Face Blindness (Prosopagnosia): Get Treatment Information *Prosopagnosia (face blindness ) facts medical author: William C. Shiel Jr., MD, FACP, FACR Face blindness is a brain disorder characterized by the inability to recognize faces. Face blindness is thought to be the result of abnormalities, damage, or impairment in the right fusiform gyrus, a fold in the brain that appears to coordinate the neural systems that control facial perception and memory. Face blindness can result from stroke , traumatic brain injury , or certain neurodegenerative diseases. The focus of any treatment should be to help the individual with face blindness develop compensatory strategies. Adults who have face blindness as a result of stroke or brain trauma can be retrained to use other clues to identify individuals. What is prosopagnosia? Share Your Story Prosopagnosia is a neurological disorder characterized by the inability to recognize faces. Prosopagnosia is also known as face blindness or facial agnosia.

The term prosopagnosia comes from the Greek words for “face” and “lack of knowledge.” Depending upon the degree of impairment, some people with prosopagnosia may only have difficulty recognizing a familiar face; others will be unable to discriminate between unknown faces, while still others may not even be able to distinguish a face as being different from an object. Some people with the disorder are unable to recognize their own face. Prosopagnosia is not related to memory dysfunction, memory loss , impaired vision, or learning disabilities . Prosopagnosia is thought to be the result of abnormalities, damage, or impairment in the right fusiform gyrus, a fold in the brain that appears to coordinate the neural systems that control facial perception and memory. Prosopagnosia can result from stroke , traumatic brain injury , or certain neurodegenerative diseases. In some cases it is a congenital disorder, present at birth in the absence of any brain damage . Congenital prosopagnosia appears to run in families, which makes it likely to be the result of a genetic mutation or deletion.

Some degree of prosopagnosia is often present in children with autism and Asperger's syndrome , and may be the cause of their impaired social development. Agnosia Agnosia Agnosia refers to the inability to recognize people or objects even when basic sensory modalities, such as vision, are intact. As an example, patients with visual agnosia may not recognize an object upon visual presentation even though they can describe its shape and other visual characteristics or the person cannot recognize their wife's face and in some cases even their own. It is therefore apparent that sensory perception of the object / face is disconnected from memories associated with the object / face. The patient can perceive the object but has no meaningful associations to it. In agnosia, while perception itself, feeling an objects shape, normal, recognition of objects is not. There are basically three different forms of agnosia; visual agnosia where the person has difficultly recognizing objects, faces and words. The second is Auditory Agnosia which involves the inability to recognize sounds and thirdly, Somatosensory Agnosia where the person has difficulty perceiving objects through tactile stimulation.

The characteristic and sub-types of the three forms of Agnosia are as follows: Visual Agnosia Visual agnosia is a neurological disorder distinguished by the inability to recognize familiar objects. There are a number of sub-types of visual agnosia. The most common are: Prosopagnosia - Inability to identify faces even though the person is known to the sufferer. More on Prosopagnosia Click Here Agnostic Alexia - Reading Material Color Agnosia - Inability to discriminate between colors and therefore cannot name the colour. Object Agnosia - Inability to name objects. Simultanagnosia - Inability to recognize a whole image although individual details are recognized. Visual agnosia is associated with lesions of the left occipital and temporal lobes. Many patients have a severe visual field defect on the right side because of the injury to the left occipital lobe. It is common for patients to have visual agnosia but intact recognition in the tactile and auditory modalities. In prosopagnosia bilateral lesions of the gray and white matter of the occipitotemporal gyrus cause prosopagnosia.

In particular, the inferior longitudinal fasciculus, a pathway that interconnects the occipital and temporal lobes, has been suggested as the lesioned area in prosopagnosia. Auditory Agnosia There are three sub-types of visual agnosia: Auditory/verbal information Agnosia - Inability to hear words. Auditory Agnosia - Inability to hear environmental sounds such as a car starting or a dog barking. Receptive Amusia - Inability to hear music. Cortical deafness is also a term applied to patients who essentially do not respond to any auditory information even when hearing is intact. Somatosensory Agnosia (Astereognosis - Tactile Agnosia) Patients with this disorder have difficulty perceiving objects through tactile stimulation although basic tactile sensation is intact. There is a distinction between the inability to recognize basic features of an object, such as size, weight, and texture, and the inability to name or recognize the object. Patients who cannot recognize an object by touch may still be able to draw the object and recognize the object pictured in the drawing. Sometimes they can describe the physical features of the object but cannot recognize it.

Pure astereognosis is thought to be caused by lesions of the somatosensory cortex (post central gyrus) in the area subsumed by the hand. Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Not a General Memory Disorder. Prosopagnosia - Definition, Symptoms, Causes, Test, Treatment Prosopagnosia Prosopagnosia Prevention What is Prosopagnosia ? Prosopagnosia is a disorder that involves face perception where the word prosopagnosia literally means not knowing face. Agnosia means impaired recognition, while prosopon means face. Others even refer this condition as face blindness, a disease process that involves impairment in face recognition. The condition basically is defined as the inability of the affected person to recognize faces, even though one is acquainted with, but still has an intact memory of recognizing other objects. As what research says, the condition is believed to be caused by brain damage or from a congenital disorder. Reports show that the condition can be inherited; at least 2.5% of the total population has been affected.

According to history, the condition has been reported first back in the year 1947. Bodamer, the person who first recognized and named the condition, has reportedly found the condition in two individuals which is very distinct to the simple condition agnosia. As to that observation, he reported the condition as prosopagnosia which is now known to the public. Acquired prosopagnosia Acquired prosopagnosia is a condition where an injury has incurred to a person’s brain. Incidents such as head injury, cerebrovascular accident or stroke, or other neurodegenerative diseases can cause prosopagnosia. Before any injury has occurred, the person involved has clear face recognition. But once the injury has greatly damaged the person’s brain, prosopagnosia can result. Those affected of the condition have difficulty recognizing various pictures of people’s faces even though they have encountered them beforehand. But those with acquired prosopagnosia can identify which from the group of pictures are from the same race and age. Developmental prosopagnosia The condition is believed to be present from childhood. Because of this, developmental prosopagnosia is noted as a type of the condition.

The condition is also considered as a lifelong disorder. The said type of prosopagnosia is stated to be from an inherited gene. Genetic link to this condition has been found by German researchers in the year 2005. The result of their study showed that the individuals involved with prosopagnosia ran in 7 families. Another study showed that children who were born with autism and Asperger syndrome also have developmental prosopagnosia. The children would manifest difficulty or inability to recognize faces as what most other people do. Accordingly, this condition is subdivided in two categories: There are patients who have impaired estimations of the third party’s age. There are patients who have inability to fully recognize the face of another person. Prosopagnosia Symptoms & signs Prosopagnosia as discussed is a condition that involves inability to recognize faces. This condition is also related to the inability of a person or another from remembering the names of other people. The condition can be identified as prosopagnosia once the affected have difficulty recognizing the face a person that he or she is acquainted with or truly familiar with. Face recognition becomes a pain to them that they are unable to identify the owner or name of the person.

It has also been observed that those affected with prosopagnosia has difficulty in following track of a television show or a movie, just because they couldn’t recognize readily the characters’ faces. Others stated that the condition is also accompanied by short-term memory loss or defect that is a sign of neurological disorder. Prosopagnosia Causes There are a lot of predisposing and precipitating factors for prosopagnosia. It has been noted that the following causes the said condition: Brain injury or damage Stoke or cerebrovascular accident Neurodegenerative disorders The affected would complain or describe that he couldn’t recognize the face of a person even though the other party is fully aware that they are acquainted or have known each other. Those with developmental prosopagnosia, they would suffer from inability to recognize faces easily in an early age. As time takes them, they would realize that their recognition skills are not of the same level as with those people surrounding him. Prosopagnosia Diagnosis (Test) Screening for prosopagnosia is not an easy task, as what most doctors would say. Because of this, a specific tool in the diagnosis for prosopagnosia was developed, called Cambridge Face Memory Test.

This is a test that is much reliable and can effectively test for a person’s ability to recognize faces. There was previous a test called Benton which also aims in testing the person for face recognition problems. The difference between the two tests is that the Cambridge Face Memory test uses faces alone; without hair, ears or neck. While Benton uses images of faces with hair, ears and neck making the test provide results as false-negative. But the Cambridge Face Memory test is not considered the gold standard of prosopagnosia since the brain is a very complex part of a person’s body, which can alter its way of functioning. According to reports, the test is not widely used for it’s still in the process of making it a good and viable test for prosopagnosia. Other tests such as the EEG and fMRI can be of health in the diagnosis of the condition, most especially the developmental prosopagnosia. Prosopagnosia Risk factors Those at risk of this condition are the people who have a family history of prosopagnosia. Those with first degree family members who suffer from prosopagnosia are most likely to develop such condition.

It has been reported that children of a person with prosopagnosia are at risk of the condition. Other risk factors include the following: People who suffered from brain injury. People who have had stroke. Those who have neurodegenerative disorders are also at risk of developing prosopagnosia. Prosopagnosia Treatment The main goal of the treatment of prosopagnosia includes helping the affected to practice ways in compensation of recognizing faces. There is no direct treatment for the condition and has no definite cure. There are coping strategies that could assist the affected. Here are some of the ways in order to assist a client in overcoming the disease process: Provide clues to client as he or she struggles to recognize a face. One can accustom the patient with the other party’s voice, style of hair and clothes. Support client and assist them as always. There is a clear possibility that the client would be withdrawn from others socially because of their problem. Research is still on the works for prosopagnosia. This condition which is starting to be recognized has taken toll to the affected that is why many are asking for answers regarding the condition.

The National Institute of Neurological Disorders and Stroke are now conducting a research in light to prosopagnosia. Prosopagnosia Prevention Prosopagnosia cannot be prevented once it’s developmental. An inherited gene cannot be taken away from a person, leading us to conclude that prevention is a far solution of the problem. However, since the condition, prosopagnosia, is quite linked to stroke, brain injury, and other neurodegenerative disorders, taking care of one’s health is a must. One can avoid stroke by practicing a healthy lifestyle, healthy diet and healthy living. Once one has been diagnosed with hypertension, we can avoid cerebrovascular accident by taking the prescribed medications that the doctor has provided and recommended. Seeking medical help once brain injury or trauma has been suspected is a must. We cannot just take for granted those small things that have placed harm on our body. Leave a Reply Prosopagnosia Research - About Prosopagnosia What is prosopagnosia? Prosopagnosia (also known as 'face blindness') refers to a severe deficit in recognizing familiar people from their face.

While some people report a very selective impairment that only influences the recognition of faces, others find the deficit extends to the recognition of other stimuli, such as objects, cars, or animals. Many people also report deficits in other aspects of face processing, such as judging age or gender, recognising certain emotional expressions, or following the direction of a person's eye gaze. Finally, a substantial number of people also report navigational difficulties. How does prosopagnosia affect a person's life? Some people cope well with their face recognition difficulties, and even develop elaborate compensatory mechanisms to help them function effectively in everyday life. For others, however, the condition has a much greater impact on daily functioning. Some people avoid social interactions, experience problems with interpersonal relationships or damage to their career, and even report episodes of depression. In extreme cases, people with prosopagnosia develop social anxiety disorder, characterized by fear and avoidance of social situations that may cause embarrassment. You can read a first hand account of prosopagnosia here . What are the causes of prosopagnosia? Until recently, it was thought that very few people experience prosopagnosia.

The condition has traditionally been studied in individuals who acquire the disorder following neurological damage (typically from stroke or head injury), and a handful of case studies were reported in the literature in the 20th century. However, it has recently become clear that many more people have prosopagnosia without experiencing neurological damage. This form of the disorder is commonly referred to as "developmental" or "congenital" prosopagnosia, and these people simply fail to develop normal face processing abilities despite normal intellectual and perceptual functions. People with developmental prosopagnosia seem to have had face recognition difficulties for most of their lives, and perhaps even since birth. Recent evidence suggests there may be a genetic contribution to the condition, and many people report at least one first-degree relative who also experiences face recognition difficulties. How many people are affected by prosopagnosia? As explained above, acquired prosopagnosia following brain damage is rare. However, developmental prosopagnosia appears to be much more common. In recent years, a flurry of media attention has raised awareness of the disorder, and thousands of people who believe they have prosopagnosia have approached researchers throughout the world.

However, little work has resulted in a formal estimate of the prevalence of developmental prosopagnosia. One study conducted in Germany surveyed the face recognition abilities of a large group of students, and reported a prevalence rate of 2-2.5%. A similar figure was obtained in objective screening of a large group of adults, and in a large-scale study of primary school children conducted by my laboratory. Although this prevalence rate from simply result from the calibration of the tests that were used, it does indicate that as many as one in 50 people may have the condition. If this figure is correct, there may be 1.5 million people with developmental prosopagnosia in the UK alone. Even if this is an overestimation, a prevalence of just 1% would indicate that 600 000 people have the disorder. I've heard that prosopagnosia may be linked to autism spectrum disorder - is this true? It is true that many people with autism spectrum disorder also experience face recognition difficulties. Problems with face-processing have also been reported in other developmental disorders such as Williams' syndrome and Turner's syndrome.

There are various theories concerned with this pattern of presentation, and some researchers believe that the face recognition impairment can be attributed to a lack of social interest in faces, and others that perceptual-processing strategy or impaired visuo-spatial skills may be the critical factor. However, while some individuals with prosopagnosia report severe social consequences resulting from their face recognition difficulties, these are not necessarily an indicator of a concurrent neuro-developmental disorder. On the contrary, there have been reports of misdiagnosis of high-functioning autism when the underlying issue is prosopagnosia alone. Importantly, many people with developmental prosopagnosia do not fulfil the diagnostic criteria of autism spectrum disorder, confirming the independence of the two disorders. How do I know if I have prosopagnosia? Many people occasionally fail to recognise a familiar face, or even mistake an unknown person for someone they know. However, individuals with prosopagnosia have a severe face recognition problem, affecting even the most familiar faces, such as their spouse or children. This failure to recognise familiar faces occurs every day, but many people have developed compensatory strategies to help with person recognition.

For example, they might recognise a person by their hairstyle, clothing or gait, or simply because they expect to see a person within a given context. However, if they unexpectedly encounter a familiar person, these compensatory strategies often break down. Some researchers advocate the use of self-report measures to diagnose prosopagnosia, but much research indicates that many people have limited insight into their face recognition skills, particularly if they have no point of comparison (i.e. they have experienced face recognition difficulties for their entire life). In all cases, proper objective testing is required to make a diagnosis. If you believe you may have prosopagnosia and live within travelling distance of Bournemouth University, we may be able to offer you a formal testing session and the opportunity to take part in our research if you wish to. You can register your details with us here . Is there any treatment for prosopagnosia? There is currently no formal treatment for prosopagnosia. However, our laboratory has recently published some attempts to remedy face recognition difficulties, either through the use of training programmes or temporary pharmaceutical intervention. While we have had some success, these techniques are still being investigated and developed.

If you believe you have prosopagnosia and would like to take part in some research investigating intervention techniques, please register here . If you live close to our laboratory in Bournemouth and don't mind travelling to us (travel expenses can normally be reimbursed), we will do our best to accommodate you within our current research programmes. However, we also have collaborators in other parts of the UK, Australia and America, and may be able to put you in touch with a researcher who is based closer to your home. Are there any techniques I can use to get round my difficulty with faces? Many people with prosopagnosia report compensatory strategies that can often help them circumvent their difficulties. For instance, teachers have described how they use classroom seating plans to identify their pupils, or even recognize different children by an external cue, such as their backpacks. Other elaborate compensatory strategies have been described, such as the use of jewellery, clothing, voice or gait to recognize a familiar person. Of course these strategies do not always work, and particularly break down when a person is met out of context and logic cannot be combined with these external cues.

If you would like to read more about the various strategies that people have found to be useful cues to recognition, why not check out and even contribute to our Discussion Forum on this topic. Dr Sarah Bate, Department of Psychology, Faculty of Science and Technology, Poole House, Bournemouth University, Fern Barrow, Poole, BH12 5BB, UK Living With Face Blindness - The Atlantic The Atlantic See our Newsletters > Living With Face Blindness Prosopagnosia is a condition that can make it impossible to recognize the faces of others, from friends to movie characters to parents. To varying degrees, it affects about two percent of people. Most Popular Text Size Deux hommes en pied by Edgar Degas (Renaud Camus/flickr) Jacob Hodes lies on the couch watching old reruns on television. It’s his roommate Sonny Singh’s turn to cook dinner tonight, and their Brooklyn apartment fills with the aroma of Indian food. As Singh bangs around in the kitchen, Hodes talks about a party he attended recently. “CUNY J-School parties are the worst, I don’t recognize anyone,” he says. Then he guffaws and glances back at Singh.

“I don’t think I could ever miss you on the street, man.” Singh runs his fingers through his long beard. “Yeah, the turban makes it difficult to forget, huh? Unless, of course it was Sikh Day Parade.” There’s a knock on the door and Singh lets in a young woman. “Hey,” she says. Hodes pretends not to notice. He sinks deeper into the couch and keeps his eyes on the television. She walks into the kitchen, unaffected, and chats animatedly with Singh. Hodes’ other roommates come out and embrace the woman. “I think I’m supposed to know who she is,” Hodes whispers once she’s out of sight. “ But I don’t recognize her at all.” Prosopagnosia, or “face blindness,” the disorder that has plagued Hodes since he was a child, is the inability to recognize faces that should be familiar. Some patients’ impairment influences only the recognition of faces; others find their deficit extends to the recognition of other objects such as cars and animals. Related Story The Girl Who Turned to Bone While anyone can have trouble recognizing faces and names, prosopagnosics can’t even identify their own parents and relatives.

They rely on non-facial information like hair color, gait, and tone of voice to distinguish people. Prosopagnosics often complain that they have trouble following movies or television shows, because they cannot recognize characters and keep up with the plot. Many also report problems with other aspects of face processing: They find it difficult to judge age or gender, recognize emotional expressions, or follow the direction of a person’s gaze. A substantial portion report navigational difficulties, because their sense of direction is impaired. Though researchers have sought cures, no therapies have demonstrated lasting improvements. “While there have been transient benefits, there has been nothing else that has made a real impact,” says Garga Chatterjee, currently pursuing doctoral research in prosopagnosia at Harvard. There are only about 100 documented cases of prosopagnosia in the worldwide medical literature. Yet scientists at the Prosopagnosia Research Centers at Dartmouth College, Harvard University and University College London are questioning whether the condition is actually that uncommon. “2.5 percent of the world’s population has the disorder. That’s one person in every 50. That is not rare at all,” Chatterjee says.

In 2004, researchers at the Institute for Human Genetics in Germany gave 576 biology students a prosopagnosia screening questionnaire and found that nearly two percent reported face blindness symptoms. Scientists at the Prosopagnosia Center in 2006 also reported, after testing 1600 individuals, that about two percent of the general population may have prosopagnosia. *** In 2007, Glenn Alperin was flying from Atlanta to Boston. “I was reading a newspaper when this man came up to me and shook my hand. He went down the aisle shaking hands with all of the passengers,” Alperin recalls. “I waited until he was at a safe distance and turned to the man sitting next to me and asked him who that was. The guy looked at me, horrified and said, ‘That was Jimmy Carter!’” Dressed in a fishing hat and an oversized green jacket, Alperin has just finished his session at a day treatment center in Cambridge, Massachusetts He makes his way to the subway station, carefully deliberating which train to take to Brookline, where he will tutor his first student of the day.

“I don’t look at people until I am spoken to,” says Alperin, who’s had prosopagnosia since infancy. He provides an interesting analogy: “Most people take a picture with their brain and store and develop the film. I take the picture, but throw the film in the trash immediately.” "God forbid if something were to happen, he wouldn't even be able to identify the person." Alperin’s mother Peggy recalls the time they discovered the disorder. “I remember we went somewhere and my eldest son’s voice had just started to crack and Glenn was having trouble telling his brothers apart,” she says. She then did some research, and doctors confirmed that Alperin did in fact suffer from prosopagnosia. Peggy did her best to support Alperin after they diagnosed the disorder. She put alarms all over the house and if reporters ever visited his school, she wouldn’t allow his photograph to appear in the newspaper. She constantly fears that people may take advantage of his condition. “I can’t say anything now, because he is a full grown adult, but he tutors and goes to people’s houses he doesn’t even know.

God forbid if something were to happen, he wouldn’t even be able to identify the person,” she says. “I am a gardener and it is only now, at the age of 63, that I have allowed my work to appear in shows. When Glenn was a child, I was so concerned for his safety, I never showed my work to anyone.” Researchers say prosopagnosia isn’t a unitary disorder, meaning that it is different for each patient. “Each prosopagnosic’s description of their experiences will be different,” Chatterjee says. Most patients develop strategies for tackling the problem. They may note carefully the clothes someone is wearing, ask relatives to always wear a particular distinctive item, or learn how to initiate and maintain conversations while they figure out whom they are talking to. But such strategies aren’t completely effective. Alperin’s mother would often test him as a child, hoping that would sharpen his mind. “My mother would keep changing her hairstyle and it would frustrate me because I couldn’t recognize her,” he says.

“But now that both of us are older and she knows there’s no real cure for my disorder, she just ties her hair at the nape of her neck with one highlight running through her bun and that’s how I can identify her.” Alperin grew up on Boston’s North Shore with two elder brothers who did their best to help him out. But with their similar features and flaming red hair he still had trouble telling them apart. Yet, he says, briskly walking through Brookline, his family was incredibly supportive. “I would tell him, at his wedding, I would have to get the word ‘wife’ monogrammed on his wife’s dress, so he wouldn’t kiss the wrong girl,” Peggy recalls, laughing. “I had to prepare him to deal with the disorder and I wanted him to have a sense of humor about it.” His father, who died when Glenn was 16, spoke little. “He never mentioned anything about my disorder,” he says. “It was only later that I learned that he was worried I would forget him. But I could never do that.” Alperin rates the severity of his prosopagnosia a 9 out of 10. He finds it difficult even to recognize himself in a mirror.

“I don’t like to take the time to see what I actually look like now, because I don’t care,” he says. At age 34, he is tall and lanky and keeps a long, red beard he constantly plays with. “That drives me crazy,” his mother says. She has been trying to get him to shave off his beard for a while now. “Although I get mad at him, I feel that the long beard is the only way he can recognize himself. His coordination is not great, so shaving too, must be trouble for him.” The stranger a person looks, the more Alperin is attracted to him or her. “I can recognize people that wear outrageous clothes or have different-colored hair a lot easier than those that blend into the crowd,” he says. “I like to believe I am attracted to people’s personalities. I can’t be attracted to the way they look.” While some prosopagnosics feel socially inept, Alperin tries to be outgoing. He stops to orders a cinnamon roll and strawberry flavored milk at the Dunkin Donuts in Brookline, which he frequents regularly. “They all know me here, but I don’t know them,” he jokes.

When the cashier asks if he wants anything else, he grins, “Yes, a million dollars would be nice, thank you.” He’s fighting the most frustrating consequence of prosopagnosia: The tendency to drive someone into isolation. “It’s far easier for me to be alone than to try and navigate my way through a sea of faces I will never be able to comprehend,” he says. “Imagine walking into a place where everyone looks like identical twins. That’s what I have to go through at social gatherings.” Because prosopagnosics are prone to depression, Alperin attends a day treatment program, which helps him overcome his unhappiness. Wolfing down his cinnamon rolls, he describes his treatment at the center. “The sessions help participants through mental health issues and provide survival techniques. It is helpful, because everyone that attends shares the problems they have together.” Social anxiety disorders and depression can ensue for prosopagnosics, because the disorder has such an impact on social groups and the patient’s interaction with society. “The Internet is probably the best thing that happened to prosopagnosics,” Alperin says.

“You can communicate with someone, build relationships, and maintain them without ever having to see their face or recognize them.” Yet, lack of direct social interaction also led him down a bad path. “I developed an online gambling problem when I was in college,” he says. “I specifically remember a telephone conversation with my mother when I was [in college] about a telephone bill which was off the wall, which effectively launched my gambling problem. It is still a problem, I don’t know if I will ever get over it.” "I am attentive all the time, but I still get confused." Alperin recognizes that gambling is dangerous. “Intellectually I know it does me far more harm than good, but addictions are rarely, if ever about applying logic.” The need for social interaction is what pushed him to become a tutor. “It’s difficult to interact with someone on a one on one basis and that’s why I wanted to pose that challenge to myself,” he says. Walking through residential Brookline, Alperin practices something he learned from Nancy Mindick’s book, Understanding Facial Recognition Difficulties in Children . He walks with his head down, and when he does look up, he avoids eye contact with passers by.

“Because I have such a hard time picking up on non-verbal communication, I appear distracted.” He changes his expression and brings a distant look into his eyes. “This way, if someone wants to speak to me, they have to make the effort to approach me.” “I am attentive all the time, but I still get confused,” he says, walking towards his student’s house. He pauses for a moment “I don’t know whether it’s this house, or the one next to it.” He walks up to one, but quickly changes his mind and rings the bell next door. Alperin doesn’t feel awkward talking about his disorder with people he’s just met, he says. It’s not like he could hide it anyway. “Prosopagnosia is something that affects my interaction and my life on a daily basis, so I’m rather unabashed about my condition,” he says. Alperin has been tutoring 14-year-old Avi Ber in math for the past three months and as a coach, he appears patient and gentle. “Are you confident?” he asks when she tells him about an upcoming math project. “Yeah, I think,” she says hesitatingly. He glances at her briefly and smiles.

“Not as confident as it sounds.” Avi, a sophomore at Brookline High, says Alperin’s tutoring has helped her perform better. “He makes things very easy to understand,” she says. Alperin says his disorder has not harmed the student-tutor relationship. “I didn’t know what it was,” Avi says. “So I guess that’s another new thing I learned.” *** Though researchers can trace face recognition problems after brain injury as far back as the 19th century, prosopagnosia was first identified as a separate neuropsychological problem by German neurologist Joachim Bodamer in 1947. While studying the brain injuries of World War II veterans, he came across two prosopagnosics. One was unable to combine features to see a whole face; the other couldn’t recognize facial expressions. Though Bodamer was investigating a condition resulting from acute brain damage, contemporary researchers have found that a congenital or developmental type also exists: some patients are born with prosopagnosia. Glenn Alperin started showing face recognition problems after a fall from his crib at 16 months. “I didn’t realize it so much when I was a child, but I was constantly confused,” he says.

Acquired prosopagnosia, when the patient suffers brain damage from an injury or stroke is better known because patients have a clear sense of their impairment and know what they were like before they suffered the brain injury. In developmental prosopagnosia, which is genetic, the impairment is less apparent to the patient. “I feel like Glenn not knowing what life was like without the disorder is a blessing and a curse,” Alperin’s mother says. “He would also be scared to cure it, because he doesn’t know what life is like without it.” Deficits commonly associated with prosopagnosia include loss of color vision and the inability to find one’s way about. When the Alperins took skiing trips as a family, Glenn couldn’t find his way from the parking lot to the lodge. “But, when he was skiing, he made his way through the mountains with no trouble at all. I realized that it was the snow. All that white took away all that noise in his head,” says Peggy. Similarly, Peggy says Alperin prefers the night, because it is quieter and navigation becomes easier for him. “I wish someone [would invent] glasses for Glenn, where he could see the world in black and white.

It would make his life a lot easier,” she says. *** “It’s not that I don’t know everyone. The problem is I don’t know whom I know,” says Hodes, talking about the party he went to recently. “I was looking for the host and she causes me trouble,” he says. “She keeps changing her hairstyle.” He glanced around the room for a while before the hostess found him. He got himself a drink and started talking to a photographer sitting next to him. “Did you also go to CUNY?” Hodes asks. “Yeah, yeah I did,” the man replied. Hodes had struck gold. “Wait a minute, you teach there now don’t you?” he asked eagerly. “Yeah.” “You teach the photo class, you’re like an assistant? You taught my class,” Hodes said. “We had many interactions and I ought to have known him, but thankfully he didn’t recognize me,” Hodes says later. A recent CUNY journalism graduate, he’s become a prosopagnosia celebrity since appearing on 60 Minutes in August 2012. Hodes doesn’t think it necessary to tell people about his disorder right away.

“It would appear like I was self absorbed,” he says. Now most of his classmates and professors are aware of his face blindness—a mixed blessing, since people started asking him jokingly, “Do you recognize me?” Though he has lived with prosopagnosia since birth, Hodes wasn’t diagnosed until he was 19, when he was a student at Swarthmore College. His parents were going through a divorce, so he took advantage of the school’s free therapy. In addition to talking about his family, he told the counselor about his trouble recognizing people. “That’s when they told me that I may be suffering from the disorder,” he says. He went home that night and read up on prosopagnosia. Bill Choisser who suffered from it for years, was sharing his experiences on a blog . “It was like every movie cliché happened,” Hodes recalls. “I was reading Bill’s work and crying because years of repressed experiences finally made sense.” He signed up for testing in Boston at the Prosopagnosia Research Center. A functional MRI showed nothing wrong with his brain, yet he couldn’t recognize faces on tests.

“I can recognize horses, houses or even guns, but when it comes to faces, nothing,” he says. When he broke the news to his mother, she didn’t seem surprised; she had noticed the problem when he was a child. “I was like, ‘Mom, what the hell? Why didn’t you ever point it out?’” he says. “I remember I was always confused as a kid because all of us on the soccer team had that same stupid buzz cut and wore that same uniform three times a week.” Unlike Alperin, who thinks his prosopagnosia results from a fall, Hodes suffers from congenital prosopagnosia, which appears to run in families and probably results from a genetic mutation or deletion. “My dad is in his 50s and when I told him about the disorder, we found out he suffers from prosopagnosia as well. A lifetime of experiences suddenly made sense. I can imaging how difficult it must have been for him, because he used be a labor organizer,” Hodes says. *** It’s a Sunday evening and it’s Hodes’s turn to cook dinner at home. His roommate Heidi Chua Schwa is in the kitchen making tea.

"Facebook actually really helps a lot, because I can see what the person looks like if I haven't met them in a few months." Hodes has lived in his Brooklyn apartment for five years. Because he doesn’t like to talk about his condition, he initially confused his roommates when he didn’t acknowledge them. “He completely ignored me on the street one day and I was like ‘what?’” says Schwa, laughing. Hodes smiles shyly. “Yeah, but then I told you about it and it was okay.” He believes he needs to meet someone at least 30 times before he can recognize him or her. Social networking, however, is helping him cope. “Facebook actually really helps a lot, because I can see what the person looks like if I haven’t met them in a few months.” Doctors and researchers say there’s no cure for the disorder, but they’ve made progress in identifying the areas of the brain that could be responsible for face blindness. In October 2012, doctors at Stanford performed a clinical procedure on a patient with electrodes temporarily implanted in his brain. They were able to find two nerve clusters that were critical for face perception.

“We stimulated the region of the brain responsible for seizures,” says Josef Parvizi, assistant professor of neurology at Stanford. “It caused the patient’s vision of faces to distort, leaving the perception of inanimate objects and other body parts the same.” While the study doesn’t provide any options for treatment, it helps distinguish the part of the brain responsible for face recognition. “I wouldn’t call it groundbreaking, but it is important because causelogy has been established for prosopagnosia, which other studies have not been able to do,” Parvizi says. Connecticut Muffin at Lafayette and Fulton in Brooklyn is one of Hodes’ regular haunts. He sits with one leg propped against the armrest of the chair, sipping chai. “I like traveling,” he says. “I went to Sri Lanka to visit this girl I was dating, it was really beautiful.” Does it ever scare him, traveling and maintaining a relationship given his disorder? He smiles “No, it doesn’t. But this girl that I was dating, she kept changing her hairstyle and it drove me nuts. It was like waking up with a different person every day.” It does cause him problems as a journalist sometimes, though.

He describes an interview he did while reporting on factory workers in the Bronx. “I’m taking really detailed notes and everything—suddenly his brother comes over. I look at them, same features, same hair and I think, ‘I’m totally screwed.’” When he returned for a follow-up interview he asked the family members their names again, checking them against his notes. If he doesn’t recognize a source, he asks for the spelling of her name. Like other prosopagnosics, Hodes complains that following the plot of a movie or television show is difficult. He watched Amour recently and didn’t find it difficult to follow because there were so few characters. But back on his favorite spot on the couch, James Cameron’s Avatar confounds him within the first two minutes when an actor morphs into a cartoonish character. “Wait, is this the same guy that was looking at the dead body?” he asks baffled. He pauses and rewinds, starting the movie over three times. He throws his hands in the air, exasperated, “How can you tell if he was the same guy in the wheelchair? Can you tell them apart?

Man, you have some superpower.” Prosopagnosia Prosopagnosia Prosopagnosia affects 2% of the population. (Vidyarthi, 2006) What is prosopagnosia? Prosopagnosia is a selective difficulty of recognizing faces, also known as face blindness. Prosopagnosia can not only affect a persons inability to recognize faces, but in some cases people with prosopagnosia may not be able to recognize objects, automobiles, animals, or even their own face. Two types of prosopagnosia 1. Apperceptive prosopagnosia is the inability to differentiate between two faces. Patients with apperceptive prosopagnosia are unable to identify facial features, age, or gender by examining their face. Although patients are unable to recognize features of a face, they can understand the typical structure of a face. 2. Associative prosopagnosia is less severe in comparison to apperceptive prosopagnosia. Patients with associative prosopagnosia are able to identify facial features, age, or genders of people in photographs. Though in real life, patients are unable to recognize people and cannot differentiate people from one another.

Not only do patients have the inability to recognize and differentiate people in real life, but they are unable to remember information about people (e.g. their names, ages, etc.) Created by Melissa Podolsky Why People with Prosopagnosia Can't Recognize Faces - TIME Follow @TIME Cecilia Burman has always had a problem with faces. As a child, she struggled to pick out her own face in school photos, and she is hard-pressed today to describe her mother's features. Over the years she has offended countless friends, passing them on neighborhood streets or in office hallways like strangers. "People think I'm just snobby," says Burman, 38, a computer consultant in Stockholm. "It makes me really, really sad to lose new friends because they think I couldn't bother to say hello." There's a name for Burman's condition: prosopagnosia or, more informally, face blindness. The disorder was thought to be exceedingly rare and mainly a result of brain injury. Until a few years ago, there were perhaps 100 documented cases, says Ken Nakayama, a professor of psychology at Harvard.

But last month a team of German researchers took the first stab at charting its prevalence, and the results, published in the American Journal of Medical Genetics, were remarkable. The new study showed that prosopagnosia (from the Greek prosopon for face and agnosia for ignorance) is highly heritable and surprisingly common, afflicting, in some form, about 1 in 50 people--more than 5 million in the U.S. alone. "That's huge," says Dr. Thomas Grüter of the Institute of Human Genetics in Münster, an author of the paper and himself a prosopagnosic. "It was a real surprise." (See ways you can live for 100 years.) Within that group of sufferers, however, the condition varies widely. For the vast majority, the problem is not so much about detecting a face--prosopagnosics can see eyes, noses and mouths as clearly as anyone else--as it is about recognizing the same set of features when seeing them again. It's a disability that complicates everything from following a movie plot to picking a perp out of a lineup.

While mild prosopagnosics can train themselves to memorize a limited number of faces (it's said to be like learning to distinguish one stone from another), others grapple with identifying family members and, in extreme cases, their own face. Gaylen Howard, 40, a homemaker in Boulder, Colo., says that when she's standing in front of a mirror in a crowded restroom, she makes a funny face so that, as she puts it, "I can tell which one is me." Most prosopagnosics learn to cope early on. They distinguish people based on cues like hairstyle, voice, gait or body shape. They avoid places where they could unexpectedly run into someone they know. They pretend to be lost in thought while walking down the street. They act friendly to everyone--or to no one. In short, they become expert at masking their dysfunction. "This is probably why [the disorder] went unnoticed for so long," says Grüter. In the new study, Grüter and his colleagues surveyed 689 local high school and medical students and diagnosed the disorder in 17. Further interviews with the families of 14 of these subjects revealed that each had at least one close relative with the same problem.

Judging from the patterns of inheritance, Grüter speculates that prosopagnosia may be caused by a defect in a single, dominant gene, so that if one parent has it, each child has a 50% chance of inheriting it. Previous Page

Question: What can sufferers of prosopagnosia not recognize?
Answer: Faces