Impaired processing of relative distances between features and of the eye region in acquired prosopagnosia-Two sides of the same holistic coin?

Acquired prosopagnosia (AP) is characterized by impaired recognition of individual faces following brain damage. The nature of the functional impairment(s) underlying AP remains debated. Recent studies have demonstrated deficient processing of diagnostic information in the region of the eyes (Caldara et al., 2005); other studies suggest that patients fail to judge relative distances between facial features (Barton et al., 2002). We hypothesized that these apparently different observations are related to a common cause. More precisely, we suggest that AP arises due to an impairment of a process that reduces uncertainty about the nature/location of the diagnostic cues for face individualization: the ability to perceive multiple elements of a face as a single global representation (holistic processing). Being impaired at processing individual faces holistically, prosopagnosic patients would tend to perform relatively worse for processing facial areas containing multiple elements (i.e., the eyes), and for elements that are widely spaced apart. Here we tested PS, a single case of AP, at matching unfamiliar faces differing either with respect to local features or inter-feature distances, over the upper and lower areas of the face. A pilot study and Experiment 1 confirmed that PS was extremely poor at using information encompassing the eyes, but was also deficient at perceiving relative distances between features. When uncertainty about the location and nature of the diagnostic cue was removed in Experiment 2, PS' performance remained below normal range, but she improved substantially. Most interestingly, her pattern of performance across the different conditions appeared qualitatively identical to that of normal controls. In line with previous observations of PS and other cases of prosopagnosia, our findings indicate that the reduced reliance on the area of the eyes and on relative distances between features in AP may have a common underlying cause-the disruption of holistic processing of the individual face.