Prosopagnosia — Facial Recognition Impairment

Introduction

Prosopagnosia (also known as face blindness or facial agnosia) is Greek for “facial” and “unknowing.” Prosopagnosia is a fascinating and complex condition that affects the ability to recognize faces, making it difficult to interact with others and live on a daily basis. This neurological disorder is characterized as facial recognition impairment. There are some people with prosopagnosia who only have difficulty identifying familiar faces, while there are others who cannot distinguish between unknown faces, depending on the degree of impairment. Some people are unable to distinguish a face from an object. Some people cannot recognize their own faces. A person with prosopagnosia can be categorized into two types: acquired and developmental prosopagnosia. Those with acquired prosopagnosia lose their ability to recognize faces due to brain damage or illness, while those with developmental prosopagnosia are unable to recognize faces from birth or very early childhood.

Research suggests that other brain regions, including the amygdala and hippocampus, may also contribute to facial perception and recognition, in addition to the right fusiform gyrus. Almost all reports are single cases or collections of unrelated patients who acquired prosopagnosia after brain injuries, strokes or atrophy of the fusiform gyrus (red in the figure below). As a result of stroke, traumatic brain injury (TBI), or certain neurodegenerative diseases, prosopagnosia may be present at birth without any brain damage, or it may be congenital. A genetic mutation or deletion is likely to cause congenital prosopagnosia since it appears to run in families. In children with autism and Asperger’s syndrome, prosopagnosia is common and may interfere with their social development. Other researchers have found that Caucasians have experienced congenital prosopagnosia with other cultures, termed the other-race effect (ORE). Notwithstanding the foregoing, memory dysfunction, memory loss, impaired vision, or learning disabilities are not associated with prosopagnosia.

Symptoms

Prosopagnosia dates back hundreds of years, and it was not until 1947 when Dr. J. Bodamer developed the term prosopagnosia based on extensive review of the then-existing evidence. Most people are occasionally unable to recognize a familiar face, yet prosopagnosia is far worse than this. Prosopagnosics struggle to discern if they have ever seen a face before, let alone identify it if encountered regularly. Even those closest to them, such as family members, can become unrecognizable in severe cases. It is vital to note that prosopagnosia concerns difficulty identifying faces and not remembering names.

There are various telltale signs of prosopagnosia, including the reliance on non-facial information, such as hair, gait, clothing, voice, etc. In addition to finding it difficult to follow the plot of television shows and movies, prosopagnosics often have trouble identifying the characters in them. Also, prosopagnosics sometimes have difficulty imagining the faces of people they know.

Our colleagues have a test of face recognition available, which includes feedback on how your score compares to the scores of people with normal face recognition abilities.

There are several signs of prosopagnosia listed below:

· Fail to recognize family members, friends, and other familiar people.

· Inability to recognize people in unexpected places.

· In settings where people share similar characteristics, such as school uniforms, there may be difficulties.

· Meeting new people by concentrating on their hairstyle or other non-face features.

· Recognizing faces based on distinctive facial features rather than the whole face.

· The inability to recognize people in photographs.

Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not include prosopagnosia as a mental disorder. To make a diagnosis, clinicians and research groups draw on evidence from patient reports as well as computer-based tests assessing face recognition. These tests can include identification of famous people, memorizing novel faces or detecting similarities between multiple faces. Acquired prosopagnosia must additionally meet the criteria of brain injury.

Treatment

There are no known cures for this disorder. It can be difficult to distinguish prosopagnosia from other conditions, such as autism spectrum disorder, when they affect social interactions and communication. Currently there are only two clinical trials that address two experimental training programs to improve facial recognition. One program involves research assistants who provide perception training, memory training, and the other program utilizes computer-based training. There are no drug treatment programs and none that are in clinical trials. Patients suffering from strokes or brain trauma, however, can be taught to use other clues to identify individuals during treatment. As a part of treatment for prosopagnosia, compensatory strategies are developed, and social skills are improved. In order to identify familiar faces more easily, people with this condition can focus on distinctive features, memorize contextual information, and use mnemonic devices. A person with prosopagnosia may also avoid social situations or experience anxiety due to their difficulty recognizing others. It may also result in feelings of isolation or frustration, which can negatively impact their mental health.

Conclusion

Prosopagnosia causes people to have difficulty recognizing family members and close friends, and they may use other methods, such as voice, clothing, or physical characteristics, to identify people.

Social interactions and understanding emotional cues may be further complicated for people with prosopagnosia due to their difficulty recognizing facial expressions. Researchers have shown that people with prosopagnosia may rely more heavily on non-facial cues, such as clothing, hairstyle, or voice, to identify people, but these cues can also change over time or be inconsistent.

Sufferers may struggle with recognizing familiar people, from family members to their own reflections. This can be socially, emotionally and professionally difficult for those affected. People with prosopagnosia can learn strategies to improve their facial recognition skills, as there is no cure yet. Using mental imagery or paying attention to unique features, they may be able to associate names with faces using memorization techniques. Additionally, some individuals may use technology to identify individuals, such as facial recognition software.

Several other famous figures have dealt with prosopagnosia, including, Brad Pitt, Jane Goodall, Steve Wozniak, and Stephen Fry, an English actor and comedian.

Prosopagnosia is comparatively rare compared to other conditions, with an estimated 1–2% prevalence rate. Despite this, those suffering have access to support which can make managing the disorder easier.

Written By: Lawrence D. Jones, Ph.D.

Keywords: prosopagnosia, recognition dysfunction, recognition