Early visual deprivation from congenital cataracts disrupts activity and functional connectivity in the face network

The development of the face-processing network has been examined with functional neuroimaging, but the effect of visual deprivation early in life on this network is not known. We examined this question in a group of young adults who had been born with dense, central cataracts in both eyes that blocked all visual input to the retina until the cataracts were removed during infancy. We used functional magnetic resonance imaging to examine regions in the "core" and "extended" face networks as participants viewed faces and other objects, and performed a face discrimination task. This task required matching faces on the basis of facial features or on the spacing between the facial features. The Cataract group (a) had reduced discrimination performance on the Spacing task relative to Controls; (b) used the same brain regions as Controls when passively viewing faces or making judgments about faces, but showed reduced activation during passive viewing of faces, especially in extended face-network regions; and (c) unlike Controls, showed activation in face-network regions for objects. In addition, the functional connections of the fusiform gyri with the rest of the face network were altered, and these brain changes were related to Cataract participants' performance on the face discrimination task. These results provide evidence that early visual input is necessary to set up or preserve activity and functional connectivity in the face-processing network that will later mediate expert face processing.