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What is face blindness? COVID-19 may cause rare brain condition, study finds

Is face blindness or "prosopagnosia" caused by COVID-19? A new case study describes a 28-year-old long COVID patient who lost the ability to recognize faces.
/ Source: TODAY

What is "face blindness?" The rare neurological disorder, also known as prosopagnosia, makes it difficult and sometimes impossible to recognize faces, including familiar ones or even your own.

Recently, researchers observed a severe case of face blindness in a young woman following infection with COVID-19 and a battle with long COVID. The case study, led by researchers at Dartmouth College, indicates that COVID-19 can cause severe and persistent neuropsychological problems, including deficits in facial recognition and navigation abilities.

Long COVID has been linked to a number of neurological and psychological problems including loss of smell and taste, brain fog, memory loss, psychosis, depression and impairments in speech and language. But the new peer-reviewed case study is the first report of prosopagnosia in a patient following infection with COVID-19, the study authors wrote.

In an article published in the journal Cortex, researchers describe a 28-year-old woman named Annie who had severe COVID-19 in March 2020 and suffered a symptom relapse two months later.

Annie, who worked part time as a portrait artist and had normal facial recognition abilities before getting COVID-19, started having difficulty recognizing faces during her symptom relapse in 2020, and these deficits have persisted ever since, according to the researchers. Describing her onset of prosopagnosia, Annie told researchers, “My dad’s voice came out of a stranger’s face."

In the case study, she scored poorly on all four facial recognition tests used to diagnose prosopagnosia but normally on other cognitive ability tests.

"Faces are like water in my head," Annie said of her current ability to recognize people, adding that she now relies on voices, the study authors wrote. Annie also reported to researchers that, since her COVID-19 infection, she has experienced "substantial" deficits in her navigation abilities, which frequently co-occur with prosopagnosia, the study authors wrote.

In addition to not recognizing familiar faces, Annie reported that she has trouble finding her way around familiar places and needs directions.

"The combination of prosopagnosia and navigational deficits that Annie had is something that caught our attention because the two deficits often go hand in hand after somebody either has had brain damage or developmental deficits,” study co-author Brad Duchaine, Ph.D., professor of psychological and brain sciences at Dartmouth College, said in news release.

To explore whether other people experienced similar problems, the researchers surveyed 54 individuals who had long COVID about their neuropsychological abilities. A majority reported a decline in visual recognition and navigation abilities, the authors wrote.

These findings indicate that COVID-19 may cause severe and selective neuropsychological impairments "similar to deficits seen following brain damage," the study authors wrote, and that these problems are not uncommon among patients with long COVID.

Long COVID is characterized by a wide range of symptoms and health conditions that can persist for weeks, months or even years after infection, according to the U.S. Centers for Disease Control and Prevention. It's found more often in people who had severe COVID-19, per the CDC, but anyone who has been infected with the SARS-CoV-2 virus can experience long-COVID too.

What is face blindness?

Face blindness is a condition defined as “trouble with recognizing facial identity in the absence of low-level vision problems or higher-level cognitive problems,” Duchaine previously told TODAY.com.

Chances are you know someone who claims they will never forget a face or someone who constantly reintroduces themselves. Among the general population, there’s a spectrum of facial recognition abilities, Duchaine said. Most of us fall in the middle, but those with incredible facial recognition are called “super recognizers,” and those at the very lowest end are prosopagnosics, Duchaine said.

Last year, actor Brad Pitt revealed in an interview that he believes he suffers from prosopagnosia.

The main symptom is difficulty recognizing people's faces, meaning that people in your daily life whom you should know may look like total strangers. People with severe prosopagnosia may struggle to recognize their own face in the mirror or point themselves out in a group photo, TODAY.com previously reported.

"People with prosopagnosia are more likely to recognize family and close friends than they are to recognize people they’re not as close to, but they still sometimes have trouble recognizing faces they’ve seen thousands of times,” Duchaine said.

Face blindness is not related to bad eyesight or blindness — nor is it related to learning disabilities, intelligence or memory loss (from dementia, for example), experts previously told TODAY.com.

Scientists believe prosopagnosia is caused by a problem with a part of the brain in the temporal and occipital lobes called the fusiform gyrus, which plays a key role in face recognition. “There’s a network of regions called face-selective areas … that respond very strongly when faces are shown ​​to people,” Duchaine said.

In people with prosopagnosia, these areas are either damaged by things like a stroke or injury, aka acquired prosopagnosia, or failed to develop normally from birth, aka developmental prosopagnosia, TODAY.com previously reported. (The doctor who treated Annie thinks it's unlikely her condition was caused by a stroke, but because she couldn't get an MRI for insurance reasons, a stroke cannot be ruled out as the cause, the study authors noted.)

The part of the brain that deals with navigation abilities — which the survey found were diminished in many of the respondents with long COVID — is also located in the temporal lobe, Duchaine noted.

It's still not known exactly how COVID-19 impacts the brain, but the researchers called for physicians to be aware of the potential for it to cause problems with facial recognition and navigation.

"If it’s happening in the visual system, it’s likely that selective deficits due to problems in other brain areas are occurring in some people, as well," Duchaine said in the news release.

There is no cure or specific treatment for prosopagnosia, but there is ongoing research into training and rehabilitative programs to improve facial recognition, TODAY.com previously reported.