High-functioning acquired prosopagnosics are rare. Forty years ago at age five, MJH suffered bilateral lesions (greater on the right) to his ventral occipito-temporal cortices, including the fusiform, but his superior temporal sulci and other brain areas were spared. He is in the normal range in identifying objects and he drives (in Los Angeles!). His performance is normal, or near normal, in his discrimination of sex, expression, age, attractiveness, and direction of gaze of faces, but he shows pronounced impairment in individuating faces, on both standard tests (Benton, Cambridge) as well as a match-to-sample test in which an identical matching stimulus is paired with a distractor differing in identity. He was at chance (controls were perfect) in selecting a famous celebrity (e.g., Bill Clinton) from a non-celebrity in pairs of faces, all of whom were highly familiar to him. He can readily individuate a person on the basis of voice and shows normal, if not superior, memory for names and biographical details of the people he encounters. Somehow surprisingly, he reports good face imagery, which he evidences on a verbal feature task, e.g., Is Clint Eastwood's nose pointy? He and control subjects were scanned when viewing dynamic face and object area localizers consisting of short video clips of changing facial expressions and objects in motion. The BOLD contrast between face blocks and object blocks in MJH revealed higher activation to faces only in bilateral posterior superior temporal sulci, not in his damaged ventral temporal cortices (which contain the fusiform face area (FFA) and occipital face area (OFA) in intact subjects). These results suggest that the ventral occipito-temporal cortices are critical for face individuation—although not the perception of other face attributes—and despite the early occurrence of the lesion, that function cannot be restored through plasticity.
NSF BCS 04-20794, 05-31177, & 06-17699 to Irving Biederman.