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Prosopagnosia: How Face Blindness Bars Recognizing Familiar People and Relatives

Prosopagnosia, also known as face blindness or facial agnosia, is a condition that causes an inability to recognize other people’s faces. Prosopagnosia isn’t the same as having trouble remembering new faces; instead, it’s a specific neurological condition.

Read on to learn more about prosopagnosia or face blindness.

The term prosopagnosia comes from the Greek words “prósōpon,” meaning “face,” and “agnōsía,” which means “non-knowledge.” It’s a neurological disorder that impairs a person’s ability to recognize faces.

The severity of prosopagnosia can vary greatly. Some people only find it difficult to recognize unfamiliar faces, while others can’t recognize the faces of their family members and friends. In more severe cases, patients can’t differentiate faces from inanimate objects, or they may even have trouble recognizing their own face. 

This disorder can be the result of lesions or damage in the right fusiform gyrus, a fold in our brains that is responsible for face perception and memory. Damages to this brain area can be caused by stroke, traumatic brain injuries, or neurodegenerative diseases. In other cases, prosopagnosia can be the result of a congenital disorder, which likely stems from a genetic mutation.

Prosopagnosia doesn’t impair a person’s memory, and it’s not related to impaired vision, concentration difficulties, or learning disabilities. However, some degree of face blindness can often be found in children who have Asperger’s syndrome or autism spectrum disorder. This condition can contribute to social development issues in these children.

It’s not uncommon for many of us to occasionally fail to recognize someone we have already met before or to absentmindedly mistake a stranger for someone we know — especially when we’re fatigued. However, these occurrences aren’t the same as having prosopagnosia.

People who suffer from prosopagnosia have severe difficulties when it comes to recognizing faces; these issues can even affect their everyday lives. Face blindness can cause someone to be unable to recognize even those closest to them, such as their partner or children.

In many cases, people with prosopagnosia develop strategies to help them differentiate people, even if they can’t recognize their faces. They may use hairstyles, clothing, or context to help them recognize people. But even these strategies can fail if they encounter someone unexpectedly.

The most characteristic symptoms of prosopagnosia include:

  • Being unable to identify people in photographs
  • Appearing to be lost in crowded spaces
  • Confusing characters that appear in films, TV series, or theatrical plays
  • Having trouble differentiating people who share physical characteristics, such as wearing a uniform, or being the same age/ethnicity/gender
  • Asking questions to help them recognize people that they encounter
  • Avoiding the use of names and introductions
  • Ignoring familiar people when encountered unexpectedly
  • Relying on non-facial information to recognize other people (such as their clothing, hairstyle, voice, gait, among others)
  • Struggling to imagine or describe other people’s faces

There are two main types of prosopagnosia with unique causes.

This type of face blindness occurs in individuals who haven’t suffered from brain damage. Instead, people with developmental prosopagnosia fail to develop normal face recognition abilities despite not having obvious brain lesions.

Developmental prosopagnosia, also called congenital prosopagnosia, can start to manifest during childhood, and it has been found to run in families. It is thought that this condition could have a genetic component.

For a long time, it was believed that most cases of face blindness were caused by brain damage, and developmental prosopagnosia was only discovered in more recent years. However, it’s now thought that the incidence of this condition could be much higher than it was previously believed. Statistics suggest that up to 2.5 percent of the world’s population could suffer from some degree of developmental prosopagnosia.

Acquired prosopagnosia can be a consequence of brain damage, usually caused by stroke, traumatic brain injury, brain hemorrhages, certain types of brain surgery, tumors, degenerative atrophy, encephalitis, Parkinson’s disease, and Alzheimer’s disease, among others.

Acquired prosopagnosia can be subdivided into two categories: apperceptive and associative prosopagnosia. Apperceptive prosopagnosia causes difficulty in recognizing faces due to impaired perceptual processing; individuals with this variant of the condition can’t recognize either familiar or unfamiliar faces.

Patients with associate prosopagnosia, on the other hand, are able to perceive faces but can still recognize some of their characteristics. Patients with this variant may be able to identify someone’s gender and approximate age by looking at them; however, they won’t be able to fully identify the person. Individuals with associative prosopagnosia are also able to tell whether two pictures show the same person — despite being unable to recognize them, whereas people with apperceptive prosopagnosia are unable to do so.

Different standardized tests can be used to evaluate face recognition and diagnose prosopagnosia.

The Benton Facial Recognition Test (BFRT) is commonly used by neuropsychologists to test for prosopagnosia. Patients see a target face above six test faces, and they’re then asked to identify which of the test faces matches the target face. Hair and clothes are cropped out of the pictures. Items get harder as the test progresses.

The Cambridge Face Memory Test (CFMT) can also be used to diagnose prosopagnosia. During the test, the patient is presented with three photos each of six target faces. Then, they’re shown multiple three-image sets, each of which contains a single target face.

The Prosopagnosia Index or PI20 is a self-report questionnaire that has been validated using other face memory tests, and it’s widely available.

The Exposure Based Face Memory Test is a self-reported, open-source test used to measure face memory with a short administration time. To be considered accurate, participants shouldn’t have seen any other faces used in the test previously.

Although there’s no cure for prosopagnosia, many patients with the condition try different strategies to help them manage it. Different patients may experience different results through these techniques, especially considering the wide variety of brain injuries that can lead to prosopagnosia. 

For example, a patient who suffered a severe stroke and developed acquired prosopagnosia may have more difficulty using these training strategies than someone with developmental prosopagnosia.

Many patients with face blindness choose to create mnemonics to remember a person’s distinctive characteristics. A mnemonic is a memory aid technique in which you create a pattern of letters or words to help you associate concepts. 

For example, you could use phrases such as “Harry’s hair,” “George’s glasses,” “Rose’s rings,” or “Dylan’s dimples” to help you remember how someone looks. It can be useful to exaggerate this person’s characteristics in your mind to make them easier to recognize.

Looking at pictures of people you know and studying them can help you identify which characteristics may be easier to remember. Adding people on social media can help you become more accustomed to their faces and features.

Schools can implement several strategies to help children with face blindness. For example, creating a fixed seating plan can help children with prosopagnosia remember exactly where everyone is seated. If possible, asking classmates or work colleagues to wear name tags can help the patient identify people more easily.

Many of us have forgotten or been unable to identify someone’s face every now and then. However, this isn’t the same as having prosopagnosia.

Prosopagnosia, or face blindness, is a neurological condition that can be congenital or acquired, and it causes an inability to recognize faces. There are different types of face blindness, and its severity can range from mild to severe.

If you suspect that you’re suffering from prosopagnosia, book an appointment with your doctor. Before being diagnosed with prosopagnosia, your doctor will usually try to rule out other medical conditions that could be causing the issue.

Although prosopagnosia can’t be cured, different strategies may be used to help you recognize people’s characteristics to be able to identify them.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398751/

https://openpsychometrics.org/tests/EBFMT/

https://prosopagnosiaresearch.org/index/information

http://www.prosopagnosiaresearch.org/symptoms

https://www.nhs.uk/conditions/face-blindness/

https://www.ninds.nih.gov/Disorders/All-Disorders/Prosopagnosia-information-page

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