Facial recognition in children after perinatal stroke.

Objective: To examine the effects of prenatal or perinatal stroke on the facial recognition skills of children and young adults. It was hypothesized that the nature and extent of facial recognition deficits seen in patients with early-onset lesions would be different from that seen in adults with later-onset neurologic impairment.

Background: Numerous studies with normal and neurologically impaired adults have found a right-hemisphere superiority for facial recognition. In contrast, little is known about facial recognition in children after early focal brain damage.

Method: Forty subjects had single, unilateral brain lesions from pre- or perinatal strokes (20 had left-hemisphere damage, and 20 had right-hemisphere damage), and 40 subjects were controls who were individually matched to the lesion subjects on the basis of age, sex, and socioeconomic status. Each subject was given the Short-Form of Benton's Test of Facial Recognition. Data were analyzed using the Wilcoxon matched-pairs signed-rank test and multiple regression.

Results: The lesion subjects performed significantly more poorly than did matched controls. There was no clear-cut lateralization effect, with the left-hemisphere group performing significantly more poorly than matched controls and the right-hemisphere group showing a trend toward poorer performance. Parietal lobe involvement, regardless of lesion side, adversely affected facial recognition performance in the lesion group. Results could not be accounted for by IQ differences between lesion and control groups, nor was lesion severity systematically related to facial recognition performance.

Conclusions: Pre- or perinatal unilateral brain damage results in a subtle disturbance in facial recognition ability, independent of the side of the lesion. Parietal lobe involvement, in particular, has an adverse effect on facial recognition skills. These findings suggest that the parietal lobes may be involved in the acquisition of facial recognition ability from a very early point in brain development, but that there is sufficient potential to reorganize or compensate such that the residual deficits, though significant, are subtle.