Adaptation to sensory loss

Effect of early versus late onset of partial visual loss on judgments of auditory distance

SIGNIFICANCE

It is important to know whether early-onset vision loss and late-onset vision loss are associated with differences in the estimation of distances of sound sources within the environment. People with vision loss rely heavily on auditory cues for path planning, safe navigation, avoiding collisions, and activities of daily living.

PURPOSE

Loss of vision can lead to substantial changes in auditory abilities. It is unclear whether differences in sound distance estimation exist in people with early-onset partial vision loss, late-onset partial vision loss, and normal vision. We investigated distance estimates for a range of sound sources and auditory environments in groups of participants with early- or late-onset partial visual loss and sighted controls.

METHODS

Fifty-two participants heard static sounds with virtual distances ranging from 1.2 to 13.8 m within a simulated room. The room simulated either anechoic (no echoes) or reverberant environments. Stimuli were speech, music, or noise. Single sounds were presented, and participants reported the estimated distance of the sound source. Each participant took part in 480 trials.

RESULTS

Analysis of variance showed significant main effects of visual status (p<0.05) environment (reverberant vs. anechoic, p<0.05) and also of the stimulus (p<0.05). Significant differences (p<0.05) were shown in the estimation of distances of sound sources between early-onset visually impaired participants and sighted controls for closer distances for all conditions except the anechoic speech condition and at middle distances for all conditions except the reverberant speech and music conditions. Late-onset visually impaired participants and sighted controls showed similar performance (p>0.05).

CONCLUSIONS

The findings suggest that early-onset partial vision loss results in significant changes in judged auditory distance in different environments, especially for close and middle distances. Late-onset partial visual loss has less of an impact on the ability to estimate the distance of sound sources. The findings are consistent with a theoretical framework, the perceptual restructuring hypothesis, which was recently proposed to account for the effects of vision loss on audition.

"Love looks not with the eyes": supranormal processing of emotional speech in individuals with late-blindness versus preserved processing in individuals with congenital-blindness

Processing of emotional speech in the absence of visual information relies on two auditory channels: semantics and prosody. No study to date has investigated how blindness impacts this process. Two theories, Perceptual Deficit, and Sensory Compensation, yiled different expectations about the role of visual experience (or its lack thereof) in processing emotional speech. To test the effect of vision and early visual experience on processing of emotional speech, we compared individuals with congenital blindness (CB, n = 17), individuals with late blindness (LB, n = 15), and sighted controls (SC, n = 21) on identification and selective-attention of semantic and prosodic spoken-emotions. Results showed that individuals with blindness performed at least as well as SC, supporting Sensory Compensation and the role of cortical reorganisation. Individuals with LB outperformed individuals with CB, in accordance with Perceptual Deficit, supporting the role of early visual experience. The LB advantage was moderated by executive functions (working-memory). Namely, the advantage was erased for individuals with CB who showed higher levels of executive functions. Results suggest that vision is not necessary for processing of emotional speech, but early visual experience could improve it. The findings support a combination of the two aforementioned theories and reject a dichotomous view of deficiencies/enhancements of blindness.

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

Auditory-motor and visual-motor networks are often coupled in daily activities, such as when listening to music and dancing; but these networks are known to be highly malleable as a function of sensory input. Thus, congenital deafness may modify neural activities within the connections between the motor, auditory, and visual cortices. Here, we investigated whether the cortical responses of children with cochlear implants (CI) to a simple and repetitive motor task would differ from that of children with typical hearing (TH) and we sought to understand whether this response related to their language development. Participants were 75 school-aged children, including 50 with CI (with varying language abilities) and 25 controls with TH. We used functional near-infrared spectroscopy (fNIRS) to record cortical responses over the whole brain, as children squeezed the back triggers of a joystick that vibrated or not with the squeeze. Motor cortex activity was reflected by an increase in oxygenated hemoglobin concentration (HbO) and a decrease in deoxygenated hemoglobin concentration (HbR) in all children, irrespective of their hearing status. Unexpectedly, the visual cortex (supposedly an irrelevant region) was deactivated in this task, particularly for children with CI who had good language skills when compared to those with CI who had language delays. Presence or absence of vibrotactile feedback made no difference in cortical activation. These findings support the potential of fNIRS to examine cognitive functions related to language in children with CI.

Social perception in deaf individuals: A meta-analysis of neuroimaging studies

Deaf individuals may report difficulties in social interactions. However, whether these difficulties depend on deafness affecting social brain circuits is controversial. Here, we report the first meta-analysis comparing brain activations of hearing and (prelingually) deaf individuals during social perception. Our findings showed that deafness does not impact on the functional mechanisms supporting social perception. Indeed, both deaf and hearing control participants recruited regions of the action observation network during performance of different social tasks employing visual stimuli, and including biological motion perception, face identification, action observation, viewing, identification and memory for signs and lip reading. Moreover, we found increased recruitment of the superior-middle temporal cortex in deaf individuals compared with hearing participants, suggesting a preserved and augmented function during social communication based on signs and lip movements. Overall, our meta-analysis suggests that social difficulties experienced by deaf individuals are unlikely to be associated with brain alterations but may rather depend on non-supportive environments.

Late Blindness and Deafness are Associated with Decreased Tactile Sensitivity, But Early Blindness is Not

Perceptual experience is shaped by a complex interaction between our sensory systems in which each sense conveys information on specific properties of our surroundings. This multisensory processing of complementary information improves the accuracy of our perceptual judgments and leads to more precise and faster reactions. Sensory impairment or loss in one modality leads to information deficiency that can impact other senses in various ways. For early auditory or visual loss, impairment and/or compensatory increase of the sensitivity of other senses are equally well described. Investigating individuals with deafness (N = 73), early (N = 51), late blindness (N = 49) and corresponding controls, we compared tactile sensitivity using the standard monofilament test on two locations, the finger and handback. Results indicate lower tactile sensitivity in people with deafness and late blindness but not in people with early blindness compared to respective controls, irrespective of stimulation location, gender, and age. Results indicate that neither sensory compensation nor simple use-dependency or a hindered development of the tactile sensory system is sufficient to explain changes in somatosensation after the sensory loss but that a complex interaction of effects is present.

Gyrification in relation to cortical thickness in the congenitally blind

Greater cortical gyrification (GY) is linked with enhanced cognitive abilities and is also negatively related to cortical thickness (CT). Individuals who are congenitally blind (CB) exhibits remarkable functional brain plasticity which enables them to perform certain non-visual and cognitive tasks with supranormal abilities. For instance, extensive training using touch and audition enables CB people to develop impressive skills and there is evidence linking these skills to cross-modal activations of primary visual areas. There is a cascade of anatomical, morphometric and functional-connectivity changes in non-visual structures, volumetric reductions in several components of the visual system, and CT is also increased in CB. No study to date has explored GY changes in this population, and no study has explored how variations in CT are related to GY changes in CB. T1-weighted 3D structural magnetic resonance imaging scans were acquired to examine the effects of congenital visual deprivation in cortical structures in a healthy sample of 11 CB individuals (6 male) and 16 age-matched sighted controls (SC) (10 male). In this report, we show for the first time an increase in GY in several brain areas of CB individuals compared to SC, and a negative relationship between GY and CT in the CB brain in several different cortical areas. We discuss the implications of our findings and the contributions of developmental factors and synaptogenesis to the relationship between CT and GY in CB individuals compared to SC. F.

How Face Masks Affect the Use of Echolocation by Individuals With Visual Impairments During COVID-19: International Cross-sectional Online Survey

Background

Although a critical safety measure, preliminary studies have suggested that the use of a face mask may pose a problem for some users with disabilities. To date, little is known about how the wearing of a traditional face mask may pose a barrier to individuals with visual impairments who draw on auditory cues and echolocation techniques during independent travel.

Objective

The goal of this study was to document the difficulties, if any, encountered during orientation and mobility due to the use of a face mask during the COVID-19 pandemic and the strategies used to address these barriers.

Methods

In total, 135 individuals aged 18 years and older who self-identified as being blind, being deafblind, or having low vision and who could communicate in either English or French completed an anonymous cross-sectional online survey between March 29 and August 23, 2021.

Results

In total, 135 respondents (n=52, 38.5%, men; n=83, 61.5%, women) between the ages of 18 and 79 (mean 48.22, SD 14.48) years participated. Overall, 78 (57.7%) self-identified as blind and 57 (42.3%) as having low vision. In addition, 13 (9.6%) identified as having a combined vision and hearing loss and 3 (2.2%) as deafblind. The most common face coverings used were cloth (n=119, 88.1%) and surgical masks (n=74, 54.8%). Among the barriers raised, participants highlighted that face masks made it more difficult to locate people (n=86, 63.7%), communicate with others (n=101, 74.8%), and locate landmarks (n=82, 60.7%). Although the percentage of those who used a white cane before the pandemic did not substantially change, 6 (14.6%) of the 41 participants who were guide dog users prior to the pandemic reported no longer working with a guide dog at the time of the survey. Moreover, although guide dog users reported the highest level of confidence with independent travel before the pandemic, they indicated the lowest level of confidence a year after the pandemic began.

Conclusions

These results suggest that participants were less able to draw on nonvisual cues during independent travel and social interactions due to the use of a facemask, contributing to a reduction in perceived self-confidence and independence. Findings inform the development of evidence-based recommendations to address identified barriers.

Evidence of visual crossmodal reorganization positively relates to speech outcomes in cochlear implant users

Deaf individuals who use a cochlear implant (CI) have remarkably different outcomes for auditory speech communication ability. One factor assumed to affect CI outcomes is visual crossmodal plasticity in auditory cortex, where deprived auditory regions begin to support non-auditory functions such as vision. Previous research has viewed crossmodal plasticity as harmful for speech outcomes for CI users if it interferes with sound processing, while others have demonstrated that plasticity related to visual language may be beneficial for speech recovery. To clarify, we used electroencephalography (EEG) to measure brain responses to a partial face speaking a silent single-syllable word (visual language) in 15 CI users and 13 age-matched typical-hearing controls. We used source analysis on EEG activity to measure crossmodal visual responses in auditory cortex and then compared them to CI users' speech-in-noise listening ability. CI users' brain response to the onset of the video stimulus (face) was larger than controls in left auditory cortex, consistent with crossmodal activation after deafness. CI users also produced a mixture of alpha (8-12 Hz) synchronization and desynchronization in auditory cortex while watching lip movement while controls instead showed desynchronization. CI users with higher speech scores had stronger crossmodal responses in auditory cortex to the onset of the video, but those with lower speech scores had increases in alpha power during lip movement in auditory areas. Therefore, evidence of crossmodal reorganization in CI users does not necessarily predict poor speech outcomes, and differences in crossmodal activation during lip reading may instead relate to strategies or differences that CI users use in audiovisual speech communication.

Lifelong changes of neurotransmitter receptor expression and debilitation of hippocampal synaptic plasticity following early postnatal blindness

In the weeks immediately after onset of sensory loss, extensive reorganization of both the cortex and hippocampus occurs. Two fundamental characteristics comprise widespread changes in the relative expression of GABA and glutamate receptors and debilitation of hippocampal synaptic plasticity. Here, we explored whether recovery from adaptive changes in the expression of plasticity-related neurotransmitter receptors and hippocampal synaptic plasticity occurs in the time-period of up to 12 months after onset of sensory loss. We compared receptor expression in CBA/J mice that develop hereditary blindness, with CBA/CaOlaHsd mice that have intact vision and no deficits in other sensory modalities throughout adulthood. GluN1-subunit expression was reduced and the GluN2A:GluN2B ratio was persistently altered in cortex and hippocampus. GABA-receptor expression was decreased and metabotropic glutamate receptor expression was altered. Hippocampal synaptic plasticity was persistently compromised in vivo. But although LTP in blind mice was chronically impaired throughout adulthood, a recovery of the early phase of LTP became apparent when the animals reached 12 months of age. These data show that cortical and hippocampal adaptation to early postnatal blindness progresses into advanced adulthood and is a process that compromises hippocampal function. A partial recovery of hippocampal synaptic plasticity emerges in advanced adulthood, however.

Cross-modal integration and plasticity in the superior temporal cortex

In congenitally deaf people, temporal regions typically believed to be primarily auditory enhance their response to nonauditory information. The neural mechanisms and functional principles underlying this phenomenon, as well as its impact on auditory recovery after sensory restoration, yet remain debated. In this chapter, we demonstrate that the cross-modal recruitment of temporal regions by visual inputs in congenitally deaf people follows organizational principles known to be present in the hearing brain. We propose that the functional and structural mechanisms allowing optimal convergence of multisensory information in the temporal cortex of hearing people also provide the neural scaffolding for feeding visual or tactile information into the deafened temporal areas. Innate in their nature, such anatomo-functional links between the auditory and other sensory systems would represent the common substrate of both early multisensory integration and expression of selective cross-modal plasticity in the superior temporal cortex.

The Importance of Intact Senses in Mating and Social Assessments Made by Deaf Individuals

Social perception is a multimodal process involving vision and audition as central input sources for human social cognitive processes. However, it remains unclear how profoundly deaf people assess others in the context of mating and social interaction. The current study explored the relative importance of different sensory modalities (vision, smell, and touch) in assessments of opposite- and same-sex strangers. We focused on potential sensory compensation processes in mate selection (i.e., increased importance of the intact senses in forming impressions of an opposite-sex stranger as a potential partner). A total of 74 deaf individuals and 100 normally hearing controls were included in the study sample. We found diminished importance of vision and smell in deaf participants compared with controls for opposite- and same-sex strangers, and increased importance of touch for the assessment of same-sex strangers. The results suggested that deaf people rely less on visual and olfactory cues in mating and social assessments, highlighting a possible role of sign language in shaping interpersonal tactile experience in non-romantic relationships.

Partial visual loss disrupts the relationship between judged room size and sound source distance

Visual spatial information plays an important role in calibrating auditory space. Blindness results in deficits in a number of auditory abilities, which have been explained in terms of the hypothesis that visual information is needed to calibrate audition. When judging the size of a novel room when only auditory cues are available, normally sighted participants may use the location of the farthest sound source to infer the nearest possible distance of the far wall. However, for people with partial visual loss (distinct from blindness in that some vision is present), such a strategy may not be reliable if vision is needed to calibrate auditory cues for distance. In the current study, participants were presented with sounds at different distances (ranging from 1.2 to 13.8 m) in a simulated reverberant (T₆₀ = 700 ms) or anechoic room. Farthest distance judgments and room size judgments (volume and area) were obtained from blindfolded participants (18 normally sighted, 38 partially sighted) for speech, music, and noise stimuli. With sighted participants, the judged room volume and farthest sound source distance estimates were positively correlated (p < 0.05) for all conditions. Participants with visual losses showed no significant correlations for any of the conditions tested. A similar pattern of results was observed for the correlations between farthest distance and room floor area estimates. Results demonstrate that partial visual loss disrupts the relationship between judged room size and sound source distance that is shown by sighted participants.

Perception of Beauty in the Visually Blind: A Pilot Observational Study

BACKGROUND

Blind individuals have demonstrated the ability to detect danger and facial expressions without conscious awareness of visual stimuli. These embodied sensations are believed to be the result of primitive neural networks refined by evolutionary adaptations. We postulate that similar embodied sensations may have evolved to allow blind individuals to perceive beauty.

OBJECTIVE

To determine whether the visually blind can detect physical beauty.

PATIENTS AND METHODS

This observational study consisted of 8 blind and 10 nonblind test subjects and 6 models that were categorized into predetermined beauty categories. Test subjects were individually asked to rate 6 models on a 1 to 10 numerical beauty scale. This process was repeated in both groups while blindfolded (masked). All groups' mean model beauty scores underwent multivariate and univariate analysis.

RESULTS

All groups rated preselected (greater than 8) more beautiful models, higher except for the masked, nonblind group. Intraclass correlation was good in the blind raters with a score of 0.751, whereas poor in the nonblind masked raters with a score of 0.458.

CONCLUSION

This is the first pilot study demonstrating with supporting evidence that blind individuals can detect beauty and supports that beauty may rely on primal forms of messaging that are subconsciously appreciated.

Enhanced Odorant Localization Abilities in Congenitally Blind but not in Late-Blind Individuals

Although often considered a nondominant sense for spatial perception, chemosensory perception can be used to localize the source of an event and potentially help us navigate through our environment. Would blind people who lack the dominant spatial sense-vision-develop enhanced spatial chemosensation or suffer from the lack of visual calibration on spatial chemosensory perception? To investigate this question, we tested odorant localization abilities across nostrils in blind people compared to sighted controls and if the time of vision loss onset modulates those abilities. We observed that congenitally blind individuals (10 subjects) outperformed sighted (20 subjects) and late-blind subjects (10 subjects) in a birhinal localization task using mixed olfactory-trigeminal stimuli. This advantage in congenitally blind people was selective to olfactory localization but not observed for odorant detection or identification. We, therefore, showed that congenital blindness but not blindness acquired late in life is linked to enhanced localization of chemosensory stimuli across nostrils, most probably of the trigeminal component. In addition to previous studies highlighting enhanced localization abilities in auditory and tactile modalities, our current results extend such enhanced abilities to chemosensory localization.

Improvements and Degradation to Spatial Tactile Acuity Among Blind and Deaf Individuals

Cross-modal reorganization takes place for sensory cortices when there is no more primary input. For instance, the visual cortex in blind individuals which receives no visual input starts responding to auditory and tactile stimuli. Reorganization may improve or degrade processing of other modality inputs, via bottom-up compensational processes and top-down updating. In two experiments, we measured the spatial tactile response in a large sample of early- (N = 49) and late-blind (N = 51) individuals with varying levels of Braille proficiencies, and early-deaf (N = 69) with varying levels of hearing devices against separate hearing and sighted controls. Spatial tactile responses were measured using a standard gradient orientation task on two locations, the finger and tongue. Experiments show limited to no advantage in passive tactile response for blind individuals and degradation for deaf individuals at the finger. However, the use of hearing devices decreased the tactile impairment in early-deaf individuals. Also, no differences in age-related decline in both sensory-impaired groups were shown. Results show less tactile acuity differences between blind and sighted than previously reported, but supports recent reports of tactile impairment among the early-deaf.

Altered visuomotor integration in complex regional pain syndrome

During self-guided movements, we optimise performance by combining sensory and self-motion cues optimally, based on their reliability. Discrepancies between such cues and problems in combining them are suggested to underlie some pain conditions. Therefore, we examined whether visuomotor integration is altered in twenty-two participants with upper or lower limb complex regional pain syndrome (CRPS) compared to twenty-four controls. Participants located targets that appeared in the unaffected (CRPS) / dominant (controls) or affected (CRPS) / non-dominant (controls) side of space, using the hand of their unaffected/dominant or affected/non-dominant side of the body. For each side of space and each hand, participants located the target using visual information and no movement (vision only condition), an unseen pointing movement (self-motion only condition), or a visually-guided pointing movement (visuomotor condition). In all four space-by-hand conditions, controls reduced their variability in the visuomotor compared to the vision and self-motion only conditions and in line with a model prediction for optimal integration. Participants with CRPS showed similar evidence of cue combination in two of the four conditions. However, they had better-than-optimal integration for the unaffected hand in the affected space. Furthermore, they did not integrate optimally for the hand of the affected side of the body in unaffected space, but instead relied on the visual information. Our results suggest that people with CRPS can optimally integrate visual and self-motion cues under some conditions, despite lower reliability of self-motion cues, and use different strategies to controls.

Sensory Feedback Control of Locomotor Pattern Generation in Cats and Mice

Traditionally, research aimed at the understanding of the sensory control of terrestrial mammalian locomotion has focused on cats as the animal model. But advances in molecular genetics and new methods to record movement in small animals have moved mice into the forefront of locomotor research. In this review article, I will first give an overview of what is known about sensory feedback control of locomotion, mainly emerged from experiments performed on cats. This overview will not be an exhaustive overview, but will rather aim to give a broad picture of what has been learned about the sensory control of locomotion using cats as the animal model. I will then give a brief summary of how the mouse is adding to these insights.

The accuracy of auditory spatial judgments in the visually impaired is dependent on sound source distance

Blindness leads to substantial enhancements in many auditory abilities, and deficits in others. It is unknown how severe visual losses need to be before changes in auditory abilities occur, or whether the relationship between severity of visual loss and changes in auditory abilities is proportional and systematic. Here we show that greater severity of visual loss is associated with increased auditory judgments of distance and room size. On average participants with severe visual losses perceived sounds to be twice as far away, and rooms to be three times larger, than sighted controls. Distance estimates for sighted controls were most accurate for closer sounds and least accurate for farther sounds. As the severity of visual impairment increased, accuracy decreased for closer sounds and increased for farther sounds. However, it is for closer sounds that accurate judgments are needed to guide rapid motor responses to auditory events, e.g. planning a safe path through a busy street to avoid collisions with other people, and falls. Interestingly, greater visual impairment severity was associated with more accurate room size estimates. The results support a new hypothesis that crossmodal calibration of audition by vision depends on the severity of visual loss.

Contribution of Vision, Touch, and Hearing to the Use of Sham Devices in Acupuncture-Related Studies

This study investigates whether visual deprivation influences participants' accuracy in differentiating between real and sham acupuncture needles. It also evaluates the relative contributions of tactile, visual, and auditory cues that participants use in their decision-making processes. In addition, a simple sensory decision-making model for research using acupuncture sham devices as comparative controls is proposed. Forty healthy individuals underwent two conditions (blindfolded and sighted) in random sequence. Four sham and four real needles were randomly applied to the participants' lower limb acupoints (ST32 to ST39). Participants responded which needle type was applied. Participants then verbally answered a questionnaire on which sensory cues influenced their decision-making. The proportion of correct judgments, P(C), was calculated to indicate the participants' accuracy in distinguishing between the needle types. Visual deprivation did not significantly influence the participants' discrimination accuracy. Tactile cues were the dominant sensory modality used in decision-making, followed by visual and auditory cues. Sharp and blunt sensations were associated with the real and sham needles, respectively, for both conditions. This study confirmed that tactile cues were the main sensory modalities used in participant decision-making during acupuncture administration. Also, short-term blindfolding of participants during procedures will unlikely influence blinding effectiveness. CLINICAL TRIAL REGISTRATION NUMBER: Not applicable. This study does not fall under the definition of a clinical trial under the ICMJE guidelines.

Brain (re)organization following visual loss

The study of the neural consequences of sensory loss provides a unique window into the brain's functional and organizational principles. Although the blind visual cortex has been implicated in the cross-modal processing of nonvisual inputs for quite some time, recent research has shown that certain cortical organizational principles are preserved even in the case of complete sensory loss. Furthermore, a growing body of work has shown that markers of neuroplasticity extend to neuroanatomical metrics that include cortical thickness and myelinization. Although our understanding of the mechanisms that underlie sensory deprivation-driven cross-modal plasticity is improving, several critical questions remain unanswered. The specific pathways that underlie the rerouting of nonvisual information, for instance, have not been fully elucidated. The fact that important cross-modal recruitment occurs following transient deprivation in sighted individuals suggests that significant rewiring following blindness may not be required. Furthermore, there are marked individual differences regarding the magnitude and functional relevance of the cross-modal reorganization. It is also not clear to what extent precise environmental factors may play a role in establishing the degree of reorganization across individuals, as opposed to factors that might specifically relate to the cause or the nature of the visual loss. In sum, although many unresolved questions remain, sensory deprivation continues to be an excellent model for studying the plastic nature of the brain. This article is categorized under: Psychology > Brain Function and Dysfunction Psychology > Perception and Psychophysics Neuroscience > Plasticity.

Neurophysiological evidence for enhanced tactile acuity in early blindness in some but not all haptic tasks

Previous research assessing the presence of enhanced tactile skills in early-blind (EB) population obtained conflicting results. Most of the studies relied on behavioral measures with which different mechanisms leading to the same outcome go unnoticed. Moreover, the scarce electrophysiological research that has been conducted focused exclusively on the processing of microgeometric properties. To clarify the extent of superior tactile abilities in EBs using high-density multichannel electrophysiological recordings, the present study compared the electrophysiological correlates of EBs and sighted controls (CON) in two tactile discrimination tasks that targeted microgeometric (texture) and macrogeometric (shape) properties. After a restricted exploration (haptic glance), participants judged whether a touched stimulus corresponded to an expected stimulus whose name had been previously presented aurally. In the texture discrimination task, differences between groups emerged at ∼75 ms (early perceptual processing stages) whereas we found no between-group differences during shape discrimination. Furthermore, for the first time, we were able to determine the latency at which EBs started to discriminate micro- (EB: 170 ms; CON: 230 ms) and macrogeometric (EB: 250 ms; CON: 270 ms) properties. Altogether, the results suggest different electrophysiological signatures during texture (but not shape) discrimination in EBs, possibly due to cortical reorganization in occipital areas and their increased connectivity with S1.

Partial Visual Loss Affects Self-reports of Hearing Abilities Measured Using a Modified Version of the Speech, Spatial, and Qualities of Hearing Questionnaire

We assessed how visually impaired (VI) people perceived their own auditory abilities using an established hearing questionnaire, the Speech, Spatial, and Qualities of Hearing Scale (SSQ), that was adapted to make it relevant and applicable to VI individuals by removing references to visual aspects while retaining the meaning of the original questions. The resulting questionnaire, the SSQvi, assessed perceived hearing ability in diverse situations including the ability to follow conversations with multiple speakers, assessing how far away a vehicle is, and the ability to perceptually segregate simultaneous sounds. The SSQvi was administered to 33 VI and 33 normally sighted participants. All participants had normal hearing or mild hearing loss, and all VI participants had some residual visual ability. VI participants gave significantly higher (better) scores than sighted participants for: (i) one speech question, indicating less difficulty in following a conversation that switches from one person to another, (ii) one spatial question, indicating less difficulty in localizing several talkers, (iii) three qualities questions, indicating less difficulty with segregating speech from music, hearing music more clearly, and better speech intelligibility in a car. These findings are consistent with the perceptual enhancement hypothesis, that certain auditory abilities are improved to help compensate for loss of vision, and show that full visual loss is not necessary for perceived changes in auditory ability to occur for a range of auditory situations. For all other questions, scores were not significantly different between the two groups. Questions related to effort, concentration, and ignoring distracting sounds were rated as most difficult for VI participants, as were situations involving divided-attention contexts with multiple streams of speech, following conversations in noise and in echoic environments, judging elevation or distance, and externalizing sounds. The questionnaire has potential clinical applications in assessing the success of clinical interventions and setting more realistic goals for intervention for those with auditory and/or visual losses. The results contribute toward providing benchmark scores for VI individuals.

Blindness enhances auditory obstacle circumvention: Assessing echolocation, sensory substitution, and visual-based navigation

Performance for an obstacle circumvention task was assessed under conditions of visual, auditory only (using echolocation) and tactile (using a sensory substitution device, SSD) guidance. A Vicon motion capture system was used to measure human movement kinematics objectively. Ten normally sighted participants, 8 blind non-echolocators, and 1 blind expert echolocator navigated around a 0.6 x 2 m obstacle that was varied in position across trials, at the midline of the participant or 25 cm to the right or left. Although visual guidance was the most effective, participants successfully circumvented the obstacle in the majority of trials under auditory or SSD guidance. Using audition, blind non-echolocators navigated more effectively than blindfolded sighted individuals with fewer collisions, lower movement times, fewer velocity corrections and greater obstacle detection ranges. The blind expert echolocator displayed performance similar to or better than that for the other groups using audition, but was comparable to that for the other groups using the SSD. The generally better performance of blind than of sighted participants is consistent with the perceptual enhancement hypothesis that individuals with severe visual deficits develop improved auditory abilities to compensate for visual loss, here shown by faster, more fluid, and more accurate navigation around obstacles using sound.

Auditory Spatial Perception without Vision

Valuable insights into the role played by visual experience in shaping spatial representations can be gained by studying the effects of visual deprivation on the remaining sensory modalities. For instance, it has long been debated how spatial hearing evolves in the absence of visual input. While several anecdotal accounts tend to associate complete blindness with exceptional hearing abilities, experimental evidence supporting such claims is, however, matched by nearly equal amounts of evidence documenting spatial hearing deficits. The purpose of this review is to summarize the key findings which support either enhancements or deficits in spatial hearing observed following visual loss and to provide a conceptual framework that isolates the specific conditions under which they occur. Available evidence will be examined in terms of spatial dimensions (horizontal, vertical, and depth perception) and in terms of frames of reference (egocentric and allocentric). Evidence suggests that while early blind individuals show superior spatial hearing in the horizontal plane, they also show significant deficits in the vertical plane. Potential explanations underlying these contrasting findings will be discussed. Early blind individuals also show spatial hearing impairments when performing tasks that require the use of an allocentric frame of reference. Results obtained with late-onset blind individuals suggest that early visual experience plays a key role in the development of both spatial hearing enhancements and deficits.

Auditory spatial representations of the world are compressed in blind humans

Compared to sighted listeners, blind listeners often display enhanced auditory spatial abilities such as localization in azimuth. However, less is known about whether blind humans can accurately judge distance in extrapersonal space using auditory cues alone. Using virtualization techniques, we show that auditory spatial representations of the world beyond the peripersonal space of blind listeners are compressed compared to those for normally sighted controls. Blind participants overestimated the distance to nearby sources and underestimated the distance to remote sound sources, in both reverberant and anechoic environments, and for speech, music, and noise signals. Functions relating judged and actual virtual distance were well fitted by compressive power functions, indicating that the absence of visual information regarding the distance of sound sources may prevent accurate calibration of the distance information provided by auditory signals.

Auditory distance perception in humans: a review of cues, development, neuronal bases, and effects of sensory loss

Auditory distance perception plays a major role in spatial awareness, enabling location of objects and avoidance of obstacles in the environment. However, it remains under-researched relative to studies of the directional aspect of sound localization. This review focuses on the following four aspects of auditory distance perception: cue processing, development, consequences of visual and auditory loss, and neurological bases. The several auditory distance cues vary in their effective ranges in peripersonal and extrapersonal space. The primary cues are sound level, reverberation, and frequency. Nonperceptual factors, including the importance of the auditory event to the listener, also can affect perceived distance. Basic internal representations of auditory distance emerge at approximately 6 months of age in humans. Although visual information plays an important role in calibrating auditory space, sensorimotor contingencies can be used for calibration when vision is unavailable. Blind individuals often manifest supranormal abilities to judge relative distance but show a deficit in absolute distance judgments. Following hearing loss, the use of auditory level as a distance cue remains robust, while the reverberation cue becomes less effective. Previous studies have not found evidence that hearing-aid processing affects perceived auditory distance. Studies investigating the brain areas involved in processing different acoustic distance cues are described. Finally, suggestions are given for further research on auditory distance perception, including broader investigation of how background noise and multiple sound sources affect perceived auditory distance for those with sensory loss.

Brain Plasticity in Blind Subjects Centralizes Beyond the Modal Cortices

It is well established that the human brain reorganizes following sensory deprivations. In blind individuals, visual processing regions including the lateral occipital cortex (LOC) are activated by auditory and tactile stimuli as demonstrated by neurophysiological and neuroimaging investigations. The mechanisms for such plasticity remain unclear, but shifts in connectivity across existing neural networks appear to play a critical role. The majority of research efforts to date have focused on neuroplastic changes within visual unimodal regions, however we hypothesized that neuroplastic alterations may also occur in brain networks beyond the visual cortices including involvement of multimodal integration regions and heteromodal cortices. In this study, two recently developed graph-theory based functional connectivity analyses, interconnector analyses and local and distant connectivity, were applied to investigate functional reorganization in regional and distributed neural-systems in late-onset blind (LB) and congenitally blind (CB) cohorts each compared to their own group of sighted controls. While functional network alterations as measured by the degree of differential links (DDL) occurred in sensory cortices, neuroplastic changes were most prominent within multimodal and association cortices. Subjects with LB showed enhanced multimodal integration connections in the parieto-opercular, temporoparietal junction (TPJ) and ventral premotor (vPM) regions, while CB individuals exhibited increased superior parietal cortex (SPC) connections. This study reveals the critical role of recipient multi-sensory integration areas in network reorganization and cross-modal plasticity in blind individuals. These findings suggest that aspects of cross-modal neuroplasticity and adaptive sensory-motor and auditory functions may potentially occur through reorganization in multimodal integration regions.

A inclusão de surdos no trânsito

RESUMO: Objetivo: investigar como se dá o processo de inclusão de surdos no cenário do trânsito. Métodos: participaram do estudo 20 sujeitos, divididos em três grupos: G1, composto por 10 surdos; G2 composto por cinco profissionais de uma instituição de referência em assistência a sujeitos com necessidades educacionais específicas e G3 composto por cinco profissionais de um Departamento Estadual de Trânsito. Foram aplicadas entrevistas gravadas em áudio e vídeo, cujas respostas foram analisadas por meio do software Qualiquantisoft e aquelas com sentido semelhante foram reunidas para a construção de discursos do sujeito coletivo, tendo como base o método proposto por Lefèvre e Lefèvre. Resultados: os discursos do sujeito coletivo apontam para dificuldades na acessibilidade de surdos no trânsito e no processo de obtenção e renovação da carteira nacional de habilitação. De uma forma geral, todos os grupos apontaram sugestões como: a necessidade de intérprete para mediar o processo, a capacitação de profissionais para atenderem surdos e a realização da prova teórica em Libras, utilizando recursos de vídeo. Conclusão: embora haja avanços, há inúmeras falhas no que se trata da acessibilidade de pessoas surdas tanto no processo de obtenção/renovação da carteira nacional de habilitação quanto no trânsito. Portanto, é urgente que seja discutida a realidade enfrentada por essa população, visando soluções que possam garantir aos surdos não apenas o acesso ao trânsito, mas também a construção e adequada execução de políticas públicas que venham a lhes fornecer acessibilidade e segurança.

Early visual deprivation changes cortical anatomical covariance in dorsal-stream structures

Early blind individuals possess thicker occipital cortex compared to sighted ones. Occipital cortical thickness is also predictive of performance on several auditory discrimination tasks in the blind, which suggests that it can serve as a neuroanatomical marker of auditory behavioural abilities. In light of this atypical relationship between occipital thickness and auditory function, we sought to investigate here the covariation of occipital cortical morphology in occipital areas with that of all other areas across the cortical surface, to assess whether the anatomical covariance with the occipital cortex differs between early blind and sighted individuals. We observed a reduction in anatomical covariance between the right occipital cortex and several areas of the visual dorsal stream in a group of early blind individuals relative to sighted controls. In a separate analysis, we show that the performance of the early blind in a transposed melody discrimination task was strongly predicted by the strength of the cortical covariance between the occipital cortex and intraparietal sulcus, a region for which cortical thickness in the sighted was previously shown to predict performance in the same task. These findings therefore constitute the first evidence linking altered anatomical covariance to early sensory deprivation. Moreover, since covariation of cortical morphology could potentially be related to anatomical connectivity or driven by experience-dependent plasticity, it could consequently help guide future functional connectivity and diffusion tractography studies.

Evidence for both compensatory plastic and disuse atrophy-related neuroanatomical changes in the blind

The behavioural and neurofunctional consequences of blindness are becoming increasingly well established, and it has become evident that the amount of reorganization is directly linked to the behavioural adaptations observed in the blind. However investigations of potential neuroanatomical changes resulting from blindness have yielded conflicting results as to the nature of the observed changes, because apparent loss of occipital tissue is difficult to reconcile with observed functional recruitment. To address this issue we used two complementary brain measures of neuroanatomy, voxel-based morphometry and magnetization transfer imaging, with the latter providing insight into myelin concentration through the magnetization transfer ratio. Both early and late blind, as well as sighted control subjects participated in the study and were tested on a series of auditory and tactile tasks to provide behavioural data that we could relate to neuroanatomy. The behavioural findings show that the early blind outperform the sighted in four of five tasks, whereas the late blind do so for only one. Moreover, correlations between the auditory and tactile performance of early blind individuals seem to indicate that they might benefit from some general-purpose compensatory plasticity mechanisms, as opposed to modality-specific ones. Neuroanatomical findings reveal three key findings: (i) occipital regions in the early blind have higher magnetization transfer ratio and grey matter concentration than in the sighted; (ii) behavioural performance of the blind is strongly predicted by magnetization transfer ratio and grey matter concentration in different occipital regions; and (iii) lower grey matter and white matter concentration was also found in other occipital areas in the early blind compared to the sighted. We thus show a clear dissociation between anatomical changes that are direct result of sensory deprivation and consequent atrophy, and those related to compensatory reorganization and behavioural adaptations. Moreover, the magnetization transfer ratio results also suggest that one mechanism for this reorganization may be related to increased myelination of intracortical neurons, or perhaps of fibres conveying information to and from remote locations.

Enhancement of visual motion detection thresholds in early deaf people

In deaf people, the auditory cortex can reorganize to support visual motion processing. Although this cross-modal reorganization has long been thought to subserve enhanced visual abilities, previous research has been unsuccessful at identifying behavioural enhancements specific to motion processing. Recently, research with congenitally deaf cats has uncovered an enhancement for visual motion detection. Our goal was to test for a similar difference between deaf and hearing people. We tested 16 early and profoundly deaf participants and 20 hearing controls. Participants completed a visual motion detection task, in which they were asked to determine which of two sinusoidal gratings was moving. The speed of the moving grating varied according to an adaptive staircase procedure, allowing us to determine the lowest speed necessary for participants to detect motion. Consistent with previous research in deaf cats, the deaf group had lower motion detection thresholds than the hearing. This finding supports the proposal that cross-modal reorganization after sensory deprivation will occur for supramodal sensory features and preserve the output functions.

A summary of research investigating echolocation abilities of blind and sighted humans

There is currently considerable interest in the consequences of loss in one sensory modality on the remaining senses. Much of this work has focused on the development of enhanced auditory abilities among blind individuals, who are often able to use sound to navigate through space. It has now been established that many blind individuals produce sound emissions and use the returning echoes to provide them with information about objects in their surroundings, in a similar manner to bats navigating in the dark. In this review, we summarize current knowledge regarding human echolocation. Some blind individuals develop remarkable echolocation abilities, and are able to assess the position, size, distance, shape, and material of objects using reflected sound waves. After training, normally sighted people are also able to use echolocation to perceive objects, and can develop abilities comparable to, but typically somewhat poorer than, those of blind people. The underlying cues and mechanisms, operable range, spatial acuity and neurological underpinnings of echolocation are described. Echolocation can result in functional real life benefits. It is possible that these benefits can be optimized via suitable training, especially among those with recently acquired blindness, but this requires further study. Areas for further research are identified.

Altered intrinsic neuronal interactions in the visual cortex of the blind

In congenital blindness, the brain develops under severe sensory deprivation and undergoes remarkable plastic changes in both structure and function. Visually deprived occipital cortical regions are histologically and morphologically altered and exhibit a strikingly remodeled functional state: absolute levels of neural activity are heightened and are modulated by nonvisual sensory stimulation as well as higher cognitive processes. However, the neuronal mechanisms that underlie this altered functional state remain largely unknown. Here, we show that the visual cortex of the congenitally blind exhibits a characteristic gain in frequency-specific intrinsic neuronal interactions. We studied oscillatory activity in 11 congenitally blind humans and matched sighted control subjects with magnetoencephalography at rest. We found increased spontaneous correlations of delta band (1-3 Hz) and gamma band (76-128 Hz) oscillations across the visual cortex of the blind that were functionally coupled. Local delta phase modulated gamma amplitude. Furthermore, classical resting rhythms (8-20 Hz) were reduced in amplitude but showed no altered correlation pattern. Our results suggest that both decreased inhibition and circuit mechanisms that support active processing are intrinsic features underlying the altered functional state of the visual cortex in congenitally blind individuals.

Assessment of the caudate nucleus and its relation to route learning in both congenital and late blind individuals

Background

In the absence of visual input, the question arises as to how complex spatial abilities develop and how the brain adapts to the absence of this modality. As such, the aim of the current study was to investigate the relationship between visual status and an important brain structure with a well established role in spatial cognition and navigation, the caudate nucleus. We conducted a volumetric analysis of the caudate nucleus in congenitally and late blind individuals, as well as in matched sighted control subjects.

Results

No differences in the volume of the structure were found either between congenitally blind (CB) and matched sighted controls or between late blind (LB) and matched sighted controls. Moreover, contrary to what was expected, no significant correlation was found between caudate volume and performance in a spatial navigation task. Finally, consistent with previously published reports, the volume of the caudate nucleus was found to be negatively correlated with age in the sighted; however such correlations were not significant in the blind groups.

Conclusion

Although there were no group differences, the absence of an age-volume correlation in the blind suggests that visual deprivation may still have an effect on the developmental changes that occur in the caudate nucleus.

Sensitive and critical periods in visual sensory deprivation

While the demonstration of crossmodal plasticity is well established in congenital and early blind individuals, great debate still surrounds whether those who acquire blindness later in life can also benefit from such compensatory changes. No proper consensus has been reached despite the fact that a proper understanding of the developmental time course of these changes, and whether their occurrence is limited to—or within—specific time windows, is crucial to our understanding of the crossmodal phenomena. An extensive review of the literature reveals that while the majority of investigations to date have examined the crossmodal plasticity available to late blind individuals in quantitative terms, recent findings rather suggest that this reorganization also likely changes qualitatively compared to what is observed in early blindness. This obviously could have significant repercussions not only for the training and rehabilitation of blind individuals, but for the development of appropriate neuroprostheses designed to aid and potentially restore vision. Important parallels will also be drawn with the current state of research on deafness, which is particularly relevant given in the development of successful neuroprostheses (e.g., cochlear implants) for providing auditory input to the central nervous system otherwise aurally deafferented. Lastly, this paper will address important inconsistencies across the literature concerning the definition of distinct blind groups based on the age of blindness onset, and propose several alternatives to using such a categorization.

Evidence for enhanced discrimination of virtual auditory distance among blind listeners using level and direct-to-reverberant cues

Totally blind listeners often demonstrate better than normal capabilities when performing spatial hearing tasks. Accurate representation of three-dimensional auditory space requires the processing of available distance information between the listener and the sound source; however, auditory distance cues vary greatly depending upon the acoustic properties of the environment, and it is not known which distance cues are important to totally blind listeners. Our data show that totally blind listeners display better performance compared to sighted age-matched controls for distance discrimination tasks in anechoic and reverberant virtual rooms simulated using a room-image procedure. Totally blind listeners use two major auditory distance cues to stationary sound sources, level and direct-to-reverberant ratio, more effectively than sighted controls for many of the virtual distances tested. These results show that significant compensation among totally blind listeners for virtual auditory spatial distance leads to benefits across a range of simulated acoustic environments. No significant differences in performance were observed between listeners with partial non-correctable visual losses and sighted controls, suggesting that sensory compensation for virtual distance does not occur for listeners with partial vision loss.

Human echolocation: pitch versus loudness information

Blind persons emit sounds to detect objects by echolocation. Both perceived pitch and perceived loudness of the emitted sound change as they fuse with the reflections from nearby objects. Blind persons generally are better than sighted at echolocation, but it is unclear whether this superiority is related to detection of pitch, loudness, or both. We measured the ability of twelve blind and twenty-five sighted listeners to determine which of two sounds, 500 ms noise bursts, that had been recorded in the presence of a reflecting object in a room with reflecting walls using an artificial head. The sound pairs were original recordings differing in both pitch and loudness, or manipulated recordings with either the pitch or the loudness information removed. Observers responded using a 2AFC method with verbal feedback. For both blind and sighted listeners the performance declined more with the pitch information removed than with the loudness information removed. In addition, the blind performed clearly better than the sighted as long as the pitch information was present, but not when it was removed. Taken together, these results show that the ability to detect pitch is a main factor underlying high performance in human echolocation.

Occipital cortical thickness predicts performance on pitch and musical tasks in blind individuals

The behavioral and neurofunctional consequences of blindness often include performance enhancements and recruitment of occipital regions for nonvisual tasks. How the neuroanatomical changes resulting from this sensory loss relate to these functional changes is, however, less clear. Previous studies using cortical thickness (CT) measures have shown thicker occipital cortex in early-blind (EB) individuals compared with sighted controls. We hypothesized that this finding reflects the crossmodal plasticity often observed in blind individuals and thus could reflect behavioral adaptations. To address this issue, CT measures in blind (early and late) and sighted subjects were obtained along with several auditory behavioral measures in an attempt to relate behavioral and neuroanatomical changes. Group contrasts confirmed previous results in showing thicker occipital cortex in the EB. Regression analyses between CT measures across the whole brain of all blind individuals with the behavioral scores from 2 tasks in which EB subjects were superior (pitch and melody discrimination) showed that CT of occipital areas was directly related to behavioral enhancements. These findings constitute a compelling demonstration that anatomical changes in occipital areas are directly related to heightened behavioral abilities in the blind and hence support the idea that these anatomical features reflect adaptive compensatory plasticity.

Relevance of spectral cues for auditory spatial processing in the occipital cortex of the blind

We have previously shown that some blind individuals can localize sounds more accurately than their sighted counterparts when one ear is obstructed, and that this ability is strongly associated with occipital cortex activity. Given that spectral cues are important for monaurally localizing sounds when one ear is obstructed, and that blind individuals are more sensitive to small spectral differences, we hypothesized that enhanced use of spectral cues via occipital cortex mechanisms could explain the better performance of blind individuals in monaural localization. Using positron-emission tomography (PET), we scanned blind and sighted persons as they discriminated between sounds originating from a single spatial position, but with different spectral profiles that simulated different spatial positions based on head-related transfer functions. We show here that a sub-group of early blind individuals showing superior monaural sound localization abilities performed significantly better than any other group on this spectral discrimination task. For all groups, performance was best for stimuli simulating peripheral positions, consistent with the notion that spectral cues are more helpful for discriminating peripheral sources. PET results showed that all blind groups showed cerebral blood flow increases in the occipital cortex; but this was also the case in the sighted group. A voxel-wise covariation analysis showed that more occipital recruitment was associated with better performance across all blind subjects but not the sighted. An inter-regional covariation analysis showed that the occipital activity in the blind covaried with that of several frontal and parietal regions known for their role in auditory spatial processing. Overall, these results support the notion that the superior ability of a sub-group of early-blind individuals to localize sounds is mediated by their superior ability to use spectral cues, and that this ability is subserved by cortical processing in the occipital cortex.

The nature of working memory for Braille

Blind individuals have been shown on multiple occasions to compensate for their loss of sight by developing exceptional abilities in their remaining senses. While most research has been focused on perceptual abilities per se in the auditory and tactile modalities, recent work has also investigated higher-order processes involving memory and language functions. Here we examined tactile working memory for Braille in two groups of visually challenged individuals (completely blind subjects, CBS; blind with residual vision, BRV). In a first experimental procedure both groups were given a Braille tactile memory span task with and without articulatory suppression, while the BRV and a sighted group performed a visual version of the task. It was shown that the Braille tactile working memory (BrWM) of CBS individuals under articulatory suppression is as efficient as that of sighted individuals' visual working memory in the same condition. Moreover, the results suggest that BrWM may be more robust in the CBS than in the BRV subjects, thus pointing to the potential role of visual experience in shaping tactile working memory. A second experiment designed to assess the nature (spatial vs. verbal) of this working memory was then carried out with two new CBS and BRV groups having to perform the Braille task concurrently with a mental arithmetic task or a mental displacement of blocks task. We show that the disruption of memory was greatest when concurrently carrying out the mental displacement of blocks, indicating that the Braille tactile subsystem of working memory is likely spatial in nature in CBS. The results also point to the multimodal nature of working memory and show how experience can shape the development of its subcomponents.