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Testing the connections within face processing circuitry in Capgras delusion with diffusion imaging tractography.

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Capgras delusion (CD) involves believing familiar faces are impostors. Neuroimaging revealed reduced left inferior fronto-occipital fasciculus (IFOF) integrity in a CD patient, suggesting its role in facial affect processing.

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Capgras delusion (CD) is characterized by the delusional belief that familiar individuals have been replaced by impostors, despite intact facial recognition.
  • Existing theories propose CD arises from a disrupted pathway responsible for processing the affective value of familiar faces.

Observation:

  • Diffusion tensor imaging (DTI) and voxel-based morphometry were employed to investigate the neural underpinnings of CD in one patient and ten controls.
  • Gray matter damage was observed in the right frontal areas of the CD patient.

Findings:

  • Tractography analysis revealed no significant differences in commissural tracts, superior longitudinal fasciculus (SLF), or right/left inferior longitudinal fasciculus (ILF) between the patient and controls.
  • Crucially, the left inferior fronto-occipital fasciculus (IFOF) was significantly reduced in the CD patient compared to controls.
  • This reduction in the left IFOF, with preserved ILF, indicates a selective impairment in the white matter tract connecting occipital and frontal regions.

Implications:

  • The findings suggest the left IFOF plays a critical role in the affective processing of facial information.
  • This impairment may underlie the characteristic symptoms of Capgras delusion.
  • The study also proposes a potential involvement of the IFOF in covert facial recognition in individuals with prosopagnosia.