Prosopagnosia — MRCPsych Paper A MCQ

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ModerateNeuroanatomyProsopagnosiaMRCPsych Paper A

A 61-year-old man develops difficulty recognising faces after bilateral occipitotemporal infarction. He identifies familiar people by their voices and correctly names common objects presented visually, but he cannot recognise familiar faces or reliably match photographs of an unfamiliar face taken from different angles. Damage to which cortical region most directly accounts for this deficit?

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Correct answer: A — Fusiform gyrus

This is acquired prosopagnosia. Preserved object naming and recognition by voice indicate a selective face-processing deficit rather than general visual agnosia or global loss of person knowledge. Difficulty matching faces across viewpoints specifically suggests impaired structural or configural face processing. Lesion studies associate this most strongly with the right fusiform gyrus; bilateral occipitotemporal lesions involving the fusiform gyri produce particularly severe deficits. Therefore, A is correct. The posterior superior temporal sulcus is more involved in changeable facial signals such as gaze and expression. The adjacent lingual gyrus is visual association cortex but is not the principal fusiform face region. The parahippocampal gyrus is more closely associated with contextual, scene and memory processing. Angular gyrus lesions typically affect language, calculation, reading or multimodal association rather than causing selective prosopagnosia.

Reference: Barton JJS. Structure and function in acquired prosopagnosia: lessons from a series of 10 patients with brain damage. Journal of Neuropsychology. 2008;2(1):197–225. https://pubmed.ncbi.nlm.nih.gov/19334311/