Face Blindness Is Not Always Permanent

— Largest research study to date takes a look at failure to acknowledge familiar faces

by
Judy GeorgeDeputy Managing Editor, MedPage Today
January 12, 2024

Prosopagnosia– likewise called face loss of sight, or the failure to acknowledge familiar faces– took place throughout a variety of degenerative and non-degenerative neurologic conditions, a big case series revealed.

In a research study of more than 300 clients with prosopagnosia, the temporal and occipital lobes and linking fusiform gyrus were essential brain locations included, reported Keith Josephs Jr., MD, MST, MSc, of Mayo Clinic in Rochester, Minnesota, and co-author in Brain Communications

“This is without a doubt the biggest research study worldwide on neurological illness connected with prosopagnosia,” Josephs informed MedPage Today“In nearly all circumstances, the ideal brain hemisphere was impacted.”

The case series likewise determined conditions not formerly connected to prosopagnosia, Josephs stated.

“One of the most crucial findings from the research study is that loss of facial acknowledgment in the adult years is not constantly long-term, however can be short-term and might enhance with time when related to particular medical diagnoses– for instance, migraine headaches,” he included.

The term prosopagnosia was initially utilized in 1947, however a description of the condition goes back to a case report in 1867, the scientists kept in mind. “Prosopagnosia makes complex acknowledgment of faces of formerly experienced people, particularly unknown faces (i.e., deals with rarely seen; e.g., high school schoolmates or previous colleagues) and likewise impacts acknowledgment of familiar faces (i.e., deals with come across regularly; e.g., relative),” they composed.

Prosopagnosia can be developmental or gotten, depending upon whether beginning happens in early youth or later on. Obtained cases can have degenerative or non-degenerative etiology. Literature about prosopagnosia consists primarily of case reports and little case series.

The scientists determined 336 clients with likely or certain prosopagnosia in Mayo Clinic consumption and recommendation center records from 2000 to 2023. They examined local participation of the right and left frontal, temporal, parietal, and occipital lobes based upon 18F-fluorodeoxyglucose PET or MRI scans. Typical age at prosopagnosia beginning was 66.

Probable prosopagnosia was specified as a subjective report of facial-recognition loss by a client, caretaker, or partner without unbiased proof. Guaranteed prosopagnosia consisted of unbiased proof of prosopagnosia by official or casual screening.

10 clients (8 males) had developmental prosopagnosia, consisting of one with Niemann-Pick illness type C and another with a FOXG1 anomaly.

Of 326 cases of gotten prosopagnosia, 235 (72.1%) were classified as degenerative and 91 (27.9%) as non-degenerative. The most typical degenerative medical diagnoses were posterior cortical atrophy (21%), main prosopagnosia syndrome (21%), Alzheimer’s illness dementia (16%), or semantic dementia (11%). Amongst individuals with degenerative prosopagnosia, face loss of sight was steady or intensified with time.

In 117 clients with degenerative prosopagnosia who had PET, the temporal lobes were most often impacted. In a subset of clients with degenerative prosopagnosia who passed away, the most typical pathology findings were frontotemporal lobar degeneration with hippocampal sclerosis or combined Alzheimer’s and Lewy body illness pathology.

Non-degenerative medical diagnoses typically were main brain growths (40%), ischemic or hemorrhagic infarcts (12%), or seizure-related illness (12%). 5 clients established non-degenerative prosopagnosia right away after a terrible brain injury. 2 other clients had visual snow syndrome, and 2 had attention deficit condition.

In 82 clients with non-degenerative prosopagnosia who had MRI, a focal sore impacted the ideal temporal or best occipital lobe.

The scientists determined a group of clients with non-degenerative prosopagnosia whose face loss of sight enhanced or solved. These were individuals with migraine-related prosopagnosia, posterior reversible encephalopathy syndrome, delirium hypoxic encephalopathy, or ischemic infarcts.

“Two of the most intriguing findings in clients with a non-degenerative medical diagnosis were the association of prosopagnosia with migraines and the observation that prosopagnosia can be short-term and deal with gradually,” they composed.

“Prosopagnosia as a function of timeless migraine is seldom explained in the literature considering that the very first report over twenty years earlier,” they continued. “We did experience clients with traditional migraines in which the prosopagnosia was a function of aura.”

The research study had a number of constraints, the scientists acknowledged, including its retrospective style. Not all clients finished a standardized unbiased test and prosopagnosia intensity might not be identified.