Enhancement of face recognition learning in patients with brain injury using three cognitive training procedures

Twenty patients with impairments of face recognition, in the context of a broader pattern of cognitive deficits, were administered three new training procedures derived from contemporary theories of face processing to enhance their learning of new faces: semantic association (being given additional verbal information about the to-be-learned faces); caricaturing (presentation of caricatured versions of the faces during training and veridical versions at recognition testing); and part recognition (focusing patients on distinctive features during the training phase). Using a within-subjects design, each training procedure was applied to a different set of 10 previously unfamiliar faces and entailed six presentations of each face. In a "simple exposure" control procedure (SE), participants were given six presentations of another set of faces using the same basic protocol but with no further elaboration. Order of the four procedures was counterbalanced, and each condition was administered on a different day. A control group of 12 patients with similar levels of face recognition impairment were trained on all four sets of faces under SE conditions. Compared to the SE condition, all three training procedures resulted in more accurate discrimination between the 10 studied faces and 10 distractor faces in a post-training recognition test. This did not reflect any intrinsic lesser memorability of the faces used in the SE condition, as evidenced by the comparable performance across face sets by the control group. At the group level, the three experimental procedures were of similar efficacy, and associated cognitive deficits did not predict which technique would be most beneficial to individual patients; however, there was limited power to detect such associations. Interestingly, a pure prosopagnosic patient who was tested separately showed benefit only from the part recognition technique. Possible mechanisms for the observed effects, and implications for rehabilitation, are discussed.