Face Processing in Turner Syndrome
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Face Processing in Turner syndrome Kate Louise Elgar Thesis submitted for the degree of Doctor of Philosophy September 2002 Institute of Child Health, University College London ProQuest Number: 10015080 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest 10015080 Published by ProQuest LLC(2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Abstract This thesis explored the influence of X-linked genes on the development of face- processing abilities. It assessed face-processing abilities in women with Turner syndrome (TS) who have just one, instead of two, X-chromosomes. Study One assessed the nature and severity of face processing deficits by applying a diverse battery of neuropsychological tests to 45,X"’ and control females. Women with TS performed at below average levels in terms of face and emotion recognition (particularly fearful faces) despite processing faces in a typical configurai manner. Study Two found equivalent deficits in 45,X*^ women. Using Voxel Based Morphometry, Study Three found evidence for increased volume of the amygdalae and orbito-frontal cortices in women with TS. Because males, like 45,X females, have a single X-chromosome, Study Four sought to identify whether there was any sexual dimorphism in face processing abilities - there was not. However, differences were found between normal males and females in terms of correlations between face and emotion recognition task performance. These differences were similar to those seen in 45,X"'compared with 45,X'^ females and are consistent with the hypothesis that imprinted X-linked genes influence functional mechanisms that are relevant to social cognition. Together, the results of these studies suggest a role for X-linked genes in the typical development of face processing abilities. This role might involve the development of structures involved in social and emotional processing, including the amygdala and orbito-frontal cortices. It is suggested that affective responses to faces may have an important role in our subsequent memory for them. Ways in which issues raised by these studies could be explored further are discussed. ACKNOWLEDGEMENTS Many thanks to: Ruth Campbell and David Skuse for their support and supervision. Thanks for your enthusiasm, endless patience and always having (or finding) the time! All the participants and their families for the time and information they generously gave and for welcoming me into their homes. Grace Adlam, Beckie Akers, Mike Coleman, Tina Good, Alice Jones, Jonna Kuntsi, Elena Morris, John Morris, Elinore Percy, Emily Prince, Becky Shah and Janneke Terstegge for their invaluable contributions to the ongoing project and great friendship. Everyone at the BBSU for making it such a great place to work. My family for their support and encouragement, always. Andy, for being my best friend. Wouldn’t it be nice... Table of Contents 1 CHAPTER ONE - INTRODUCTION..................................................... 17 1.1 STUDYING GENETIC INFLUENCES ON COGNITIVE DEVELOPMENT..............17 1 2 TURNER SYNDROME - OUTLINE.............................................................................. 19 1.2.1 Historical Perspective................................................................................................20 1.2.2 Diagnosis.....................................................................................................................21 1.2.3 Cytogenetic variants.................................................................................................. 22 1.2.4 Life expectancy.......................................................................................................... 24 1.2.5 Physical abnormalities............................................................................................... 24 1.2.5.1 Short stature......................................................................................................... 24 1.2.5.2 Ovarian Dysgenesis............................................................................................. 26 1.2.5.3 Other physical characteristics.............................................................................27 1.2.6 Turner syndrome - psychological diaracteristics.................................................. 28 1.2.6.1 Cognitive functioning............................................................................................ 28 1.2.6.2 Behavioural and Psycho-social characteristics................................................. 30 1.2.6.3 Psychopathology.................................................................................................. 31 1.2.6.4 Social dysfunction................................................................................................ 32 1.2.7 Turner syndrome - Neuropsychology....................................................................... 33 1.2.7.1 Right hemisphere dysfunction.............................................................................33 1.2.7.2 Occipital/Parietal dysfunction..............................................................................34 1.2.7.3 Neuropathology and neuroimaging.....................................................................35 1.2.7.4 Neural correlates of sœial adjustment drfticutties........................................... ? 36 1.2.8 Insights into social cognitive impairments................................................................37 1.2.8.1 Autistic symptomatology......................................................................................37 1.2.9 Face Processing in Turner syndrome......................................................................42 1.2.9.1 Face perception and face matching....................................................................43 1.2.9.2 Interpreting social information from faces......................................................... 44 1.3 FROM GENES TO BEHAVIOUR...................................................................................45 1.3.1 Haploinsufticiency.......................................................................................................46 4 1.3.2 Genomic imprinting.................................................................................................... 48 1.3.3 Oestrogen................................................................................................................... 51 1.4 CHAPTER SUMMARY....................................................................................... 53 2 CHAPTER TWO - FACE PROCESSING SYSTEMS...................... 56 2.1 OVERVIEW..................................................................................................................... 56 2.2 HISTORICAL PERSPECTIVE....................................................................................... 59 2.3 CONFIGURAL PROCESSING IN FACE RECOGNITION......................................... 60 2.3.1 Sensitivity to first order relations...............................................................................61 2.3.2 Holistic processhg.................................................................................................... 62 2.3.3 Sensitivity to second order relations.........................................................................64 2.4 FACE PERCEPTION....................................................................................................68 2.4.1 The fusiform face area............................................................................................. 69 2.4.1.1 Intra-class discrimination..................................................................................... 70 2.4.1.2 Expertise................................................................................................................71 2.4.1.3 Damage to the fusifonn....................................................................................... 73 2.4.1.4 Developmental prosopagnosia............................................................................74 2.4.1.5 Face processing in developmental disorders.....................................................77 2.4.1.6 Beyond the Fusiform face area........................................................................... 79 2.4.2 Face Perception (œntinued)..................................................................................... 79 2.4.2.1 Parietal lobe...........................................................................................................79 2.5 FACE RECOGNITION AND FACE MEMORY............................................................80 2.5.1 Fusiform Gyrus.......................................................................................................... 80 2.5.2 Hippocampus............................................................................................................. 81 2.5.3 Amygdala.................................................................................................................... 82 2.5.3.1 Damage to the amygdala.....................................................................................84