may also report visual field deficits. They may describe difficulty with facial recognition (prosopagnosia), instead relying upon visual cues such as attire and accessories or nonvisual cues such as an individual’s voice for proper identification. Eventually, most patients’ visual impairments lead to functional blindness which can cause significant problems with ambulation and overall function.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2022
David A. Bellows, Noel C. Y. Chan, John J. Chen, Hui-Chen Cheng, Peter W. MacIntosh, Michael S. Vaphiades, Xiaojun Zhang
Facial processing networks in people are right hemispheric dominant, and acquired prosopagnosia usually results from right or bilateral hemispheric lesions. There may be a complementary contribution of the left hemisphere to certain types of face processing. The authors performed two behavioural studies on seven subjects with developmental prosopagnosia. They first examined their ability to match faces across viewpoint changes, with either unaltered photographs or images that had been reduced to line drawings. Prosopagnosic subjects had normal performance with line-contour faces but failed to show the normal benefit from the additional information in unaltered photographs. The second experiment examined their ability to perceive facial speech patterns. Prosopagnosic subjects can detect, discriminate and identify facial speech patterns, but most show reduced use of these cues or anomalous audiovisual integration in the McGurk effect (an auditory-visual illusion that shows how perceivers merge information for speech sounds across the senses), with only one subject performing normally. The authors concluded that developmental prosopagnosia can be associated with a subtle impairment in lip-reading, which in prior studies of acquired lesions has been associated more with left than with right-fusiform damage.
Coping strategies for developmental prosopagnosia
Published in Neuropsychological Rehabilitation, 2020
Amanda Adams, Peter J. Hills, Rachel J. Bennetts, Sarah Bate
Collectively these findings reveal the serious negative impact that DP can have on interpersonal relationships and wellbeing in both adults and children. Thus, establishing methods of remediation is clearly an urgent issue. However, few studies have attempted to improve face recognition skills in individuals with prosopagnosia (for reviews see Bate & Bennetts, 2014 ; DeGutis, Cohan, & Nakayama, 2014), with most investigating the acquired form of the condition with varying success (e.g., Bate et al., 2015; Davies-Thompson et al., 2017). A small number of studies have attempted to improve face recognition performance in DP, more recently using perceptual training programmes (DeGutis, Bentin, Robertson, & D’Esposito, 2007; DeGutis et al., 2014). While gains in some aspects of face-processing were observed in a subset of individuals, they were not experienced by all participants and transfer to everyday life was limited. Other studies have reported short-term gains from non-facial training programmes (e.g., cognitive map training: Bate, Adams, Bennetts, & Line, in press), or intranasal inhalation of the hormone oxytocin (Bate et al., 2014). While both studies present novel insights into the underpinnings of DP, gains rapidly decayed when intervention ceased, and are likely limited to subsets of individuals (e.g., those with particular cognitive presentations).