title: Lesions of the fusiform face area impair perception of facial configuration in prosopagnosia.
abstract: BACKGROUND
  Prosopagnosia, the inability to recognize faces, is associated with medial occipitotemporal lesions, especially on the right. Functional imaging has revealed a focal region in the right fusiform gyrus activated specifically during face perception.
  
  
  OBJECTIVE
  The study attempted to determine whether lesions of this region were associated with defects in face perception in patients with prosopagnosia.
  
  
  METHODS
  Five patients with acquired prosopagnosia were tested. They were asked to discriminate faces in which the spatial configuration of features had been altered. This was contrasted with their discrimination of changes in feature color, an alteration that does not affect spatial relations.
  
  
  RESULTS
  All four patients whose lesions included the right fusiform face area were severely impaired in discriminating changes in the spatial position of features. The one patient with anterior bilateral lesions was normal in this perceptual ability. For three of the five patients, accuracy was normal for changes in eye color. When subjects knew that only changes in mouth position would be shown, performance improved markedly in two of the four patients who were impaired in the initial test.
  
  
  CONCLUSIONS
  Perception of facial configuration is impaired in patients with prosopagnosia whose lesions involve the right fusiform gyrus. This deficit is especially manifest when attention must be distributed across numerous facial elements. It does not occur with more anterior bilateral temporal lesions. Loss of this ability may contribute to the recognition defect in some forms of prosopagnosia.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA. jbarton@caregroup.harvard.edu
authors.forename: Jason J S
authors.initials: JJ
authors.lastname: Barton
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Press
authors.forename: Julian P
authors.initials: JP
authors.lastname: Keenan
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D001931:Brain Mapping; D004192:Discrimination, Psychological / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000473:pathology*; D020238:Prosopagnosia / Q000473:pathology* / Q000503:physiopathology*; D011930:Reaction Time / Q000502:physiology; D013702:Temporal Lobe / Q000473:pathology*; D014796:Visual Perception / Q000502:physiology*