Face processing improvements in prosopagnosia: successes and failures over the last 50 years

Abstract

Clinicians and researchers have widely believed that face processing cannot be improved in prosopagnosia. Though more than a dozen reported studies have attempted to enhance face processing in prosopagnosics over the last 50 years, evidence for effective treatment approaches has only begun to emerge. Here, we review the current literature on spontaneous recovery in acquired prosopagnosia (AP), as well as treatment attempts in acquired and developmental prosopagnosia (DP), differentiating between compensatory and remedial approaches. We find that for AP, rather than remedial methods, strategic compensatory training such as verbalizing distinctive facial features has shown to be the most effective approach (despite limited evidence of generalization). In children with DP, compensatory training has also shown some effectiveness. In adults with DP, two recent larger-scale studies, one using remedial training and another administering oxytocin, have demonstrated group-level improvements and evidence of generalization. These results suggest that DPs, perhaps because of their more intact face processing infrastructure, may benefit more from treatments targeting face processing than APs.

The neuropsychological rehabilitation of visual agnosia and Balint’s syndrome

“…Both literature reviews concluded that restorative training has not yet proven to be very successful and that compensatory strategies appeared to be a more effective approach for the rehabilitation of acquired prosopagnosia (Bate & Bennetts, 2014;DeGutis, Chiu, Grosso, & Cohan, 2014). The additional eight articles appeared to be in line with the outcome of the literature reviews, especially with regard to transferring the training to real-life face recognition (Bate et al, 2015).…”

A vision of graded hemispheric specialization

“…Why doesn't the intact hemisphere come to mediate recognition, especially if, as we have claimed, the representations in the non‐preferred hemisphere play a functional role and are not merely epiphenomenal? The existing evidence, however, suggests otherwise, and to date, there is rather little reported recovery of function in pure alexia or in acquired forms of prosopagnosia …”

Prosopagnosia: current perspectives

“…Given the rarity of acquired prosopagnosia, it will be very difficult to establish the impact of each of these factors. To date, there have been few remedial attempts for the acquired variant, and most focus on enhancing coping strategies to circumvent poor face recognition 158,159. Only one published study attempted to improve face recognition, in a child with diffuse damage after meningococcal meningitis: 18 months of training did not improve matters 160.…”