Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report
Abstract
:1. Introduction
2. Materials and Methods
2.1. Case Description
2.2. Neuropsychological Assessment
2.3. Single Case Analysis
3. Results
3.1. Neuropsychological Profile
3.2. Single-Case Analysis
3.3. DP Diagnosis
4. Discussion
4.1. Face Recognition and Other Cognitive Functions
4.2. The Importance of Proper Assessment
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Starrfelt, R.; Barton, J.J.S. Prosopagnosia. In Encyclopedia of Behavioral Neuroscience, 2nd ed.; Della Sala, S., Ed.; Elsevier: Oxford, UK, 2022; pp. 597–604. [Google Scholar]
- Barton, J.J. Structure and function in acquired prosopagnosia: Lessons from a series of 10 patients with brain damage. J. Neuropsychol. 2008, 2, 197–225. [Google Scholar] [CrossRef] [PubMed]
- Dalrymple, K.A.; Palermo, R. Guidelines for studying developmental prosopagnosia in adults and children. Wiley Interdiscip. Rev. Cogn. Sci. 2016, 7, 73–87. [Google Scholar] [CrossRef]
- Volfart, A.; Rossion, B. The neuropsychological evaluation of face identity recognition. Neuropsychologia 2024, 198, 108865. [Google Scholar] [CrossRef]
- Kennerknecht, I.; Grueter, T.; Welling, B.; Wentzek, S.; Horst, J.; Edwards, S.; Grueter, M. First report of prevalence of non-syndromic hereditary prosopagnosia (HPA). Am. J. Med. Genet. A 2006, 140, 1617–1622. [Google Scholar] [CrossRef] [PubMed]
- Kennerknecht, I.; Ho, N.Y.; Wong, V.C. Prevalence of hereditary prosopagnosia (HPA) in Hong Kong Chinese population. Am. J. Med. Genet. A 2008, 146A, 2863–2870. [Google Scholar] [CrossRef]
- Bowles, D.C.; McKone, E.; Dawel, A.; Duchaine, B.; Palermo, R.; Schmalzl, L.; Rivolta, D.; Wilson, C.E.; Yovel, G. Diagnosing prosopagnosia: Effects of ageing, sex, and participant-stimulus ethnic match on the Cambridge Face Memory Test and Cambridge Face Perception Test. Cogn. Neuropsychol. 2009, 26, 423–455. [Google Scholar] [CrossRef]
- Barton, J.J.S.; Corrow, S.L. The problem of being bad at faces. Neuropsychologia 2016, 89, 119–124. [Google Scholar] [CrossRef]
- DeGutis, J.; Bahierathan, K.; Barahona, K.; Lee, E.; Evans, T.C.; Shin, H.M.; Mishra, M.; Likitlersuang, J.; Wilmer, J.B. What is the prevalence of developmental prosopagnosia? An empirical assessment of different diagnostic cutoffs. Cortex 2023, 161, 51–64. [Google Scholar] [CrossRef] [PubMed]
- Gerlach, C.; Nørkær, E.; Starrfelt, R.; Class, A.; Class, B. Is that the only chemistry?: A commentary on DeGutis et al. (2023): What is the prevalence of developmental prosopagnosia? An empirical assessment of different diagnostic cutoffs. Cortex 2024, 117, 385–388. [Google Scholar] [CrossRef]
- Burns, E.J. Improving the DSM-5 approach to cognitive impairment: Developmental prosopagnosia reveals the need for tailored diagnoses. Behav. Res. Methods 2024, 56, 7872–7891. [Google Scholar] [CrossRef] [PubMed]
- Minio-Paluello, I.; Porciello, G.; Pascual-Leone, A.; Baron-Cohen, S. Face individual identity recognition: A potential endophenotype in autism. Mol. Autism 2020, 11, 81. [Google Scholar] [CrossRef]
- Shah, P.; Bird, G.; Cook, R. Face processing in autism: Reduced integration of cross-feature dynamics. Cortex 2016, 75, 113–119. [Google Scholar] [CrossRef]
- Stantić, M.; Ichijo, E.; Catmur, C.; Bird, G. Face memory and face perception in autism. Autism 2022, 26, 276–280. [Google Scholar] [CrossRef] [PubMed]
- Wilson, C.E.; Freeman, P.; Brock, J.; Burton, A.M.; Palermo, R. Facial identity recognition in the broader autism phenotype. PLoS ONE 2010, 5, e12876. [Google Scholar] [CrossRef] [PubMed]
- Chen, Y.; Ekstrom, T. Perception of faces in schizophrenia: Subjective (self-report) vs. objective (psychophysics) assessments. J. Psychiatr. Res. 2016, 76, 136–142. [Google Scholar] [CrossRef] [PubMed]
- Ekstrom, T.; Maher, S.; Shinn, A.; Ongur, D.; Chen, Y. Face identity discrimination in schizophrenia: Impairments to faces with high exposure in society. Schizophr. Res. 2016, 171, 237–238. [Google Scholar] [CrossRef]
- Kühn, C.D.; Gerlach, C.; Andersen, K.B.; Poulsen, M.; Starrfelt, R. Face recognition in developmental dyslexia: Evidence for dissociation between faces and words. Cogn. Neuropsychol. 2021, 38, 107–115. [Google Scholar] [CrossRef] [PubMed]
- Robotham, R.J.; Starrfelt, R. Face and Word Recognition Can Be Selectively Affected by Brain Injury or Developmental Disorders. Front. Psychol. 2017, 8, 1547. [Google Scholar] [CrossRef] [PubMed]
- Sigurdardottir, H.M.; Ívarsson, E.; Kristinsdóttir, K.; Kristjánsson, Á. Impaired recognition of faces and objects in dyslexia: Evidence for ventral stream dysfunction? Neuropsychology 2015, 29, 739–750. [Google Scholar] [CrossRef]
- Demirci, E.; Erdogan, A. Is emotion recognition the only problem in ADHD? effects of pharmacotherapy on face and emotion recognition in children with ADHD. Atten. Defic. Hyperact. Disord. 2016, 8, 197–204. [Google Scholar] [CrossRef] [PubMed]
- Romani, M.; Vigliante, M.; Faedda, N.; Rossetti, S.; Pezzuti, L.; Guidetti, V.; Cardona, F. Face memory and face recognition in children and adolescents with attention deficit hyperactivity disorder: A systematic review. Neurosci. Biobehav. Rev. 2018, 89, 1–12. [Google Scholar] [CrossRef] [PubMed]
- Hong, D.; Scaletta Kent, J.; Kesler, S. Cognitive profile of Turner syndrome. Dev. Disabil. Res. Rev. 2009, 15, 270–278. [Google Scholar] [CrossRef] [PubMed]
- Bate, S.; Cook, S.J.; Mole, J.; Cole, J. First report of generalized face processing difficulties in möbius sequence. PLoS ONE 2013, 8, e62656. [Google Scholar] [CrossRef] [PubMed]
- Svart, N.; Starrfelt, R. Is It Just Face Blindness? Exploring Developmental Comorbidity in Individuals with Self-Reported Developmental Prosopagnosia. Brain Sci. 2022, 12, 230. [Google Scholar] [CrossRef] [PubMed]
- Corrow, S.L.; Dalrymple, K.A.; Barton, J.J. Prosopagnosia: Current perspectives. Eye Brain 2016, 8, 165–175. [Google Scholar] [CrossRef] [PubMed]
- Barton, J.J.S.; Albonico, A.; Susilo, T.; Duchaine, B.; Corrow, S.L. Object recognition in acquired and developmental prosopagnosia. Cogn. Neuropsychol. 2019, 36, 54–84. [Google Scholar] [CrossRef] [PubMed]
- Bate, S.; Adams, A.; Bennetts, R.; Line, H. Developmental prosopagnosia with concurrent topographical difficulties: A case report and virtual reality training programme. Neuropsychol. Rehabil. 2019, 29, 1290–1312. [Google Scholar] [CrossRef]
- Ishihara, S. Ishihara’s Tests for Colour Deficiency; Kanehara & Co.: Tokyo, Japan, 1996. [Google Scholar]
- Anaki, D.; Kaufman, Y.; Freedman, M.; Moscovitch, M. Associative (prosop)agnosia without (apparent) perceptual deficits: A case-study. Neuropsychologia 2007, 45, 1658–1671. [Google Scholar] [CrossRef] [PubMed]
- Schultz, R.R.; Bertolucci, P.H.F. Congenital prosopagnosia: A case report. Dement. Neuropsychol. 2011, 5, 54–57. [Google Scholar] [CrossRef]
- Wechsler, D. Wechsler Adult Intelligence Scale–Fourth Edition (WAIS–IV). In Norwegian Version; Pearson: Stockholm, Sweden, 2011. [Google Scholar]
- Wilson, B.; Cockburn, J.; Halligan, P. Development of a behavioral test of visuospatial neglect. Arch. Phys. Med. Rehabil. 1987, 68, 98–102. [Google Scholar] [PubMed]
- Riddoch, M.J.; Humphreys, G.W. Birmingham Object Recognition Battery; Ruthledge: New York, NY, USA, 1993. [Google Scholar]
- Warrington, E.; James, M. The Visual Object and Space Perception Battery; Pearson: London, UK, 1991. [Google Scholar]
- Benedict, R. Brief Visuospatial Memory Test—Revised: Professional Manual; Psychological Assessment Resources: Lutz, FL, USA, 1997. [Google Scholar]
- Trahan, D.; Larrabee, G. Continuous Visual Memory Test; Psychological Assessment Resources: Odessa, FL, USA, 1988. [Google Scholar]
- Wechsler, D. Wechsler Memory Scale-Third Edition (WMS-III); Psychological Corporation: San Antonio, TX, USA, 1997. [Google Scholar]
- Delis, D.; Kramer, J.; Kaplan, E.; Ober, B.A. California Verbal Learning Test—Second Edition: Adult Version; Psychological Corporation: San Antonio, TX, USA, 2000. [Google Scholar]
- Conners. Conners’ CPT 3: Manual; Multi-Health Systems: North Tonawanda, NY, USA, 2014. [Google Scholar]
- Delis, D.; Kaplan, E.; Kramer, J. Delis-Kaplan Executive Function System (D-KEFS); Psychological Corporation: San Antonio, TX, USA, 2001. [Google Scholar]
- Roth, R.M.; Gioia, G.A. Behavior Rating Inventory of Executive Function-Adult Version; Psychological Assessment Resources: Lutz, FL, USA, 2005. [Google Scholar]
- Constantino, J.N.; Gruber, C.P. Social Responsiveness Scale-2 (SRS-2). Norwegian Version; Hogrefe: Stockholm, Sweden, 2019. [Google Scholar]
- Duchaine, B.; Nakayama, K. The Cambridge Face Memory Test: Results for neurologically intact individuals and an investigation of its validity using inverted face stimuli and prosopagnosic participants. Neuropsychologia 2006, 44, 576–585. [Google Scholar] [CrossRef]
- McKone, E.; Hall, A.; Pidcock, M.; Palermo, R.; Wilkinson, R.B.; Rivolta, D.; Yovel, G.; Davis, J.M.; O’Connor, K.B. Face ethnicity and measurement reliability affect face recognition performance in developmental prosopagnosia: Evidence from the Cambridge Face Memory Test–Australian. Cogn. Neuropsychol. 2011, 28, 109–146. [Google Scholar] [CrossRef]
- Gerlach, C.; Barton, J.J.S.; Albonico, A.; Malaspina, M.; Starrfelt, R. Contrasting domain-general and domain-specific accounts in cognitive neuropsychology: An outline of a new approach with developmental prosopagnosia as a case. Behav. Res. Methods 2022, 54, 2829–2842. [Google Scholar] [CrossRef] [PubMed]
- Duchaine, B.; Germine, L.; Nakayama, K. Family resemblance: Ten family members with prosopagnosia and within-class object agnosia. Cogn. Neuropsychol. 2007, 24, 419–430. [Google Scholar] [CrossRef]
- Shah, P.; Gaule, A.; Sowden, S.; Bird, G.; Cook, R. The 20-item prosopagnosia index (PI20): A self-report instrument for identifying developmental prosopagnosia. R. Soc. Open Sci. 2015, 2, 140343. [Google Scholar] [CrossRef]
- Gray, K.L.; Bird, G.; Cook, R. Robust associations between the 20-item prosopagnosia index and the Cambridge Face Memory Test in the general population. R. Soc. Open Sci. 2017, 4, 160923. [Google Scholar] [CrossRef] [PubMed]
- Mishra, M.V.; Fry, R.M.; Saad, E.; Arizpe, J.M.; Ohashi, Y.-G.B.; DeGutis, J.M. Comparing the sensitivity of face matching assessments to detect face perception impairments. Neuropsychologia 2021, 163, 108067. [Google Scholar] [CrossRef] [PubMed]
- Dennett, H.W.; McKone, E.; Tavashmi, R.; Hall, A.; Pidcock, M.; Edwards, M.; Duchaine, B. The Cambridge Car Memory Test: A task matched in format to the Cambridge Face Memory Test, with norms, reliability, sex differences, dissociations from face memory, and expertise effects. Behav. Res. Methods 2012, 44, 587–605. [Google Scholar] [CrossRef] [PubMed]
- Geskin, J.; Behrmann, M. Congenital prosopagnosia without object agnosia? A literature review. Cogn. Neuropsychol. 2018, 35, 4–54. [Google Scholar] [CrossRef]
- Guilmette, T.J.; Sweet, J.J.; Hebben, N.; Koltai, D.; Mahone, E.M.; Spiegler, B.J.; Stucky, K.; Westerveld, M.; Conference, P. American Academy of Clinical Neuropsychology consensus conference statement on uniform labeling of performance test scores. Clin. Neuropsychol. 2020, 34, 437–453. [Google Scholar] [CrossRef] [PubMed]
- Crawford, J.R.; Garthwaite, P.H. Comparison of a single case to a control or normative sample in neuropsychology: Development of a Bayesian approach. Cogn. Neuropsychol. 2007, 24, 343–372. [Google Scholar] [CrossRef]
- Crawford, J.R.; Garthwaite, P.H.; Porter, S. Point and interval estimates of effect sizes for the case-controls design in neuropsychology: Rationale, methods, implementations, and proposed reporting standards. Cogn. Neuropsychol. 2010, 27, 245–260. [Google Scholar] [CrossRef] [PubMed]
- Gray, K.L.H.; Biotti, F.; Cook, R. Evaluating object recognition ability in developmental prosopagnosia using the Cambridge Car Memory Test. Cogn. Neuropsychol. 2019, 36, 89–96. [Google Scholar] [CrossRef] [PubMed]
- Gerlach, C.; Starrfelt, R. Evidence for a Classical Dissociation between Face and Object Recognition in Developmental Prosopagnosia. Brain Sci. 2024, 14, 107. [Google Scholar] [CrossRef]
- Nikolas, M.A.; Marshall, P.; Hoelzle, J.B. The role of neurocognitive tests in the assessment of adult attention-deficit/hyperactivity disorder. Psychol. Assess. 2019, 31, 685–698. [Google Scholar] [CrossRef] [PubMed]
- Morand-Beaulieu, S.; Leclerc, J.B.; Valois, P.; Lavoie, M.E.; O’Connor, K.P.; Gauthier, B. A Review of the Neuropsychological Dimensions of Tourette Syndrome. Brain Sci. 2017, 7, 106. [Google Scholar] [CrossRef] [PubMed]
- Andersen, P.N.; Egeland, J.; Oie, M. Learning and memory impairments in children and adolescents with attention-deficit/hyperactivity disorder. J. Learn. Disabil. 2013, 46, 453–460. [Google Scholar] [CrossRef]
- Yardley, L.; McDermott, L.; Pisarski, S.; Duchaine, B.; Nakayama, K. Psychosocial consequences of developmental prosopagnosia: A problem of recognition. J. Psychosom. Res. 2008, 65, 445–451. [Google Scholar] [CrossRef]
- Murray, E.; Hills, P.J.; Bennetts, R.J.; Bate, S. Identifying Hallmark Symptoms of Developmental Prosopagnosia for Non-Experts. Sci. Rep. 2018, 8, 1690. [Google Scholar] [CrossRef]
- Adams, A.; Hills, P.J.; Bennetts, R.J.; Bate, S. Coping strategies for developmental prosopagnosia. Neuropsychol. Rehabil. 2020, 30, 1996–2015. [Google Scholar] [CrossRef] [PubMed]
- Baron-Cohen, S.; Wheelwright, S.; Hill, J.; Raste, Y.; Plumb, I. The “Reading the Mind in the Eyes” Test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. J. Child Psychol. Psychiatry 2001, 42, 241–251. [Google Scholar] [CrossRef] [PubMed]
- Higgins, W.C.; Ross, R.M.; Langdon, R.; Polito, V. The “Reading the Mind in the Eyes” Test Shows Poor Psychometric Properties in a Large, Demographically Representative U.S. Sample. Assessment 2023, 30, 1777–1789. [Google Scholar] [CrossRef]
- Leckman, J.F.; Riddle, M.A.; Hardin, M.T.; Ort, S.I.; Swartz, K.L.; Stevenson, J.; Cohen, D.J. The Yale Global Tic Severity Scale: Initial testing of a clinician-rated scale of tic severity. J. Am. Acad. Child Adolesc. Psychiatry 1989, 28, 566–573. [Google Scholar] [CrossRef] [PubMed]
- Kessler, R.C.; Adler, L.; Ames, M.; Demler, O.; Faraone, S.; Hiripi, E.; Howes, M.J.; Jin, R.; Secnik, K.; Spencer, T.; et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population. Psychol. Med. 2005, 35, 245–256. [Google Scholar] [CrossRef] [PubMed]
- Ward, M.F.; Wender, P.H.; Reimherr, F.W. The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am. J. Psychiatry 1993, 150, 885–890. [Google Scholar] [CrossRef] [PubMed]
Measure | Raw Score | Norm-Based Score | Qualitative Descriptive Label |
---|---|---|---|
General cognitive ability | |||
WAIS-IV | |||
Fullscale IQ | 111 a | High average | |
Verbal Comprehension Index | 102 a | Average | |
Perceptual Reasoning Index | 120 a | Above average | |
Processing Speed Index | 112 a | High average | |
Working Memory Index | 105 a | Average | |
Visual perception | |||
BORB | |||
Length match | 29 | 1.3 b | Within normal expectations |
Size match | 27 | −0.1 b | Within normal expectations |
Orientation match | 26 | 0.5 b | Within normal expectations |
Position of gap match | 34 | −0.3 b | Within normal expectations |
Picture Naming (animate) | 15 | 1 b | Within normal expectations |
Picture Naming (inanimate) | 20 | 0.6 b | Within normal expectations |
VOSP | |||
Object perception | |||
Screening test | 20 | 0.2 b | Within normal expectations |
Incomplete letters | 20 | 0.9 b | Within normal expectations |
Silhouettes | 26 | 0.7 b | Within normal expectations |
Object decision | 16 | −1.6 b | Below average |
Progressive silhouettes | 9 | 0.3 b | Within normal expectations |
Space perception | |||
Dot counting | 10 | 0.3 b | Within normal expectations |
Position discrimination | 20 | 0.4 b | Within normal expectations |
Number location | 10 | 0.6 b | Within normal expectations |
Cube analysis | 9 | −0.3 b | Within normal expectations |
Star Cancellation Test | 54/ 54 | - | - |
Memory | |||
BVMT-R | |||
Trial 1 | 8 | 60 c | High average |
Total Recall | 30 | 61 c | High average |
Delayed Recall | 11 | 59 c | High average |
Recognition Discrimination | 6 | >16%ile | Within normal expectations |
Index | |||
CVMT | |||
Total Score | 75 | −0.8 b | Low average |
Delayed Recognition | 4 | −0.5 b | Average |
Visual discrimination | 7/7 | − | - |
CVLT-II | |||
Trial 1 | 5 | −1 b | Low average |
List B trial 1 | 4 | −1 b | Low average |
Trials 1–5 Total Score | 46 | 52 c | Average |
Short Delay Free Recall | 10 | 0.5 b | Average |
Long Delay Free Recall | 10 | 0 b | Average |
Recognition Hits | 14 | 0 b | Average |
Recognition False Positives | 4 | −0.5 b | Average |
Forced Recognition | 16/ 16 | - | - |
WMS-III | |||
Logical Memory I—Recall | 48 | 12 d | High average |
Logical Memory II | |||
Recall | 30 | 12 d | High average |
Recognition | 27/ 30 | - | - |
Spatial Span | 19 | 14 d | Above average |
CCMT | 43 | −1 b | Low average |
Executive and attentional control | |||
BRIEF-A Self Report Form | |||
Behavioral Regulation Index | 76 c | Exceptionally high | |
Metacognitive Index | 81 c | Exceptionally high | |
Global Executive Composite | 81 c | Exceptionally high | |
CCPT-3 | |||
d′ | - | 57 c | High average |
Omissions | - | 55 c | Average |
Commissions | - | 53 c | Average |
Perseverations | - | 55 c | Average |
Hit Reaction Time | - | 39 c | Low average |
Hit Reaction Time SD | - | 39 c | Low average |
Variability | - | 44 c | Average |
Hit Reaction Time Block | - | 43 c | Average |
Change | |||
Hit Reaction Time | - | 32 c | Below average |
Interstimulus Interval Change | |||
D-KEFS Tower Test Total | 18 | 11 d | Average |
Achievement | |||
Social cognition | |||
SRS-2 Self Report Form | 54 | 50 c | Within normal levels |
Face processing | |||
CFPT | 66 | −2.1 b | Exceptionally low |
CFMT | 34 | −3.5 b | Exceptionally low |
CFMT-Aus | 25 | −4 b | Exceptionally low |
PI-20 | 91 | 4.8 b | Exceptionally high |
Controls Min | Controls Max | Controls Mean | Controls SD | ON | ON z Score | ON z Score CI | Two-Tailed p | |
---|---|---|---|---|---|---|---|---|
CFMT | 45 | 72 | 59.02 | 7.17 | 34 | −3.49 | (−4.16–-2.82) | 0.001 |
CCMT | 31 | 69 | 52.05 | 9.16 | 43 | −0.99 | (−1.29–-0.68) | 0.331 |
CFPT | 12 | 92 | 39.08 | 13.10 | 66 | 2.06 | (1.61–2.5) | 0.046 |
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Emhjellen, P.E.; Starrfelt, R.; Raudeberg, R.; Hassel, B. Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report. Brain Sci. 2025, 15, 56. https://doi.org/10.3390/brainsci15010056
Emhjellen PE, Starrfelt R, Raudeberg R, Hassel B. Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report. Brain Sciences. 2025; 15(1):56. https://doi.org/10.3390/brainsci15010056
Chicago/Turabian StyleEmhjellen, Petter Espeseth, Randi Starrfelt, Rune Raudeberg, and Bjørnar Hassel. 2025. "Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report" Brain Sciences 15, no. 1: 56. https://doi.org/10.3390/brainsci15010056
APA StyleEmhjellen, P. E., Starrfelt, R., Raudeberg, R., & Hassel, B. (2025). Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report. Brain Sciences, 15(1), 56. https://doi.org/10.3390/brainsci15010056