When the face doesn't ring a bell

The hall was brimming with the crowd and Neelam and Sanjiv were virtually running to make it to the birthday party in time. But as they darted in, Sanjiv was confused, and so was Neelam. Had they come to the right place? For, not a single face they could recognise. With the guests staring at them for the couple’s  ‘un-guestly’ demeanour, Sanjiv practically had a hard time recalling the face of Goutam, his childhood pal who was throwing the party at his son’s fifth birthday.

A majority of the invited had been friends or colleagues of Sanjiv for years though!
Like Sanjiv, many of us might face that disquieting feeling that some things have slipped out of our minds and it could be faces of persons, who have stood by us through thick and thin. Researchers at the University of Harvard are studying a neurological disorder known as prosopagnosia, or “face blindness,” a disease many of us  suffer from, but are not exactly aware of.

People with prosopagnosia cannot remember faces. Millions of people in the world may unknowingly suffer from this little-known disorder.

A seven-year-old boy walked out of his classroom and entered another classroom without realising his mistake. Soon his parents noticed that he always played with the same girl who wore a pink skirt. Prosopagnosia may not be a term that most people hear every day, but a surprising two per cent of the world population is believed to be living with the disease at various  degrees.

Characterised by the inability to recognise faces or to distinguish one from another, the condition can be embarrassing and socially disabling. People with severe prosopagnosia may fail to recognise  family members or close friends or mistake complete strangers for acquaintances. Some face-blind people have trouble watching TV shows or movies because they cannot remember characters or plots. In some extreme cases, persons having symptoms of severe deficiencies could even greet strangers, taking them to be their siblings.

Shocked by a real life incident in which a young woman could not identify her son during the pick-up time at the school, a city student, after completing her MBBS from the Calcutta Medical College, decided to pursue the disease ‘in depth’ abroad. “And I found very little is known about it except some pioneering research at Harvard,” said Soma Chatterjee. She joined Harvard University at Boston in the US under Dr Ken Nakayama and Richard Russell at the Vision Science Laboratory of the Department of Psychology, to study the likely reasons behind the syndrome.

Ken Nakayama and Richard Russell at the University of Boston and Dr Bradley Duchaine at University College, London, have been engaged in researching the genesis, diagnostic tests and some possible cures of the ailment for more than a decade. According to them, there are two types of prosopagnosia.

Acquired prosopagnosia develops in adults from brain damage caused by head trauma, stroke, and degenerative diseases. Developmental prosopagnosia, occurs in minors with no initial evidence of brain damage. This group may be the most  common across the world, they have found. But there is no concrete conclusion so far behind the exact reason of the syndrome.

Hence, the two universities have been experimenting with and looking for children suffering from developmental prosopagnosia in order to develop a screening mechanism that will allow for earlier diagnosis. This, in turn, will facilitate treatment to begin earlier and be more effective.

Chatterjee is perhaps the only student from India who plans to bring the fruits of her research into the country in a big way and plans to extend her research in India. How?
As part of their research into prosopagnosia, Dr Nakayama and Dr Russell
besides Dr Duchaine developed a diagnostic test, which led to the identification of hundreds of face-blind individuals over the past several years - far more than had been identified previously. Following their footsteps, Chatterjee intends to conduct an identical study at Regional Institute of Ophthalmology (RIO) laboratory in the premises of Calcutta Medical College through application of the same test.

“We’ll request people from all strata of life to visit our lab at RIO and they will
include medical professionals and teachers besides security personnel among others,” explains Chatterjee. She has already held a preliminary discussion about launching the project with senior teacher in Ophthalmology at RIO Himadri Dutta. And, there are plans to collaborate with the researchers of the Harvard University as well.

The test the researchers have developed involves looking at a series of pictures of
objects such as cars, tools, guns, houses, and landscapes, along with close-up cropped black and white pictures of faces. Some of the images are repeated in cycles in the computer while some are not. Subjects are asked to identify, as quickly as possible, whether each image they see is new or repeated.

“Until a few years ago, only 100 cases of prosopagnosia had been documented worldwide, but it now appears that the condition is much less rare than had previously been assumed,” Nakayama said in a university statement. “Testing of 1,600 individuals found that two per cent of the general public may have face-blindness and a German group has recently made a similar estimate. But we think developmental or congenital prosopagnosia is much more common.”

Many with this disorder have no apparent brain damage; but they have not been able to recognise the faces well, Chatterjee points out. Unless exposed to the test, they would not know they have the disorder. “It’s like colour-blindness; many people don’t know they are colour blind until they are tested.”

The area of concern stems from the fact that there isn’t any treatment presently available for face-blindness. “Researchers are in the process of trying to understand what prosopagnosia is and raise awareness about it in the medical community and public at large,” Chatterjee contends and adds that the “cure may take some more time”.

Those keen on testing their level of deficiency may log on to www.faceblind.org and complete a questionnaire. At the moment, the diagnostic test for the disorder is not available online, but that’s one goal, Chatterjee and other researchers
aim at.