Covert face recognition without prosopagnosia

An experiment is reported where subjects were presented with familiar or unfamiliar faces for supraliminal durations or for durations individually assessed as being below the threshold for recognition. Their electrodermal responses to each stimulus were measured and the results showed higher peak amplitude skin conductance responses for familiar than for unfamiliar faces, regardless of whether they had been displayed supraliminally or subliminally. A parallel is drawn between elevated skin conductance responses to subliminal stimuli and findings of covert recognition of familiar faces in prosopagnosic patients, some of whom show increased electrodermal activity (EDA) to previously familiar faces. The supraliminal presentation data also served to replicate similar work by Tranel et al (1985). The results are considered alongside other data indicating the relation between non-conscious, "automatic" aspects of normal visual information processing and abilities which can be found to be preserved without awareness after brain injury.

Face processing impairments and delusional misidentification

We report detailed investigations of the face processing abilities of four patients who had shown symptoms involving delusional misidentification. One (GC) was diagnosed as a Frégoli case, and the other three (SL, GS, and JS) by symptoms of intermetamorphosis. The face processing tasks examined their ability to recognize emotional facial expressions, identify familiar faces, match photographs of unfamiliar faces, and remember photographs of faces of unfamiliar people. The Frégoli patient (GC) was impaired at identifying familiar faces, and severely impaired at matching photographs of unfamiliar people wearing different disguises to undisguised views. Two of the intermetamorphosis patients (SL and GS) also showed impaired face processing abilities, but the third US) performed all tests at a normal level. These findings constrain conceptions of the relation between delusional misidentification, face processing impairment, and brain injury.

Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders

BACKGROUND

Previous behavioural and neuroimaging studies of emotion processing in autistic spectrum disorder (ASD) have focused on the use of facial stimuli. To date, however, no studies have examined emotion processing in autism across a broad range of social signals.

METHOD

This study addressed this issue by investigating emotion processing in a group of 23 adults with ASD and 23 age- and gender-matched controls. Recognition of basic emotions ('happiness', 'sadness', 'anger', disgust' and 'fear') was assessed from facial, body movement and vocal stimuli. The ability to make social judgements (such as approachability) from facial stimuli was also investigated.

RESULTS

Significant deficits in emotion recognition were found in the ASD group relative to the control group across all stimulus domains (faces, body movements and voices). These deficits were seen across a range of emotions. The ASD group were also impaired in making social judgements compared to the control group and this correlated with impairments in basic emotion recognition.

CONCLUSIONS

This study demonstrates that there are significant and broad-ranging deficits in emotion processing in ASD present across a range of stimulus domains and in the auditory and visual modality; they cannot therefore be accounted for simply in terms of impairments in face processing or in the visual modality alone. These results identify a core deficit affecting the processing of a wide range of emotional information in ASD, which contributes to the impairments in social function seen in people with this condition.

A common neural system mediating two different forms of social judgement

BACKGROUND

A wide range of neuropsychiatric conditions, including schizophrenia and autistic spectrum disorder (ASD), are associated with impairments in social function. Previous studies have shown that individuals with schizophrenia and ASD have deficits in making a wide range of social judgements from faces, including decisions related to threat (such as judgements of approachability) and decisions not related to physical threat (such as judgements of intelligence). We have investigated healthy control participants to see whether there is a common neural system activated during such social decisions, on the basis that deficits in this system may contribute to the impairments seen in these disorders.

METHOD

We investigated the neural basis of social decision making during judgements of approachability and intelligence from faces in 24 healthy participants using functional magnetic resonance imaging (fMRI). We used conjunction analysis to identify common brain regions activated during both tasks.

RESULTS

Activation of the amygdala, medial prefrontal cortex, inferior prefrontal cortex and cerebellum was seen during performance of both social tasks, compared to simple gender judgements from the same stimuli. Task-specific activations were present in the dorsolateral prefrontal cortex in the intelligence task and in the inferior and middle temporal cortex in the approachability task.

CONCLUSIONS

The present study identified a common network of brain regions activated during the performance of two different forms of social judgement from faces. Dysfunction of this network is likely to contribute to the broad-ranging deficits in social function seen in psychiatric disorders such as schizophrenia and ASD.

Disgust in pre-clinical Huntington's disease: A longitudinal study

Emotion recognition from both face and voice and experience of emotions were investigated in a group of non-symptomatic people at risk of carrying the Huntington's disease gene who presented for genetic testing. Based on the results of the DNA test, a group of people carrying the Huntington's disease gene (HD+), and a group of non-carriers (HD-) were formed. Since we were especially interested in the time course of possible deficits in emotion recognition, all people at risk were reassessed 6 and 12 months after the initial assessment. Recognising facial expressions of disgust was significantly impaired on all three assessments in the HD+ group, while recognition of vocal emotions and the experience of emotions were largely unaffected, confirming that deficits in recognition of facial expressions of disgust are an early correlate of carrying the gene for Huntington's disease. The inclusion of a healthy control group (n = 37) further allowed an estimate of the genetic and environmental contribution to deficits in facial emotion recognition.

Facial expression recognition in people with medicated and unmedicated Parkinson's disease

Recognition of facial expressions of emotion was investigated in people with medicated and unmedicated Parkinson's disease (PD) and matched controls (unmedicated PD, n=16; medicated PD, n=20; controls, n=40). Participants in the medicated group showed some visual impairment (impaired contrast sensitivity) and performed less well on perception of unfamiliar face identity, but did not show significant deficits in the perception of sex, gaze direction, or familiar identity from the face. For both Parkinson's disease groups, there was evidence of impaired recognition of facial expressions in comparison to controls. These deficits were more consistently noted in the unmedicated group, who were also found to perform worse than the medicated group at recognising disgust from prototypical facial expressions, and at recognising anger and disgust in computer-manipulated images. Although both Parkinson's disease groups showed impairments of facial expression recognition, the consistently worse recognition of disgust in the unmedicated group is consistent with the hypothesis from previous studies that brain regions modulated by dopaminergic neurons are involved in the recognition of disgust.

Dissociation of affective modulation of recollective and perceptual experience following amygdala damage

It has been suggested that similar neural mechanisms may underlie the affective modulation of both recollective and perceptual experience. A case is reported of a patient who has bilateral amygdala damage and marked impairment in the perception of emotion, particularly fear. The patient DR and 10 healthy control subjects (matched for school leaving age, intelligence quotient, and non-emotional memory performance) were shown a series of slides accompanied by an emotionally arousing narrative. One week later DR and the controls were given a surprise memory test for this material. In addition, they completed a verbal memory test using emotionally arousing stimuli. Both DR and the healthy control subjects showed a normative pattern of enhanced memory for emotional material. On the basis of these results and the previously demonstrated impairment of perception of emotion in this patient, it is concluded that different neural mechanisms may underlie affective modulation of recollective and perceptual experience.

Neuropsychology of fear and loathing

For over 60 years, ideas about emotion in neuroscience and psychology have been dominated by a debate on whether emotion can be encompassed within a single, unifying model. In neuroscience, this approach is epitomized by the limbic system theory and, in psychology, by dimensional models of emotion. Comparative research has gradually eroded the limbic model, and some scientists have proposed that certain individual emotions are represented separately in the brain. Evidence from humans consistent with this approach has recently been obtained by studies indicating that signals of fear and disgust are processed by distinct neural substrates. We review this research and its implications for theories of emotion.

A principal component analysis of facial expressions

Pictures of facial expressions from the Ekman and Friesen set (Ekman, P., Friesen, W. V., (1976). Pictures of facial affect. Palo Alto, California: Consulting Psychologists Press) were submitted to a principal component analysis (PCA) of their pixel intensities. The output of the PCA was submitted to a series of linear discriminant analyses which revealed three principal findings: (1) a PCA-based system can support facial expression recognition, (2) continuous two-dimensional models of emotion (e.g. Russell, J. A. (1980). A circumplex model of affect. Journal of Personality and Social Psychology, 39, 1161-1178) are reflected in the statistical structure of the Ekman and Friesen facial expressions, and (3) components for coding facial expression information are largely different to components for facial identity information. The implications for models of face processing are discussed.

Time courses of left and right amygdalar responses to fearful facial expressions

Despite the many studies highlighting the role of the amygdala in fear perception, few have examined differences between right and left amygdalar responses. Using functional magnetic resonance imaging (fMRI), we examined neural responses in three groups of healthy volunteers (n = 18) to alternating blocks of fearful and neutral faces. Initial observation of extracted time series of both amygdalae to these stimuli indicated more rapid decreases of right than left amygdalar responses to fearful faces, and increasing magnitudes of right amygdalar responses to neutral faces with time. We compared right and left responses statistically by modeling each time series with (1) a stationary fit model (assuming a constant magnitude of amygdalar response to consecutive blocks of fearful faces) and (2) an adaptive model (no assumptions). Areas of significant sustained nonstationarity (time series points with significantly greater adaptive than stationary model fits) were demonstrated for both amygdalae. There was more significant nonstationarity of right than left amygdalar responses to neutral, and left than right amygdalar responses to fearful faces. These findings indicate significant variability over time of both right and left amygdalar responses to fearful and neutral facial expressions and are the first demonstration of specific differences in time courses of right and left amygdalar responses to these stimuli.

Time courses of left and right amygdalar responses to fearful facial expressions

Despite the many studies highlighting the role of the amygdala in fear perception, few have examined differences between right and left amygdalar responses. Using functional magnetic resonance imaging (fMRI), we examined neural responses in three groups of healthy volunteers (n = 18) to alternating blocks of fearful and neutral faces. Initial observation of extracted time series of both amygdalae to these stimuli indicated more rapid decreases of right than left amygdalar responses to fearful faces, and increasing magnitudes of right amygdalar responses to neutral faces with time. We compared right and left responses statistically by modeling each time series with (1) a stationary fit model (assuming a constant magnitude of amygdalar response to consecutive blocks of fearful faces) and (2) an adaptive model (no assumptions). Areas of significant sustained nonstationarity (time series points with significantly greater adaptive than stationary model fits) were demonstrated for both amygdalae. There was more significant nonstationarity of right than left amygdalar responses to neutral, and left than right amygdalar responses to fearful faces. These findings indicate significant variability over time of both right and left amygdalar responses to fearful and neutral facial expressions and are the first demonstration of specific differences in time courses of right and left amygdalar responses to these stimuli.

Impaired recognition and experience of disgust following brain injury

Huntington's disease can particularly affect people's recognition of disgust from facial expressions, and functional neuroimaging research has demonstrated that facial expressions of disgust consistently engage different brain areas (insula and putamen) than other facial expressions. However, it is not known whether these particular brain areas process only facial signals of disgust or disgust signals from multiple modalities. Here we describe evidence, from a patient with insula and putamen damage, for a neural system for recognizing social signals of disgust from multiple modalities.

Caricaturing facial expressions

The physical differences between facial expressions (e.g. fear) and a reference norm (e.g. a neutral expression) were altered to produce photographic-quality caricatures. In Experiment 1, participants rated caricatures of fear, happiness and sadness for their intensity of these three emotions; a second group of participants rated how 'face-like' the caricatures appeared. With increasing levels of exaggeration the caricatures were rated as more emotionally intense, but less 'face-like'. Experiment 2 demonstrated a similar relationship between emotional intensity and level of caricature for six different facial expressions. Experiments 3 and 4 compared intensity ratings of facial expression caricatures prepared relative to a selection of reference norms - a neutral expression, an average expression, or a different facial expression (e.g. anger caricatured relative to fear). Each norm produced a linear relationship between caricature and rated intensity of emotion; this finding is inconsistent with two-dimensional models of the perceptual representation of facial expression. An exemplar-based multidimensional model is proposed as an alternative account.

Configural information in facial expression perception

Composite facial expressions were prepared by aligning the top half of one expression (e.g., anger) with the bottom half of another (e.g., happiness). Experiment 1 shows that participants are slower to identify the expression in either half of these composite images relative to a "noncomposite" control condition in which the 2 halves are misaligned. This parallels the composite effect for facial identity (A. W. Young, D. Hellawell, & D. C. Hay, 1987), and like its identity counterpart, the effect is disrupted by inverting the stimuli (Experiment 2). Experiment 3 shows that no composite effect is found when the top and bottom sections contain different models' faces posing the same expression; this serves to exclude many nonconfigural interpretations of the composite effect (e.g., that composites are more "attention-grabbing" than noncomposites). Finally, Experiment 4 demonstrates that the composite effects for identity and expression operate independently of one another.

Configural information in facial expression perception

Composite facial expressions were prepared by aligning the top half of one expression (e.g., anger) with the bottom half of another (e.g., happiness). Experiment 1 shows that participants are slower to identify the expression in either half of these composite images relative to a "noncomposite" control condition in which the 2 halves are misaligned. This parallels the composite effect for facial identity (A. W. Young, D. Hellawell, & D. C. Hay, 1987), and like its identity counterpart, the effect is disrupted by inverting the stimuli (Experiment 2). Experiment 3 shows that no composite effect is found when the top and bottom sections contain different models' faces posing the same expression; this serves to exclude many nonconfigural interpretations of the composite effect (e.g., that composites are more "attention-grabbing" than noncomposites). Finally, Experiment 4 demonstrates that the composite effects for identity and expression operate independently of one another.

Knowing no fear

People with brain injuries involving the amygdala are often poor at recognizing facial expressions of fear, but the extent to which this impairment compromises other signals of the emotion of fear has not been clearly established. We investigated N.M., a person with bilateral amygdala damage and a left thalamic lesion, who was impaired at recognizing fear from facial expressions. N.M. showed an equivalent deficit affecting fear recognition from body postures and emotional sounds. His deficit of fear recognition was not linked to evidence of any problem in recognizing anger (a common feature in other reports), but for his everyday experience of emotion N.M. reported reduced anger and fear compared with neurologically normal controls. These findings show a specific deficit compromising the recognition of the emotion of fear from a wide range of social signals, and suggest a possible relationship of this type of impairment with alterations of emotional experience.

Dyspraxia in a patient with corticobasal degeneration: the role of visual and tactile inputs to action

OBJECTIVES

To investigate the roles of visual and tactile information in a dyspraxic patient with corticobasal degeneration (CBD) who showed dramatic facilitation in miming the use of a tool or object when he was given a tool to manipulate; and to study the nature of the praxic and neuropsychological deficits in CBD.

METHODS

The subject had clinically diagnosed CBD, and exhibited alien limb behaviour and striking ideomotor dyspraxia. General neuropsychological evaluation focused on constructional and visuospatial abilities, calculation, verbal fluency, episodic and semantic memory, plus spelling and writing because impairments in this domain were presenting complaints. Four experiments assessed the roles of visual and tactile information in the facilitation of motor performance by tools. Experiment 1 evaluated the patient's performance of six limb transitive actions under six conditions: (1) after he described the relevant tool from memory, (2) after he was shown a line drawing of the tool, (3) after he was shown a real exemplar of the tool, (4) after he watched the experimenter perform the action, (5) while he was holding the tool, and (6) immediately after he had performed the action with the tool but with the tool removed from his grasp. Experiment 2 evaluated the use of the same six tools when the patient had tactile but no visual information (while he was blindfolded). Experiments 3 and 4 assessed performance of actions appropriate to the same six tools when the patient had either neutral or inappropriate tactile feedback-that is, while he was holding a non-tool object or a different tool.

RESULTS

Miming of tool use was not facilitated by visual input; moreover, lack of visual information in the blindfolded condition did not reduce performance. The principal positive finding was a dramatic facilitation of the patient's ability to demonstrate object use when he was holding either the appropriate tool or a neutral object. Tools inappropriate to the requested action produced involuntary performance of the stimulus relevant action.

CONCLUSIONS

Tactile stimulation was paramount in the facilitation of motor performance in tool use by this patient with CBD. This outcome suggests that tactile information should be included in models which hypothesise modality specific inputs to the action production system. Significant impairments in spelling and letter production that have not previously been reported in CBD have also been documented.

Recognition of facial emotion in nine individuals with bilateral amygdala damage

Findings from several case studies have shown that bilateral amygdala damage impairs recognition of emotions in facial expressions, especially fear. However, one study did not find such an impairment, and, in general, comparison across studies has been made difficult because of the different stimuli and tasks employed. In a collaborative study to facilitate such comparisons, we report here the recognition of emotional facial expressions in nine subjects with bilateral amygdala damage, using a sensitive and quantitative assessment. Compared to controls, the subjects as a group were significantly impaired in recognizing fear, although individual performances ranged from severely impaired to essentially normal. Most subjects were impaired on several negative emotions in addition to fear, but no subject was impaired in recognizing happy expressions. An analysis of response consistency showed that impaired recognition of fear could not be attributed simply to mistaking fear for another emotion. While it remains unclear why some subjects with amygdala damage included here are not impaired on our task, the results overall are consistent with the idea that the amygdala plays an important role in triggering knowledge related to threat and danger signaled by facial expressions.

Neural responses to facial and vocal expressions of fear and disgust

Neuropsychological studies report more impaired responses to facial expressions of fear than disgust in people with amygdala lesions, and vice versa in people with Huntington's disease. Experiments using functional magnetic resonance imaging (fMRI) have confirmed the role of the amygdala in the response to fearful faces and have implicated the anterior insula in the response to facial expressions of disgust. We used fMRI to extend these studies to the perception of fear and disgust from both facial and vocal expressions. Consistent with neuropsychological findings, both types of fearful stimuli activated the amygdala. Facial expressions of disgust activated the anterior insula and the caudate-putamen; vocal expressions of disgust did not significantly activate either of these regions. All four types of stimuli activated the superior temporal gyrus. Our findings therefore (i) support the differential localization of the neural substrates of fear and disgust; (ii) confirm the involvement of the amygdala in the emotion of fear, whether evoked by facial or vocal expressions; (iii) confirm the involvement of the anterior insula and the striatum in reactions to facial expressions of disgust; and (iv) suggest a possible general role for the perception of emotional expressions for the superior temporal gyrus.

Face processing impairments after encephalitis: amygdala damage and recognition of fear

Face processing and facial emotion recognition were investigated in five post-encephalitic people of average or above-average intelligence. Four of these people (JC, YW, RB and SE) had extensive damage in the region of the amygdala. A fifth post-encephalitic person with predominantly hippocampal damage and relative sparing of the amygdala (RS) participated, allowing us to contrast the effects of temporal lobe damage including and excluding the amygdala region. The findings showed impaired recognition of fear following bilateral temporal lobe damage when this included the amygdala. For JC, this was part of a constellation of deficits on face processing tasks, with impaired recognition of several emotions. SE, YW and RB, however, showed relatively circumscribed deficits. Although they all had some problems in recognizing or naming famous faces, and had poor memory for faces on the Warrington Recognition Memory Test, none showed a significant impairment on the Benton Test of Facial Recognition, indicating relatively good perception of the face's physical structure. In a test of recognition of basic emotions (happiness, surprise, fear, sadness, disgust and anger), SE, YW and RB achieved normal levels of performance in comparison to our control group for all emotions except fear. Their results contrast with those of RS, with relative sparing of the amygdala region and unimpaired recognition of emotion, pointing clearly toward the importance of the amygdala in the recognition of fear.

A neuromodulatory role for the human amygdala in processing emotional facial expressions

Localized amygdalar lesions in humans produce deficits in the recognition of fearful facial expressions. We used functional neuroimaging to test two hypotheses: (i) that the amygdala and some of its functionally connected structures mediate specific neural responses to fearful expressions; (ii) that the early visual processing of emotional faces can be influenced by amygdalar activity. Normal subjects were scanned using PET while they performed a gender discrimination task involving static grey-scale images of faces expressing varying degrees of fear or happiness. In support of the first hypothesis, enhanced activity in the left amygdala, left pulvinar, left anterior insula and bilateral anterior cingulate gyri was observed during the processing of fearful faces. Evidence consistent with the second hypothesis was obtained by a demonstration that amygdalar responses predict expression-specific neural activity in extrastriate cortex.

Disgust implicated in obsessive-compulsive disorder

Psychiatric classificatory systems consider obsessions and compulsions as forms of anxiety disorder. However, the neurology of diseases associated with obsessive-compulsive symptoms suggests the involvement of fronto-striatal regions likely to be involved in the mediation of the emotion of disgust, suggesting that dysfunctions of disgust should be considered alongside anxiety in the pathogenesis of obsessive-compulsive behaviours. We therefore tested recognition of facial expressions of basic emotions (including disgust) by groups of participants with obsessive-compulsive disorder (OCD) and with Gilles de la Tourette's syndrome (GTS) with an without co-present obsessive-compulsive behaviours (GTS with OCB; GTS without OCB). A group of people suffering from panic disorder and generalized anxiety were also included in the study. Both groups with obsessive-compulsive symptoms (OCD; GTS with OCB) showed impaired recognition of facial expressions of disgust. Such problems were not evident in participants with panic disorder and generalized anxiety, or for participants with GTS without obsessions or compulsions, indicating that the deficit is closely related to the presence of obsessive-compulsive symptoms. Participants with OCD were able to assign words to emotion categories without difficulty, showing that their problem with disgust is linked to a failure to recognize this emotion in others and not a comprehension or response criterion effect. Impaired recognition of disgust is consistent with the neurology of OCD and with the idea that abnormal experience of disgust may be involved in the genesis of obsessions and compulsions.

The effect of self-referent material on the reasoning of people with delusions

People with delusions have been shown to have both generalized (Huq, Garety & Hemsley, 1988) and content-specific biases in reasoning (Bentall, 1994). Our concern here was whether the hastiness that has been found when people with delusions reason on relatively abstract tasks would be present on a more realistic task. A second concern was whether reasoning with salient or emotional material would increase the hastiness bias in people with delusions. Two versions of a probabilistic reasoning task were used to study the data gathering of people with delusions. The first version employed realistic but emotionally neutral material. People with delusions requested less evidence before making a decision than psychiatric and normal comparison groups. Therefore, the hastiness found previously with abstract materials was seen to generalize to a more realistic task. In the second version participants were required to reason with material that had an emotional content and may have been regarded as being personally meaningful. In this condition all groups reduced the amount of evidence requested before making a decision.

Impaired recognition of disgust in Huntington's disease gene carriers

Face processing and facial expression recognition were investigated in the earliest stages of Huntington's disease, by studying 40 people who presented for genetic testing. Twenty-three of these 'at risk' individuals turned out not to carry the gene for Huntington's disease (the AR- group). Seventeen were found to be gene carriers (the AR+ group); 15 from genetic testing, and two who showed signs of early stages of Huntington's disease. A number of standard tasks were used to provide background information, including recognition memory for words, picture naming, verbal fluency, and figure copying; none revealed significant differences between the AR+ and AR- groups. Face processing abilities were investigated using tests of identification of familiar (famous) faces, unfamiliar face matching, recognition memory for faces, and recognition of facial expressions of emotion. No statistically significant differences between the AR+ and AR- groups were found for any of these tests, but the AR+ group showed a borderline overall impairment in recognizing facial expressions of emotion (0.05 < P < 0.1). When recognition of each of the six basic emotions used was examined separately, only disgust was found to be significantly impaired. This highly selective deficit in the recognition of disgust was confirmed in the subgroup of 15 individuals shown by genetic testing to be Huntington's gene carriers; it was therefore found in people who were free from clinical symptoms and did not perform significantly more poorly than non-carriers on any of the background tests, on any of the other face processing tasks, and even for recognition of any other basic emotion. This points strongly to the importance of the basal ganglia in the emotion of disgust.

A specific neural substrate for perceiving facial expressions of disgust

Recognition of facial expressions is critical to our appreciation of the social and physical environment, with separate emotions having distinct facial expressions. Perception of fearful facial expressions has been extensively studied, appearing to depend upon the amygdala. Disgust-literally 'bad taste'-is another important emotion, with a distinct evolutionary history, and is conveyed by a characteristic facial expression. We have used functional magnetic resonance imaging (fMRI) to examine the neural substrate for perceiving disgust expressions. Normal volunteers were presented with faces showing mild or strong disgust or fear. Cerebral activation in response to these stimuli was contrasted with that for neutral faces. Results for fear generally confirmed previous positron emission tomography findings of amygdala involvement. Both strong and mild expressions of disgust activated anterior insular cortex but not the amygdala; strong disgust also activated structures linked to a limbic cortico-striatal-thalamic circuit. The anterior insula is known to be involved in responses to offensive tastes. The neural response to facial expressions of disgust in others is thus closely related to appraisal of distasteful stimuli.

Knowing where and knowing what: a double dissociation

We report a double dissociation between visuo-spatial abilities and semantic knowledge (knowledge of the names and attributes of objects and people), in two brain-injured people with longstanding stable impairments, using a wide range of tests to explore the extent of the dissociation, MU, who has bilateral lesions of occipito-parietal cortex, shows severe spatial disorientation with relatively well-preserved semantic knowledge. He is contrasted with JBR, who has bilateral temporal lobe damage and shows severe semantic problems and no impairment on visuo-spatial tasks. Our findings thus demonstrate a double dissociation between the performance of semantic and spatial tasks by MU and JBR. This pattern is consistent with Ungerleider and Mishkin's (1982) neurophysiological hypothesis of separable cortical visual pathways; one which is specialised for spatial perception and follows a dorsal route from occipital to parietal lobes, and the other following a more ventral route from occipital to temporal lobes, whose target is semantic information needed in specifying what an object is.

Reduced autonomic responses to faces in Capgras delusion

People experiencing the Capgras delusion claim that others, usually those quite close emotionally, have been replaced by near-identical impostors. Ellis & Young suggested in 1990 that the Capgras delusion results from damage to a neurological system involved in orienting responses to seen faces based on their personal significance. This hypothesis predicts that people suffering the Capgras delusion will be hyporesponsive to familiar faces. We tested this prediction in five people with Capgras delusion. Comparison data were obtained from five middle-aged members of the general public, and a psychiatric control group of five patients taking similar anti-psychotic medication. Capgras delusion patients did not reveal autonomic discrimination between familiar and unfamiliar faces, but orienting responses to auditory tones were normal in magnitude and rate of initial habituation, showing that the hyporesponsiveness is circumscribed.

Computer-enhanced emotion in facial expressions

Benson & Perrett's (1991 b) computer-based caricature procedure was used to alter the positions of anatomical landmarks in photographs of emotional facial expressions with respect to their locations in a reference norm face (e.g. a neutral expression). Exaggerating the differences between an expression and its norm produces caricatured images, whereas reducing the differences produces 'anti-caricatures'. Experiment 1 showed that caricatured (+50% different from neutral) expressions were recognized significantly faster than the veridical (0%, undistorted) expressions. This held for all six basic emotions from the Ekman & Friesen (1976) series, and the effect generalized across different posers. For experiment 2, caricatured (+50%) and anti-caricatured (-50%) images were prepared using two types of reference norm; a neutral-expression norm, which would be optimal if facial expression recognition involves monitoring changes in the positioning of underlying facial muscles, and a perceptually-based norm involving an average of the expressions of six basic emotions (excluding neutral) in the Ekman & Friesen (1976) series. The results showed that the caricatured images were identified significantly faster, and the anti-caricatured images significantly slower, than the veridical expressions. Furthermore, the neutral-expression and average-expression norm caricatures produced the same pattern of results.

Facial expression megamix: tests of dimensional and category accounts of emotion recognition

We report four experiments investigating the perception of photographic quality continua of interpolated ('morphed') facial expressions derived from prototypes of the 6 emotions in the Ekman and Friesen (1976) series (happiness, surprise, fear, sadness, disgust and anger). In Experiment 1, morphed images made from all possible pairwise combinations of expressions were presented in random order; subjects identified these as belonging to distinct expression categories corresponding to the prototypes at each end of the relevant continuum. This result was replicated in Experiment 2, which also included morphs made from a prototype with a neutral expression, and allowed 'neutral' as a response category. These findings are inconsistent with the view that facial expressions are recognised by locating them along two underlying dimensions, since such a view predicts that at least some transitions between categories should involve neutral regions or identification as a different emotion. Instead, they suggest that facial expressions of basic emotions are recognised by their fit to discrete categories. Experiment 3 used continua involving 6 emotions to demonstrate best discrimination of pairs of stimuli falling across category boundaries; this provides further evidence of categorical perception of facial expressions of emotion. However, in both Experiment 1 and Experiment 2, reaction time data showed that increasing distance from the prototype had a definite cost on ability to identify emotion in the resulting morphed face. Moreover, Experiment 4 showed that subjects had some insight into which emotions were blended to create specific morphed images. Hence, categorical perception effects were found even though subjects were sensitive to physical properties of these morphed facial expressions. We suggest that rapid classification of prototypes and better across boundary discriminability reflect the underlying organisation of human categorisation abilities.

Normal and abnormal reasoning in people with delusions

People who experience delusions have been found to request less information prior to making a decision than control participants on tasks that are unrelated to the theme of the delusion (Huq, Garety & Hemsley, 1988). Two studies investigated whether people with delusions have an absolute deficit in reasoning or a more specific data-gathering bias. In Expt 1, 12 people with delusions, 12 people with depression and 12 normal controls were shown the results of spinning a supposedly biased coin. The evidence provided varied in the number of heads to tails. In normal controls a high ratio of head to tails produces a high estimate that the coin is biased. In this experiment, where the evidence gathered was predetermined by the experimenter, all groups of participants were shown to reason in a similar way. Experiment 2 tested whether a difference would exist between the groups in conditions where participants were free to determine the amount of evidence seen, in contrast to when all of them viewed the same evidence. Two jars of beads in opposite but equal ratios (e.g. 85:15, 15:85) were shown to 15 people with delusions, 15 with depression and 15 normal controls. On the basis of beads being drawn one at a time, it was the participants' task to determine which jar they came from. When free to decide when they wished, people with delusions decided on the basis of less evidence than the other groups. However, as in Expt 1, the group with delusions did not differ when made to view the same amount of beads as other participants. Therefore, people with delusions have a data-gathering bias rather than a difficulty in employing the data in reasoning. This "jump to conclusions' bias generalized to a less discriminable ratio of beads (60:40), and was not a consequence of impulsiveness or memory deficit.

Impaired auditory recognition of fear and anger following bilateral amygdala lesions

The amygdalar complex is a medial temporal lobe structure in the brain which is widely considered to be involved in the neural substrates of emotion. Selective bilateral damage to the human amygdala is rare, offering a unique insight into its functions. There is impairment of social perception after amygdala damage, with defective recognition of facial expressions of emotion. Among the basic emotions, the processing of fear and anger has been shown to be disrupted by amygdala damage. Although it remains puzzling why this not found in all cases, the importance of the amygdala in negative emotion, and especially fear, has been confirmed by conditioning, memory and positron emission tomography (PET) experiments. Central to our understanding of these findings is the question of whether the amygdala is involved specifically in the perception of visual signals of emotion emanating from the face, or more widely in the perception of emotion in all sensory modalities. We report here a further investigation of one of these rare cases, a woman (D.R.) who has impaired perception of the intonation patterns that are essential to the perception of vocal affect, despite normal hearing. As is the case for recognition of facial expressions, it is recognition of fear and anger that is most severely affected in the auditory domain. This shows that the amygdala's role in the recognition of certain emotions is not confined to vision, which is consistent with its being involved in the appraisal of danger and the emotion of fear.

Face recognition impairments

Face recognition impairments are often found in the context of brain injury involving the right cerebral hemisphere. Recognition impairments can be dissociated from impairments affecting the processing of other types of information carried by the face, such as expression. The face recognition impairments themselves take different forms, corresponding to idealized stages or levels of recognition. These types of error can also arise as transitory phenomena in normal everyday life. From these observations, psychologists have proposed functional models that characterize the organization of the face processing system in schematic form. Such models provide useful ways of summarizing what is known. More importantly, they also allow new findings to act as tests of each model’s usefulness by the extent to which they can be readily accommodated or force revision. Examples of this are briefly considered, including delusional misidentification, impaired learning of new faces, disordered attention to faces, ‘covert’ recognition in prosopagnosia, and unawareness of impaired face recognition.

A differential neural response in the human amygdala to fearful and happy facial expressions

The amygdala is thought to play a crucial role in emotional and social behaviour. Animal studies implicate the amygdala in both fear conditioning and face perception. In humans, lesions of the amygdala can lead to selective deficits in the recognition of fearful facial expressions and impaired fear conditioning, and direct electrical stimulation evokes fearful emotional responses. Here we report direct in vivo evidence of a differential neural response in the human amygdala to facial expressions of fear and happiness. Positron-emission tomography (PET) measures of neural activity were acquired while subjects viewed photographs of fearful or happy faces, varying systematically in emotional intensity. The neuronal response in the left amygdala was significantly greater to fearful as opposed to happy expressions. Furthermore, this response showed a significant interaction with the intensity of emotion (increasing with increasing fearfulness, decreasing with increasing happiness). The findings provide direct evidence that the human amygdala is engaged in processing the emotional salience of faces, with a specificity of response to fearful facial expressions.

Loss of disgust. Perception of faces and emotions in Huntington's disease

Face perception and emotion recognition were investigated in a group of people with Huntington's disease and matched controls. In conventional tasks intended to explore the perception of age, sex, unfamiliar face identity (Benton test) and gaze direction from the face, the Huntington's disease group showed a borderline impairment of gaze direction perception and were significantly impaired on unfamiliar face matching. With a separate set of tasks using computerinterpolated ('morphed') facial images, people with Huntington's disease were markedly impaired at discriminating anger from fear, but experienced less difficulty with continua varying from male to female, between familiar identities, and from happiness to sadness. In a further test of recognition of facial expressions of basic emotions from the Ekman and Friesen (1976) series, interpolated images were created for six continua that lay around the perimeter of an emotion hexagon (happiness-surprise; surprise-fear; fear-sadness; sadness-disgust; disgust-anger; anger-happiness). In deciding which emotion these morphed images were most like, people with Huntington's disease again showed deficits in the recognition of anger and fear, and an especially severe problem with disgust, which was recognized only at chance level. A follow-up study with tests of facially and vocally expressed emotions confirmed that the recognition of disgust was markedly poor for the Huntington's disease group, still being no better than chance level. Questionnaires were also used to examine self-assessed emotion, but did not show such striking problems. Taken together, these data reveal severe impairments of emotion recognition in Huntington's disease, and show that the recognition of some emotions is more impaired than others. The possibility that certain basic emotions may have dedicated neural substrates needs to be seriously considered: among these, disgust is a prime candidate.

Perception of Photographic-Quality Caricatures of Emotional Facial Expressions

G Rhodes, S E Brennan, S Carey (1987 Cognitive Psychology19 473 – 497) and P J Benson and D I Perrett (1991 European Journal of Cognitive Psychology3 105 – 135) have shown that computer-enhanced (caricatured) representations of familiar faces are named faster and rated as better likenesses than veridical (undistorted) representations. Here we have applied Benson and Perrett's graphic technique to examine subjects' perception of enhanced representations of photographic-quality facial expressions of basic emotions.

To enhance a facial expression the target face is compared to a norm or prototype face, and, by exaggerating the differences between the two, a caricatured image is produced; reducing the differences results in an anticaricatured image. In experiment 1 we examined the effect of degree of caricature and types of norm on subjects' ratings for ‘intensity of expression’. Three facial expressions (fear, anger, and sadness) were caricatured at seven levels (−50%, −30%, −15%, 0%, +15%, +30%, and +50%) relative to three different norms; (1) an average norm prepared by blending pictures of six different emotional expressions; (2) a neutral expression norm; and (3) a different expression norm (eg anger caricatured relative to a happy expression). Irrespective of norm, the caricatured expressions were rated as significantly more intense than the veridical images. Furthermore, for the average and neutral norm sets, the anticaricatures were rated as significantly less intense. We also examined subjects' reaction times to recognise caricatured (−50%, 0%, and +50%) representations of six emotional facial expressions. The results showed that the caricatured images were identified fastest, followed by the veridical, and then anticaricatured images. Hence the perception of facial expression and identity is facilitated by caricaturing; this has important implications for the mental representation of facial expressions.

Object-based neglect: an investigation of the contributions of eye movements and perceptual completion

Eye movements made by a patient with object-based neglect and no hemianopia, R.R., were recorded while he viewed whole, half, and chimaeric objects. When whole or chimaeric objects were presented centred on his initial fixation point, and when right half objects were presented, R.R. restricted his saccades to the right sides of the images. R.R.'s verbal identifications were consistent with these scan paths, since he correctly reported the identities of whole objects, right half objects, and the right sides of chimaeric objects, but failed to report objects on the left sides of chimaerics. When a left half object was presented to the left of initial fixation, however, R.R. made left saccades to scan the image and correctly named these objects; hence his failure to scan the left sides of chimaeric object cannot simply be attributed to an inability to make contralesional saccades. We examined the possibility of perceptual completion by testing R.R. with sets of whole and half shapes presented tachistoscopically and asking him to report what he had seen. When R.R. viewed whole shapes he correctly reported seeing a whole shape on every trial. However, R.R. often reported seeing right half objects as whole, whereas he was much less prone to report left half objects as perceptually whole. We discuss the nature of this perceptual completion, and conclude that both scan paths and completion are consequences of object-based neglect, not its causes.

Reinstatement of prior processing and repetition priming

Two principal accounts of repetition priming describe either reinstatement of prior processing demands or activation of item-specific representations used in stimulus recognition as mechanisms by which the effect occurs. The former type of account predicts maximal priming when the same task is performed at first and second encounter (i.e. at training and test). The latter type of account predicts priming in any test task that requires access to item-specific representations as long as those items have been recognised earlier, regardless of the training task. An experiment was performed to test these contrasting predictions, in which subjects matched pairs of object pictures on the basis of either the colour of a segment of each object or on the basis of each object's identity. No repetition priming was observed when subjects performed colour matching at both first and second encounter. Priming was observed when responses were made on the basis of identity at both first and second encounter, and there was equivalent priming when colour matching was performed at the first encounter and identity matching at the second encounter. These results pose problems for theories of repetition priming based on reinstatement of prior processing demands, as colour matching did not prime subsequent colour matching (exact reinstatement of processing demands), whereas it did prime subsequent identity matching as much as did prior identity matching (a change in processing demands). These results are consistent with repetition priming occurring within a system that represents the identities of items.

Delusional misidentification of inanimate objects: a literature review and neuropsychological analysis of cognitive deficits in two cases

Following a brief review of the literature on Delusions of Inanimate Doubles (DID), compared with other similar delusions, two cases are presented. Each completed a battery of tests designed to explore their cognitive abilities. In both cases, familiar and unfamiliar face-processing skills remained intact and word memory was unaffected. Their abilities to identify famous buildings and recognise unfamiliar houses were impaired. We propose that an extension of Ellis and Young's (1990) account of Capgras delusion can explain the cognitive impairments in case of DID. A comparison of the hypotheses of Staton et el. (1982), Ellis and Young (1990), and Van Lancker (1991) is also made. The last two have obvious similarities and seem to provide the best general approach. Finally, we caution the need to consider how a mood of suspiciousness may be needed to distort attribution processes that sustain delusional thinking.

Delusions demand attention

We used a variant of the Stroop paradigm to investigate attention bias in a young woman (JK) with delusional beliefs that she had died and that members of her family had changed. JK was shown sets of words printed in different colours of ink, and was asked to name the colour of each word. Sets of words were chosen which related to her delusions, and to possible contributory moods. The times taken by JK to colour-name words in these lists were compared with her times to colour-name sets of neutral words. There were three separate testing sessions which took place over a two-year period. In comparison to her times to name the colours of words in the neutral lists, JK was significantly slower to colour-name test lists containing words related to her delusional beliefs. When she was no longer experiencing these delusions, however, she was no slower to colour-name any of the test word lists. The results indicate that the Stroop paradigm can be useful in investigating individual cases of delusions and in monitoring changes in attentional bias over time.

Facial expression processing after amygdalotomy

Facial expression processing impairments were studied in D.R., a 51-year-old woman with a partial bilateral amygdalotomy. D.R. was poor at recognising emotional facial expressions, both in static and moving stimuli. In identity matching tasks (same vs different person) and expression matching tasks (same vs different expression), D.R. was impaired at expression matching with simultaneously or successively presented faces; she experienced difficulties whenever the faces' identities were discrepant with their expressions. For identity matching, she also had problems when simultaneously presented images showed the same face with two different expressions; her deficit in interpreting facial expressions could lead her to mistake differences in expression for a difference in identity. In imagery tasks, D.R. was able to answer questions about the appearance of familiar people, yet she was very poor at imaging facial expressions of emotion. We suggest that her problems in processing facial expressions included impaired knowledge of the patterning of facial features in each emotion; without this, remembering or reconstructing what emotional facial expressions look like is as impaired as perceptual recognition. These findings are consistent with the hypothesis of a role for the amygdala in social behaviour.

Squamous cell carcinoma in situ arising within lichen planus of the vulva

BACKGROUND

Lichen planus is a common dermatologic disorder involving the glabrous skin, hair-bearing skin and scalp, nails, and mucous membranes of the oral cavity, penis, and vulva. There have been multiple case reports of squamous cell carcinoma (SCC) developing within lesions of hypertrophic cutaneous lichen planus and erosive oral lichen planus. Recently, there have been several case reports of SCC arising within lesions of the genital mucosa: one case of penile lichen planus, and two cases of vulvar lichen planus.

OBJECTIVE

To report a case of SCC in situ developing within erosive vulvar lichen planus. To heighten the awareness, and facilitate the recognition of vulvar lichen planus.

RESULTS

We present SCC in situ developing within a lesion of erosive vulvar lichen planus. The patient was treated with simple total vulvectomy by gynecologic surgery. Her vulva remain disease-free 2 years postoperatively.

CONCLUSIONS

Vulvar lesions of lichen planus should be recognized and followed closely. In long-standing erosive lesions of the vulva, periodic sampling biopsies should be examined to rule out malignant degeneration.