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From the Departments of Neurology (Drs. Barton and O’Connor, and M. Cherkasova) and Ophthalmology (Dr. Barton), Beth Israel Deaconess Medical Center and Harvard Medical School; and Department of Biomedical Engineering, Boston University (Dr. Barton), MA.
Address correspondence and reprint requests to Dr. J.J.S. Barton, Department of Neurology, KS 452, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215; e-mail: jbarton{at}caregroup.harvard.edu
Background: Some patients with prosopagnosia have covert recognition, meaning that they retain some familiarity or knowledge of facial identity of which they are not aware. Objective:To test the hypothesis that prosopagnosic patients with right occipitotemporal lesions and impaired face perception lack covert processing, whereas patients with associative prosopagnosia and bilateral anterior temporal lesions possess it. Methods: Eight patients with prosopagnosia were tested with a battery of four face recognition tests to determine their ability to discriminate between famous and unknown faces. Results: Measures of overt familiarity revealed better residual discrimination in patients with acquired prosopagnosia than in those with the developmental form. With forced-choice methods using famous faces paired with unknown faces, no patient demonstrated covert familiarity. However, when the semantic cue of the name of the famous face was provided, covert processing was present in all five patients with acquired prosopagnosia, including the three with extensive right-sided lesions and impaired perceptual discrimination of facial configuration. Sorting unrecognized faces by occupation was also performed above chance in three of these five patients. In contrast, none of the three patients with developmental prosopagnosia had covert processing, even though two demonstrated flawless performance on similar tests of name (rather than face) recognition. Overt familiarity correlated highly with the degree of covert recognition. Conclusions: Extensive right occipitotemporal lesions with significant deficits in face perception are not incompatible with covert face processing. Covert processing is absent in developmental prosopagnosia, because this condition likely precludes the establishment of a store of accurate facial memories. The presence of covert processing correlates with the degree of residual overt familiarity, indicating that these are related phenomena.
This article has been cited by other articles:
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  J. J. S. Barton, H. Hanif, and S. Ashraf Relating visual to verbal semantic knowledge: the evaluation of object recognition in prosopagnosia Brain, October 5, 2009; (2009) awp252v1. [Abstract] [Full Text] [PDF]
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 M. V. Peelen, N. Lucas, E. Mayer, and P. Vuilleumier Emotional attention in acquired prosopagnosia Soc Cogn Affect Neurosci, September 1, 2009; 4(3): 268 - 277. [Abstract] [Full Text] [PDF]
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 W. K. Simmons, M. Reddish, P. S. F. Bellgowan, and A. Martin The Selectivity and Functional Connectivity of the Anterior Temporal Lobes Cereb Cortex, July 20, 2009; (2009) bhp149v1. [Abstract] [Full Text] [PDF]
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 J. J.S. Barton, R. L. Hefter, M. V. Cherkasova, and D. S. Manoach Investigations of face expertise in the social developmental disorders Neurology, August 28, 2007; 69(9): 860 - 870. [Abstract] [Full Text] [PDF]
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I. R. Olson, A. Plotzker, and Y. Ezzyat The Enigmatic temporal pole: a review of findings on social and emotional processing Brain, July 1, 2007; 130(7): 1718 - 1731. [Abstract] [Full Text] [PDF]
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R. L. Hefter, D. S. Manoach, and J. J.S. Barton Perception of facial expression and facial identity in subjects with social developmental disorders Neurology, November 22, 2005; 65(10): 1620 - 1625. [Abstract] [Full Text] [PDF]
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J. J.S. Barton, M. V. Cherkasova, and R. Hefter The covert priming effect of faces in prosopagnosia Neurology, December 14, 2004; 63(11): 2062 - 2068. [Abstract] [Full Text] [PDF]
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J. J. S. Barton, M. V. Cherkasova, R. Hefter, T. A. Cox, M. O'Connor, and D. S. Manoach Are patients with social developmental disorders prosopagnosic? Perceptual heterogeneity in the Asperger and socio-emotional processing disorders Brain, August 1, 2004; 127(8): 1706 - 1716. [Abstract] [Full Text] [PDF]
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 B. de Gelder, I. Frissen, J. Barton, and N. Hadjikhani A modulatory role for facial expressions in prosopagnosia PNAS, October 28, 2003; 100(22): 13105 - 13110. [Abstract] [Full Text] [PDF]
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J. J.S. Barton and M. Cherkasova Face imagery and its relation to perception and covert recognition in prosopagnosia Neurology, July 22, 2003; 61(2): 220 - 225. [Abstract] [Full Text] [PDF]
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J. J.S. Barton, D. Z. Press, J. P. Keenan, and M. O'Connor Lesions of the fusiform face area impair perception of facial configuration in prosopagnosia Neurology, January 8, 2002; 58(1): 71 - 78. [Abstract] [Full Text] [PDF]
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A. Chatterjee and M. J. Farah Face module, face network: The cognitive architecture of the brain revealed through studies of face processing Neurology, October 9, 2001; 57(7): 1151 - 1152. [Full Text] [PDF]
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