Who is who: areas of the brain associated with recognizing and naming famous faces

Clinical article

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Object

It has been hypothesized that specific brain regions involved in face naming may exist in the brain. To spare these areas and to gain a better understanding of their organization, the authors studied patients who underwent surgery by using direct electrical stimulation mapping for brain tumors, and they compared an object-naming task to a famous face–naming task.

Methods

Fifty-six patients with brain tumors (39 and 17 in the left and right hemispheres, respectively) and with no significant preoperative overall language deficit were prospectively studied over a 2-year period. Four patients who had a partially selective famous face anomia and 2 with prosopagnosia were not included in the final analysis.

Results

Face-naming interferences were exclusively localized in small cortical areas (< 1 cm2). Among 35 patients whose dominant left hemisphere was studied, 26 face-naming specific areas (that is, sites of interference in face naming only and not in object naming) were found. These face naming–specific sites were significantly detected in 2 regions: in the left frontal areas of the superior, middle, and inferior frontal gyri (p < 0.001) and in the anterior part of the superior and middle temporal gyri (p < 0.01). Variable patterns of interference were observed (speech arrest, anomia, phonemic, or semantic paraphasia) probably related to the different stages in famous face processing. Only 4 famous face–naming interferences were found in the right hemisphere.

Conclusions

Relative anatomical segregation of naming categories within language areas was detected. This study showed that famous face naming was preferentially processed in the left frontal and anterior temporal gyri. The authors think it is necessary to adapt naming tasks in neurosurgical patients to the brain region studied.

Abbreviations used in this paper: IFG = inferior frontal gyrus; ITG = inferior temporal gyrus; MFG = middle frontal gyrus; MTG = middle temporal gyrus; SFG = superior frontal gyrus; STG = superior temporal gyrus.

Article Information

Address correspondence to: Franck-Emmanuel Roux, M.D., Ph.D., Service de Neurochirurgie et Institut National de la Santé et de la Recherche Médicale 825, Hôpital Purpan, F-31059 Toulouse, France. email: franck.roux@club-internet.fr.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Axial (A–left side of D) and coronal (right side of D) MR images obtained in each of the 4 patients with a selective deficit in famous face naming. Note that all these right-handed patients had tumors localized in the left anterior temporal lobe. These patients were not included in the study because of their initial famous face–naming difficulties. There is different enhancement between left and right images of each panel.

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    Sagittal (left) and axial (right) MR images obtained in the 2 patients with a high-grade glioma and prosopagnosia. These patients were not included in the study because of their prosopagnosia.

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    Illustration of the findings of this study regarding object and famous face interferences. Twenty-six specific facenaming areas (that is, sites of interference in face naming only and not in object naming) were found. These face-naming specific sites were found in the left SFG, MFG, and IFG, and in the anterior part of the STG and MTG.

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    Intraoperative cortical brain mapping of famous face naming versus object naming in a right-handed patient revealed 2 different areas of dissociation between famous face and picture naming in the left frontal lobe. During tumor removal, both these areas were spared. F = famous face–naming area; L = object-naming area; N = negative area (no famous face interference).

  • View in gallery

    Illustration of intraoperative subcortical brain mapping of famous face versus object naming of the left temporal lobe. Cortical intraoperative brain mapping of famous face versus object naming found different areas. One cortical area (F) in the anterior temporal lobe was involved in famous face naming. Interferences in object naming (L) were found elsewhere. To improve the understanding of the intraoperative photographs, cortical sites producing language impairment areas were not systematically labeled with a sterile ticket.

  • View in gallery

    Illustration showing the dissociation between famous face and picture naming in the left temporal lobe. Subcortical intraoperative brain mapping of famous face versus object naming found 2 different areas. One cortical area (12) was involved in object naming whereas a subcortical area was involved only in face naming (31).

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