Multimodal face and voice recognition disorders in a case with unilateral right anterior temporal lobe atrophy

Objective: Familiar face recognition disorders are often observed in patients with lesions of the right anterior temporal lobe (ATL). It is not clear, however, if this defect must be considered as a form of associative prosopagnosia, or as a multimodal (face and voice) people recognition disorder, because voice recognition is rarely examined in these patients. The most appropriate manner of solving this problem could consist in evaluating, in one or more patients with right ATL lesions, recognition disorders through face and voice of the same well known people. Methods: The 'Famous People Recognition Battery' (FPRB), in which the same 40 persons (very well-known at the national level) should be identified through face and voice recognition, was used to clarify this issue. The FPRB was administered to a 56-year-old woman (BM) who complained, as early sign of a fronto-temporal degeneration, of familiar people recognition defects in a context of relatively intact cognitive functions. Results: On the FPRB, BM showed a severe defect of people recognition (familiarity judgement) and identification through face and voice, but not through personal name. Voxel-based morphometry showed a focal atrophy of the right ATL (temporo-polar cortex and anterior parts of perirhinal and entorhinal cortices). Conclusions: the present case report seems to show that a unilateral right ATL atrophy can lead to a multimodal people recognition disorder through face and voice, in the absence of recognition difficulties through personal name.