Facial transplantation: adding to the reconstructive options after severe facial injury and disease

The ability to reconstruct complex facial injuries is still a considerable challenge despite the development of microsurgical techniques. The reconstructive options for conditions such as panfacial burns are severely limited. The result after multiple surgical procedures in this group is often poor in terms of function and cosmesis. Facial transplantation provides a potential solution, but opinion is currently divided about the extent to which the potential benefits to the quality of life can be justified when weighed against the technical, psychological and immunological risks. This paper reviews the current status of the debate and argues that a rigorous research strategy is the only logical basis for countering the ethical objections to a procedure that offers considerable benefits over existing reconstructive options.     

Functional connectivity between amygdala and facial regions involved in recognition of facial threat

The recognition of threatening faces is important for making social judgments. For example, threatening facial features of defendants could affect the decisions of jurors during a trial. Previous neuroimaging studies using faces of members of the general public have identified a pivotal role of the amygdala in perceiving threat. This functional magnetic resonance imaging study used face photographs of male prisoners who had been convicted of first-degree murder (MUR) as threatening facial stimuli. We compared the subjective ratings of MUR faces with those of control (CON) faces and examined how they were related to brain activation, particularly, the modulation of the functional connectivity between the amygdala and other brain regions. The MUR faces were perceived to be more threatening than the CON faces. The bilateral amygdala was shown to respond to both MUR and CON faces, but subtraction analysis revealed no significant difference between the two. Functional connectivity analysis indicated that the extent of connectivity between the left amygdala and the face-related regions (i.e. the superior temporal sulcus, inferior temporal gyrus and fusiform gyrus) was correlated with the subjective threat rating for the faces. We have demonstrated that the functional connectivity is modulated by vigilance for threatening facial features.     

胎儿头面部异常的临床咨询

胎儿头面部异常，是较为常见的结构异常。文章就常见的胎儿头面异常，包括唇腭裂、小颌畸形、耳郭畸形、巨舌症、眼畸形、颈项透明层增厚和颈部淋巴水囊瘤的分型与发生率、影像学诊断、病因、临床处理及预后分别进行论述，为临床决策和咨询提供参考。       

How the human brain exchanges information across sensory modalities to recognize other people

Recognizing the identity of other individuals across different sensory modalities is critical for successful social interaction. In the human brain, face‐ and voice‐sensitive areas are separate, but structurally connected. What kind of information is exchanged between these specialized areas during cross‐modal recognition of other individuals is currently unclear. For faces, specific areas are sensitive to identity and to physical properties. It is an open question whether voices activate representations of face identity or physical facial properties in these areas. To address this question, we used functional magnetic resonance imaging in humans and a voice‐face priming design. In this design, familiar voices were followed by morphed faces that matched or mismatched with respect to identity or physical properties. The results showed that responses in face‐sensitive regions were modulated when face identity or physical properties did not match to the preceding voice. The strength of this mismatch signal depended on the level of certainty the participant had about the voice identity. This suggests that both identity and physical property information was provided by the voice to face areas. The activity and connectivity profiles differed between face‐sensitive areas: (i) the occipital face area seemed to receive information about both physical properties and identity, (ii) the fusiform face area seemed to receive identity, and (iii) the anterior temporal lobe seemed to receive predominantly identity information from the voice. We interpret these results within a prediction coding scheme in which both identity and physical property information is used across sensory modalities to recognize individuals. Hum Brain Mapp, 36:324–339, 2015. © 2014 Wiley Periodicals, Inc .     

Object recognition in acquired and developmental prosopagnosia

Whether face and object recognition are dissociated in prosopagnosia continues to be debated: a recent review highlighted deficiencies in prior studies regarding the evidence for such a dissociation. Our goal was to study cohorts with acquired and developmental prosopagnosia with a complementary battery of tests of object recognition that address prior limitations, as well as evaluating for residual effects of object expertise. We studied 15 subjects with acquired and 12 subjects with developmental prosopagnosia on three tests: the Old/New Tests, the Cambridge Bicycle Memory Test, and the Expertise-adjusted Test of Car Recognition. Most subjects with developmental prosopagnosia were normal on the Old/New Tests: for acquired prosopagnosia, subjects with occipitotemporal lesions often showed impairments while those with anterior temporal lesions did not. Ten subjects showed a putative classical dissociation between the Cambridge Face and Bicycle Memory Tests, seven of whom had normal reaction times. Both developmental and acquired groups showed reduced car recognition on the expertise-adjusted test, though residual effects of expertise were still evident. Two subjects with developmental prosopagnosia met criteria for normal object recognition across all tests. We conclude that strong evidence for intact object recognition can be found in a few subjects but the majority show deficits, particularly those with the acquired form. Both acquired and developmental forms show residual but reduced object expertise effects.     

People with chronic facial pain perform worse than controls at a facial emotion recognition task,but it is not all about the emotion

Alexithymia, or a lack of emotional awareness, is prevalent in some chronic pain conditions and has been linked to poor recognition of others' emotions. Recognising others' emotions from their facial expression involves both emotional and motor processing, but the possible contribution of motor disruption has not been considered. It is possible that poor performance on emotional recognition tasks could reflect problems with emotional processing, motor processing or both. We hypothesised that people with chronic facial pain would be less accurate in recognising others' emotions from facial expressions, would be less accurate in a motor imagery task involving the face, and that performance on both tasks would be positively related. A convenience sample of 19 people (15 females) with chronic facial pain and 19 gender‐matched controls participated. They undertook two tasks; in the first task, they identified the facial emotion presented in a photograph. In the second, they identified whether the person in the image had a facial feature pointed towards their left or right side, a well‐recognised paradigm to induce implicit motor imagery. People with chronic facial pain performed worse than controls at both tasks (Facially Expressed Emotion Labelling (FEEL) task P < 0·001; left/right judgment task P < 0·001). Participants who were more accurate at one task were also more accurate at the other, regardless of group (P < 0·001, r² = 0·523). Participants with chronic facial pain were worse than controls at both the FEEL emotion recognition task and the left/right facial expression task and performance covaried within participants. We propose that disrupted motor processing may underpin or at least contribute to the difficulty that facial pain patients have in emotion recognition and that further research that tests this proposal is warranted.