Multiple-stage impairments of unfamiliar face learning in developmental prosopagnosia: Evidence from fMRI repetition suppression and multi-voxel pattern stability.

Individuals with developmental prosopagnosia (DP) are characterized by severe face recognition deficits, yet it remains unknown how they are hindered in the process of unfamiliar face learning. Here we tracked the changes of neural activation during unfamiliar face repetition in DP with fMRI to reveal their neural deficits in learning unfamiliar faces. At the perceptual level, we found that the bilateral fusiform face area (FFA) in individuals with DP showed attenuated repetition suppression for faces, suggesting an inefficient perceptual analysis for learned faces. At the mnemonic level, individuals with DP showed decreased multi-voxel pattern stability for repeated faces in bilateral medial temporal lobe (MTL), suggesting an unstable mnemonic representation for learned faces. In addition, resting-state functional connectivity between the FFA and MTL was also disrupted in individuals with DP. Finally, the MTL's unstable mnemonic representation was associated with the impaired face recognition performance in DP. In sum, our study provides evidence that individuals with DP showed multi-stage neural deficits in unfamiliar face learning and sheds new light on how unfamiliar faces are learned in normal population.