Seeking Answers to Face Blindness
As researchers debate its cause and remedies, those who don't recognize others by face find ways to cope


by Tom Valeo

September 28, 2007

In high school, fellow students pegged Heather Sellers as aloof, even stuck-up, because she didn’t say “hi” to people she passed in the hall. She didn’t recognize them, which made her think she was bad with names and faces, or just stupid.

The problem followed her into adulthood. One day she even failed to pick out her two stepsons as they emerged from school. At the time, her husband suggested she had a problem.

“I just thought he was really good at recognizing people,” Sellers said, “but he said no, everyone can do that.”

Testing revealed that Sellers, a fiction writer and associate professor of English at Hope College in Michigan, is profoundly face blind. She can see parts of faces perfectly and describe them in detail. She can recognize anger, sadness and other facial expressions. But she can’t assemble her perceptions into an image that will enable her to recognize a face the next time she sees it. When she traveled to Harvard to be tested by Brad Duchaine, who studies face blindness, or prosopagnosia, she scored worse than 99 percent of the population.

“But I was relieved to score so poorly,” Sellers said. “I realized I’m simply incapable of performing this task that others can do so easily.”

Duchaine, now at University College in London, also performed brain scans on Sellers and found she displayed no activity at all in the fusiform gyrus, believed to be crucial for facial recognition. This surprised him since most people born with prosopagnosia show at least a flicker of activity if the same face is shown to them repeatedly. But Duchaine is reluctant to blame prosopagnosia entirely on a faulty part.

“The evidence that the fusiform gyrus is solely at fault is quite weak,” Duchaine said. “I believe it’s a processing problem.”

Visual processing demonstrates the brain’s ability to integrate data from various regions into conscious perceptions. A stroke, a tumor or other form of brain damage can disrupt this integration and produce all sorts of deficits, including an inability to recognize faces.

But Sellers has no sign of brain damage. She apparently was born with a deficit, probably in the fusiform gyrus, but possibly elsewhere as well in the complex network of neural connections that a new generation of scanning technology is just starting to make visible to scientists.

Facial recognition depends on representations distributed widely throughout the brain, says Alumit Ishai, an assistant professor at the University of Zurich. The occipital cortex at the back of the brain may recognize faces in general, for example, but visual signals also travel to the amygdala and insula, which respond to facial expressions, and to the orbitofrontal cortex, where facial beauty and sexual attractiveness are assessed. Memory, obviously, comes into play as well.

In a paper titled, “Let’s Face It: It’s a Cortical Network,” soon to be published in NeuroImage, Ishai disputes the notion that the fusiform gyrus is essential for facial recognition. “A non-functional fusiform gyrus would result in severe impairments in face recognition,” she said. But some prosopagnosics display normal activity in that area and remain face blind.

People born with prosopagnosia were practically unknown until about a decade ago, but Harvard University professor Ken Nakayama believes as many as 1 in 50 people may have significant trouble recognizing faces.

“It could be a stealth condition,” said Nakayama who, with Brad Duchaine, maintains a web site (www.faceblind.org) that invites people who suspect they may have prosopagnosia to contact them. “There are no tests for prosopagnosia in schools. In that regard it may be like dyslexia, which took a while to recognize.”

Can anything be done to alleviate face blindness?

Joe DeGutis is trying to develop training exercises that will make prosopagnosics better able to recognize faces, and he has had some success. (He will report on this in the November issue of The Journal of Cognitive Neuroscience.)

“I’m hesitant to claim too much,” said DeGutis, who works at the Veterans Affairs Hospital in Jamaica Plains, Mass. “We still need to work out why it works, and what dosage of therapy a person needs. And if improvement in the lab doesn’t transfer to everyday life, it’s worthless.”

Heather Sellers expects no benefit from future treatments because her face blindness is so profound. She is writing a memoir of her experience titled Face First, and each semester she distributes a letter to faculty and students explaining her condition and asking for understanding. In the letter she encourages people to identify themselves when they approach her.

"Even my family members and close friends have to do this," she says in her letter.