Neural correlates of covert face processing: fMRI evidence from a prosopagnosic patient

Brains can perceive or recognize a face even though we are subjectively unaware of the existence of that face. However, the exact neural correlates of such covert face processing remain unknown. Here, we compared the fMRI activities between a prosopagnosic patient and normal controls when they saw famous and unfamiliar faces. When compared with objects, the patient showed greater activation to famous faces in the fusiform face area (FFA) though he could not overtly recognize those faces. In contrast, the controls showed greater activation to both famous and unfamiliar faces in the FFA. Compared with unfamiliar faces, famous faces activated the controls', but not the patient's lateral prefrontal cortex (LPFC) known to be involved in familiar face recognition. In contrast, the patient showed greater activation in the bilateral medial frontal gyrus (MeFG). Functional connectivity analyses revealed that the patient's right middle fusiform gyrus (FG) showed enhanced connectivity to the MeFG, whereas the controls' middle FG showed enhanced connectivity to the LPFC. These findings suggest that the FFA may be involved in both covert and overt face recognition. The patient's impairment in overt face recognition may be due to the absence of the coupling between the right FG and the LPFC.