Gainotti Guido, Marra Camillo
Department of Neuroscience, Neuropsychology Service, Università Cattolica di Roma Rome, Italy.
Front Hum Neurosci. 2011 Jun 1;5:55. doi: 10.3389/fnhum.2011.00055. eCollection 2011.
In the study of prosopagnosia, several issues (such as the specific or non-specific manifestations of prosopagnosia, the unitary or non-unitary nature of this syndrome and the mechanisms underlying face recognition disorders) are still controversial. Two main sources of variance partially accounting for these controversies could be the qualitative differences between the face recognition disorders observed in patients with prevalent lesions of the right or left hemisphere and in those with lesions encroaching upon the temporo-occipital (TO) or the (right) anterior temporal cortex. Results of our review seem to confirm these suggestions. Indeed, they show that (a) the most specific forms of prosopagnosia are due to lesions of a right posterior network including the occipital face area and the fusiform face area, whereas (b) the face identification defects observed in patients with left TO lesions seem due to a semantic defect impeding access to person-specific semantic information from the visual modality. Furthermore, face recognition defects resulting from right anterior temporal lesions can usually be considered as part of a multimodal people recognition disorder. The implications of our review are, therefore, the following: (1) to consider the components of visual agnosia often observed in prosopagnosic patients with bilateral TO lesions as part of a semantic defect, resulting from left-sided lesions (and not from prosopagnosia proper); (2) to systematically investigate voice recognition disorders in patients with right anterior temporal lesions to determine whether the face recognition defect should be considered a form of "associative prosopagnosia" or a form of the "multimodal people recognition disorder."
在面孔失认症的研究中，几个问题（如面孔失认症的特异性或非特异性表现、该综合征的单一性或非单一性本质以及面孔识别障碍的潜在机制）仍然存在争议。部分导致这些争议的两个主要差异来源可能是，在右半球或左半球存在普遍性病变的患者以及病变侵犯颞枕叶（TO）或（右侧）颞前叶皮质的患者中观察到的面孔识别障碍之间的质性差异。我们综述的结果似乎证实了这些观点。事实上，结果表明：（a）面孔失认症最具特异性的形式是由于包括枕叶面孔区和梭状面孔区在内的右侧后网络病变所致，而（b）左TO病变患者中观察到的面孔识别缺陷似乎是由于语义缺陷阻碍了从视觉模态获取特定人物的语义信息。此外，右侧颞前叶病变导致的面孔识别缺陷通常可被视为多模态人物识别障碍的一部分。因此，我们综述的意义如下：（1）将双侧TO病变的面孔失认症患者中经常观察到的视觉失认症成分视为左侧病变导致的语义缺陷（而非面孔失认症本身）的一部分；（2）系统研究右侧颞前叶病变患者的语音识别障碍，以确定面孔识别缺陷应被视为“联想性面孔失认症”的一种形式还是“多模态人物识别障碍”的一种形式。
