Abstract
Acquired prosopagnosia is usually a consequence of bilateral or right hemisphere lesions and is often associated with topographical disorientation and dyschromatopsia. Left temporo-occipital lesions sometimes result in a face recognition disorder but in a context of visual object agnosia with spared familiarity feelings for faces, usually in left-handers. We describe a patient with a left temporo-occipital hemorrhagic lesion unexpectedly resulting in a deficit of face familiarity, which could represent a mild form of associative prosopagnosia. Our patient failed to feel familiarity feelings even with very well-known famous faces but had neither visual object agnosia nor defects with semantics or naming of celebrities. This was confirmed even when the patient was re-tested a year later. We speculate that a graded lateralization of face processing could be at the basis of occasional cases of prosopagnosia.
Highlights
Acquired prosopagnosia is a disorder of visual recognition specific to faces, associated with occipital or temporal bilateral lesions; occasionally, damage is restricted to the right hemisphere (RH) [1, 2], as reported in a review with 27 cases with neuroimaging plus four cases with surgical evidence of association between prosopagnosia and RH damage only [3]
We described a patient with a persistent deficit in face recognition, representing a mild form of prosopagnosia due to a left temporo-occipital lesion
According to Barton [16], cases of prosopagnosia after leftsided lesions in left-handed subjects could be attributed to a reversed hemispheric specialization for face processing
Summary
Acquired prosopagnosia is a disorder of visual recognition specific to faces, associated with occipital or temporal bilateral lesions; occasionally, damage is restricted to the right hemisphere (RH) [1, 2], as reported in a review with 27 cases with neuroimaging plus four cases with surgical evidence of association between prosopagnosia and RH damage only [3]. To verify whether the deficit was limited to famous people or included other unique items, this patient was submitted to a famous building recognition task, which included 20 Italian and non-Italian items In contrast with his face recognition difficulties, the patient performed well, recognizing and naming 17 out of 20 famous. Since he remembered the people he did not recognize in the previous examination, we used a different version of famous face recognition This task includes 126 13 × 20 cm, black-andwhite photographs—63 belonging to celebrities and 63 to unknown people—and requires a familiarity judgment, followed by identification (providing semantic information about the correctly recognized people): participants answer two multiple-choice questions concerning the celebrity’s period of fame and his/her professional category and one open question asking for any further information. There were no significant differences in accuracy and response time (see Table 5)
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