Organization and reorganization of sensory-deprived cortex

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.

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.

Neural tracking of continuous acoustics: properties, speech-specificity and open questions

Human speech is a particularly relevant acoustic stimulus for our species, due to its role of information transmission during communication. Speech is inherently a dynamic signal, and a recent line of research focused on neural activity following the temporal structure of speech. We review findings that characterise neural dynamics in the processing of continuous acoustics and that allow us to compare these dynamics with temporal aspects in human speech. We highlight properties and constraints that both neural and speech dynamics have, suggesting that auditory neural systems are optimised to process human speech. We then discuss the speech-specificity of neural dynamics and their potential mechanistic origins and summarise open questions in the field.

Brain MRI changes in degenerative cervical myelopathy: a systematic review

BACKGROUND

Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction globally. Associated neurological symptoms and signs have historically been explained by pathobiology within the cervical spine. However, recent advances in imaging have shed light on numerous brain changes in patients with DCM, and it is hypothesised that these changes contribute to DCM pathogenesis. The aetiology, significance, and distribution of these supraspinal changes is currently unknown. The objective was therefore to synthesise all current evidence on brain changes in DCM.

METHODS

A systematic review was performed. Cross-sectional and longitudinal studies with magnetic resonance imaging on a cohort of patients with DCM were eligible. PRISMA guidelines were followed. MEDLINE and Embase were searched to 28th August 2023. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A qualitative synthesis of the literature is presented as per the Synthesis Without Meta-Analysis (SWiM) reporting guideline. The review was registered with PROSPERO (ID: CRD42022298538).

FINDINGS

Of the 2014 studies that were screened, 47 studies were identified that used MRI to investigate brain changes in DCM. In total, 1500 patients with DCM were included in the synthesis, with a mean age of 53 years. Brain alterations on MRI were associated with DCM both before and after surgery, particularly within the sensorimotor network, visual network, default mode network, thalamus and cerebellum. Associations were commonly reported between brain MRI alterations and clinical measures, particularly the Japanese orthopaedic association (JOA) score. Risk of bias of included studies was low to moderate.

INTERPRETATION

The rapidly expanding literature provides mounting evidence for brain changes in DCM. We have identified key structures and pathways that are altered, although there remains uncertainty regarding the directionality and clinical significance of these changes. Future studies with greater sample sizes, more detailed phenotyping and longer follow-up are now needed.

FUNDING

ODM is supported by an Academic Clinical Fellowship at the University of Cambridge. BMD is supported by an NIHR Clinical Doctoral Fellowship at the University of Cambridge (NIHR300696). VFJN is supported by an NIHR Rosetrees Trust Advanced Fellowship (NIHR302544). This project was supported by an award from the Rosetrees Foundation with the Storygate Trust (A2844).

Longitudinal stability of individual brain plasticity patterns in blindness

The primary visual cortex (V1) in individuals born blind is engaged in a wide spectrum of tasks and sensory modalities, including audition, touch, language, and memory. This widespread involvement raises questions regarding the constancy of its role and whether it might exhibit flexibility in its function over time, connecting to diverse network functions in response to task-specific demands. This would suggest that reorganized V1 takes on a role similar to cognitive multiple-demand system regions. Alternatively, it is possible that the varying patterns of plasticity observed in the blind V1 can be attributed to individual factors, whereby different blind individuals recruit V1 for different functions, highlighting the immense idiosyncrasy of plasticity. In support of this second account, we have recently shown that V1 functional connectivity varies greatly across blind individuals. But do these represent stable individual patterns of plasticity or merely instantaneous changes, for a multiple-demand system now inhabiting V1? Here we tested if individual connectivity patterns from the visual cortex of blind individuals are stable over time. We show that over two years, fMRI functional connectivity from the primary visual cortex is unique and highly stable in a small sample of repeatedly sampled congenitally blind individuals. Further, using multivoxel pattern analysis, we demonstrate that the unique reorganization patterns of these individuals allow decoding of participant identity. Together with recent evidence for substantial individual differences in visual cortex connectivity, this indicates there may be a consistent role for the visual cortex in blindness, which may differ for each individual. Further, it suggests that the variability in visual reorganization in blindness across individuals could be used to seek stable neuromarkers for sight rehabilitation and assistive approaches.

The impact of early-life environment on absence epilepsy and neuropsychiatric comorbidities

This review discusses the long-term effects of early-life environment on epileptogenesis, epilepsy, and neuropsychiatric comorbidities with an emphasis on the absence epilepsy. The WAG/Rij rat strain is a well-validated genetic model of absence epilepsy with mild depression-like (dysthymia) comorbidity. Although pathologic phenotype in WAG/Rij rats is genetically determined, convincing evidence presented in this review suggests that the absence epilepsy and depression-like comorbidity in WAG/Rij rats may be governed by early-life events, such as prenatal drug exposure, early-life stress, neonatal maternal separation, neonatal handling, maternal care, environmental enrichment, neonatal sensory impairments, neonatal tactile stimulation, and maternal diet. The data, as presented here, indicate that some early environmental events can promote and accelerate the development of absence seizures and their neuropsychiatric comorbidities, while others may exert anti-epileptogenic and disease-modifying effects. The early environment can lead to phenotypic alterations in offspring due to epigenetic modifications of gene expression, which may have maladaptive consequences or represent a therapeutic value. Targeting DNA methylation with a maternal methyl-enriched diet during the perinatal period appears to be a new preventive epigenetic anti-absence therapy. A number of caveats related to the maternal methyl-enriched diet and prospects for future research are discussed.

The power of vision: calibration of auditory space after sight restoration from congenital cataracts

Early visual deprivation typically results in spatial impairments in other sensory modalities. It has been suggested that, since vision provides the most accurate spatial information, it is used for calibrating space in the other senses. Here we investigated whether sight restoration after prolonged early onset visual impairment can lead to the development of more accurate auditory space perception. We tested participants who were surgically treated for congenital dense bilateral cataracts several years after birth. In Experiment 1 we assessed participants' ability to understand spatial relationships among sounds, by asking them to spatially bisect three consecutive, laterally separated sounds. Participants performed better after surgery than participants tested before. However, they still performed worse than sighted controls. In Experiment 2, we demonstrated that single sound localization in the two-dimensional frontal plane improves quickly after surgery, approaching performance levels of sighted controls. Such recovery seems to be mediated by visual acuity, as participants gaining higher post-surgical visual acuity performed better in both experiments. These findings provide strong support for the hypothesis that vision calibrates auditory space perception. Importantly, this also demonstrates that this process can occur even when vision is restored after years of visual deprivation.

Visual Tract Degradation in Bilateral Normal-Tension Glaucoma-Cortical Thickness Maps and Volumetric Study of Visual Pathway Areas

The aim of the study was to evaluate changes in the central visual pathways during the early and advanced stages of bilateral normal-tension glaucoma (NTG).

METHODS

The studied groups constituted patients with bilateral normal-tension glaucoma of the same stage (n = 45) and age-matched healthy volunteers (n = 17). All patients underwent ophthalmic examination and examination on a 1.5 Tesla Magnetic Resonance Scanner (Optima 360, GE Healthcare). Volume and cortical thickness analyses were performed using the open-source automated software package FreeSurfer.

RESULTS

There was a significant difference in lateral geniculate nuclei volume between the control and advanced glaucoma groups in the right hemisphere (p = 0.03) and in the left hemisphere between the early and advanced glaucoma patients (p = 0.026). The optic chiasm volume differed significantly between the control and advanced NTG groups (p = 0.0003) and between early and advanced glaucoma patients (p = 0.004). Mean cortical thickness analysis revealed a significant increase in values in the advanced glaucoma group in the right Brodmann area 17 (BA17) (p = 0.007) and right BA18 (p = 0.049) as compared to early NTG. In the left BA18 area, the mean thickness of the cortex in the early glaucoma group was significantly lower than in the control group (p = 0.03).

CONCLUSIONS

The increase in the grey matter thickness in the V1 region with more-advanced glaucoma stages may reflect compensatory hypertrophy. Additionally, the regions of the brain early affected during glaucoma with reduced thickness were the right lateral occipital gyrus and left lingual gyrus. The most prominent change during the course of glaucoma was the increase in grey matter thickness in the right cuneus.

Defining neuroplasticity

Neuroplasticity, i.e., the modifiability of the brain, is different in development and adulthood. The first includes changes in: (i) neurogenesis and control of neuron number; (ii) neuronal migration; (iii) differentiation of the somato-dendritic and axonal phenotypes; (iv) formation of connections; (v) cytoarchitectonic differentiation. These changes are often interrelated and can lead to: (vi) system-wide modifications of brain structure as well as to (vii) acquisition of specific functions such as ocular dominance or language. Myelination appears to be plastic both in development and adulthood, at least, in rodents. Adult neuroplasticity is limited, and is mainly expressed as changes in the strength of excitatory and inhibitory synapses while the attempts to regenerate connections have met with limited success. The outcomes of neuroplasticity are not necessarily adaptive, but can also be the cause of neurological and psychiatric pathologies.

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.

The development of allocentric spatial frame in the auditory system

The ability to encode space is a crucial aspect of interacting with the external world. Therefore, this ability appears to be fundamental for the correct development of the capacity to integrate different spatial reference frames. The spatial reference frame seems to be present in all the sensory modalities. However, it has been demonstrated that different sensory modalities follow various developmental courses. Nevertheless, to date these courses have been investigated only in people with sensory impairments, where there is a possible bias due to compensatory strategies and it is complicated to assess the exact age when these skills emerge. For these reasons, we investigated the development of the allocentric frame in the auditory domain in a group of typically developing children aged 6-10 years. To do so, we used an auditory Simon task, a paradigm that involves implicit spatial processing, and we asked children to perform the task in both the uncrossed and crossed hands postures. We demonstrated that the crossed hands posture affected the performance only in younger children (6-7 years), whereas at 10 years of age children performed as adults and were not affected by such posture. Moreover, we found that this task's performance correlated with age and developmental differences in spatial abilities. Our results support the hypothesis that auditory spatial cognition's developmental course is similar to the visual modality development as reported in the literature.

Data-Driven Classification of Spectral Profiles Reveals Brain Region-Specific Plasticity in Blindness

Congenital blindness has been shown to result in behavioral adaptation and neuronal reorganization, but the underlying neuronal mechanisms are largely unknown. Brain rhythms are characteristic for anatomically defined brain regions and provide a putative mechanistic link to cognitive processes. In a novel approach, using magnetoencephalography resting state data of congenitally blind and sighted humans, deprivation-related changes in spectral profiles were mapped to the cortex using clustering and classification procedures. Altered spectral profiles in visual areas suggest changes in visual alpha-gamma band inhibitory-excitatory circuits. Remarkably, spectral profiles were also altered in auditory and right frontal areas showing increased power in theta-to-beta frequency bands in blind compared with sighted individuals, possibly related to adaptive auditory and higher cognitive processing. Moreover, occipital alpha correlated with microstructural white matter properties extending bilaterally across posterior parts of the brain. We provide evidence that visual deprivation selectively modulates spectral profiles, possibly reflecting structural and functional adaptation.

Neuroplasticity and Braille reading

This article brings review of the studies and their findings about neuroplasticity of the brain and Braille reading, as well as some connections between the two. The goal of the article is to combine knowledge from different disciplines, thus enabling development of new efficient programs in rehabilitation. A lot of research has shown the possibility of brain reorganization (plasticity), indicating the creation of new neuron connections in people with vision loss which relate to Braille reading, especially in late-onset vision loss.

Spatial metric in blindness: behavioural and cortical processing

Visual modality dominates spatial perception and, in lack of vision, space representation might be altered. Here we review our work showing that blind individuals have a strong deficit when performing spatial bisection tasks (Gori et al., 2014). We also describe the neural correlates associated with this deficit, as blind individuals do not show the same ERP response mimicking the visual C1 reported in sighted people during spatial bisection (Campus et al., 2019). Interestingly, the deficit is not always evident in late blind individuals, and it is dependent on blindness duration. We report that the deficit disappears when one presents coherent temporal and spatial cues to blind people. This suggests that they may use time information to infer spatial maps (Gori et al., 2018). Finally, we propose a model to explain why blind individuals are impaired in this task, speculating that a lack of vision drives the construction of a multi-sensory cortical network that codes space based on temporal, rather than spatial, coordinates.

Properties of cross-modal occipital responses in early blindness: An ALE meta-analysis

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ALE meta-analysis reveals distributed brain networks for object and spatial functions in individuals with early blindness.

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ALE contrast analysis reveals specific activations in the left cuneus and lingual gyrus for language function, suggesting a reverse hierarchical organization of the visual cortex for early blind individuals.

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The findings contribute to visual rehabilitation in blind individuals by revealing the function-dependent and sensory-independent networks during nonvisual processing.

Cross-modal occipital responses appear to be essential for nonvisual processing in individuals with early blindness. However, it is not clear whether the recruitment of occipital regions depends on functional domain or sensory modality. The current study utilized a coordinate-based meta-analysis to identify the distinct brain regions involved in the functional domains of object, spatial/motion, and language processing and the common brain regions involved in both auditory and tactile modalities in individuals with early blindness. Following the PRISMA guidelines, a total of 55 studies were included in the meta-analysis. The specific analyses revealed the brain regions that are consistently recruited for each function, such as the dorsal fronto-parietal network for spatial function and ventral occipito-temporal network for object function. This is consistent with the literature, suggesting that the two visual streams are preserved in early blind individuals. The contrast analyses found specific activations in the left cuneus and lingual gyrus for language function. This finding is novel and suggests a reverse hierarchical organization of the visual cortex for early blind individuals. The conjunction analyses found common activations in the right middle temporal gyrus, right precuneus and a left parieto-occipital region. Clinically, this work contributes to visual rehabilitation in early blind individuals by revealing the function-dependent and sensory-independent networks during nonvisual processing.

The Sound of Scotoma: Audio Space Representation Reorganization in Individuals With Macular Degeneration

Blindness is an ideal condition to study the role of visual input on the development of spatial representation, as studies have shown how audio space representation reorganizes in blindness. However, how spatial reorganization works is still unclear. A limitation of the study on blindness is that it is a "stable" system and it does not allow for studying the mechanisms that subtend the progress of this reorganization. To overcome this problem here we study, for the first time, audio spatial reorganization in 18 adults with macular degeneration (MD) for which the loss of vision due to scotoma is an ongoing progressive process. Our results show that the loss of vision produces immediate changes in the processing of spatial audio signals. In individuals with MD, the lateral sounds are "attracted" toward the central scotoma position resulting in a strong bias in the spatial auditory percept. This result suggests that the reorganization of audio space representation is a fast and plastic process occurring also later in life, after vision loss.

Congenital olfactory impairment is linked to cortical changes in prefrontal and limbic brain regions

The human sense of smell is closely associated with morphological differences of the fronto-limbic system, specifically the piriform cortex and medial orbitofrontal cortex (mOFC). Still it is unclear whether cortical volume in the core olfactory areas and connected brain regions are shaped differently in individuals who suffer from lifelong olfactory deprivation relative to healthy normosmic individuals. To address this question, we examined if regional variations in gray matter volume were associated with smell ability in seventeen individuals with isolated congenital olfactory impairment (COI) matched with sixteen normosmic controls. All subjects underwent whole-brain magnetic resonance imaging, and voxel-based morphometry was used to estimate regional variations in grey matter volume. The analyses showed that relative to controls, COI subjects had significantly larger grey matter volumes in left middle frontal gyrus and right superior frontal sulcus (SFS). COI subjects with severe olfactory impairment (anosmia) had reduced grey matter volume in the left mOFC and increased volume in right piriform cortex and SFS. Within the COI group olfactory ability, measured with the "Sniffin' Sticks" test, was positively associated with larger grey matter volume in right posterior cingulate and parahippocampal cortices whereas the opposite relationship was observed in controls. Across COI subjects and controls, better olfactory detection threshold was associated with smaller volume in right piriform cortex, while olfactory identification was negatively associated with right SFS volume. Our findings suggest that lifelong olfactory deprivation trigger changes in the cortical volume of prefrontal and limbic brain regions previously linked to olfactory memory.

How body motion influences echolocation while walking

This study investigated the influence of body motion on an echolocation task. We asked a group of blindfolded novice sighted participants to walk along a corridor, made with plastic sound-reflecting panels. By self-generating mouth clicks, the participants attempted to understand some spatial properties of the corridor, i.e. a left turn, a right turn or a dead end. They were asked to explore the corridor and stop whenever they were confident about the corridor shape. Their body motion was captured by a camera system and coded. Most participants were able to accomplish the task with the percentage of correct guesses above the chance level. We found a mutual interaction between some kinematic variables that can lead to optimal echolocation skills. These variables are head motion, accounting for spatial exploration, the motion stop-point of the person and the amount of correct guesses about the spatial structure. The results confirmed that sighted people are able to use self-generated echoes to navigate in a complex environment. The inter-individual variability and the quality of echolocation tasks seems to depend on how and how much the space is explored.

Temporal Cues Influence Space Estimations in Visually Impaired Individuals

Many works have highlighted enhanced auditory processing in blind individuals, suggesting that they compensate for lack of vision with greater sensitivity of the other senses. Few years ago, we demonstrated severely impaired auditory precision in congenitally blind individuals performing an auditory spatial metric task: their thresholds for bisecting three consecutive spatially distributed sounds were seriously compromised, ranging from three times typical thresholds to total randomness. Here, we show that the deficit disappears if blind individuals are presented with coherent temporal and spatial cues. More interestingly, when the audio information is presented in conflict for space and time, sighted individuals are unaffected by the perturbation, whereas blind individuals are strongly attracted by the temporal cue. These results highlight that temporal cues influence space estimations in blind participants, suggesting for the first time that blind individuals use temporal information to infer spatial environmental coordinates.

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Blind individuals are not able to perform auditory spatial metric tasks

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Their deficit disappears when coherent temporal and spatial cues are presented

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In some cases, blind people use temporal cues to infer spatial coordinates

Different audio spatial metric representation around the body

Vision seems to have a pivotal role in developing spatial cognition. A recent approach, based on sensory calibration, has highlighted the role of vision in calibrating hearing in spatial tasks. It was shown that blind individuals have specific impairments during audio spatial bisection tasks. Vision is available only in the frontal space, leading to a "natural" blindness in the back. If vision is important for audio space calibration, then the auditory frontal space should be better represented than the back auditory space. In this study, we investigated this point by comparing frontal and back audio spatial metric representations. We measured precision in the spatial bisection task, for which vision seems to be fundamental to calibrate audition, in twenty-three sighted subjects. Two control tasks, a minimum audible angle and a temporal bisection were employed in order to evaluate auditory precision in the different regions considered. While no differences were observed between frontal and back space in the minimum audible angle (MAA) and temporal bisection task, a significant difference was found in the spatial bisection task, where subjects performed better in the frontal space. Our results are in agreement with the idea that vision is important in developing auditory spatial metric representation in sighted individuals.

Attention to speech and spoken language development in deaf children with cochlear implants: a 10-year longitudinal study

Early auditory/language experience plays an important role in language development. In this study, we examined the effects of severe-to-profound hearing loss and subsequent cochlear implantation on the development of attention to speech in children with cochlear implants (CIs). In addition, we investigated the extent to which attention to speech may predict spoken language development in children with CIs. We tested children with CIs and compared them to chronologically age-matched peers with normal hearing (NH) on their attention to speech at four time points post implantation; specifically, less than 1 month, 3 to 6 months, 12 months, and 18 months post implantation. We also collected a variety of well-established speech perception and spoken language measures from the children with CIs in a 10-year longitudinal study. Children with CIs showed reduced attention to speech as compared to their peers with NH at less than 1 month post implantation, but a similar degree of attention to speech as their NH peers during later time points. In addition, attention to speech at 3 to 6 months post implantation predicts speech perception in children with CIs. These results inform language acquisition theories and bring insights into our understanding of early severe-to-profound hearing loss on infants' attention to speech skills. In addition, the findings have significant clinical implications for early intervention on hearing loss, which emphasizes the importance of developing strong listening skills. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=f7xiYo3Ua08&feature=youtu.be.

The spatial representation of number, time, and serial order following sensory deprivation: A systematic review

The spatial representation of numerical and temporal information is thought to be rooted in our multisensory experiences. Accordingly, we may expect visual or auditory deprivation to affect the way we represent numerical magnitude and time spatially. Here, we systematically review recent findings on how blind and deaf individuals represent abstract concepts such as magnitude and time (e.g., past/future, serial order of events) in a spatial format. Interestingly, available evidence suggests that sensory deprivation does not prevent the spatial "re-mapping" of abstract information, but differences compared to normally sighted and hearing individuals may emerge depending on the specific dimension considered (i.e., numerical magnitude, time as past/future, serial order). Herein we discuss how the study of sensory deprived populations may shed light on the specific, and possibly distinct, mechanisms subserving the spatial representation of these concepts. Furthermore, we pinpoint unresolved issues that need to be addressed by future studies to grasp a full understanding of the spatial representation of abstract information associated with visual and auditory deprivation.

Early blindness is associated with increased volume of the uncinate fasciculus

Growing evidence demonstrates dramatic structural and functional neuroplastic changes in individuals born with early-onset blindness. For example, cross-modal sensory processing at the level of the occipital cortex appears to be associated with adaptive behaviors in the blind. However, detailed studies examining the structural properties of key white matter pathways in other regions of the brain remain limited. Given that blind individuals rely heavily on their sense of hearing, we examined the structural properties of two important pathways involved with auditory processing, namely the uncinate and arcuate fasciculi. High angular resolution diffusion imaging (HARDI) tractography was used to examine structural parameters (i.e., tract volume and quantitative anisotropy, or QA) of these two fasciculi in a sample of 13 early blind individuals and 14 normally sighted controls. Compared to controls, early blind individuals showed a significant increase in the volume of the left uncinate fasciculus. A small area of increased QA was also observed halfway along the right arcuate fasciculus in the blind group. These findings contribute to our knowledge regarding the broad neuroplastic changes associated with profound early blindness.

Functional Preference for Object Sounds and Voices in the Brain of Early Blind and Sighted Individuals

Sounds activate occipital regions in early blind individuals. However, how different sound categories map onto specific regions of the occipital cortex remains a matter of debate. We used fMRI to characterize brain responses of early blind and sighted individuals to familiar object sounds, human voices, and their respective low-level control sounds. In addition, sighted participants were tested while viewing pictures of faces, objects, and phase-scrambled control pictures. In both early blind and sighted, a double dissociation was evidenced in bilateral auditory cortices between responses to voices and object sounds: Voices elicited categorical responses in bilateral superior temporal sulci, whereas object sounds elicited categorical responses along the lateral fissure bilaterally, including the primary auditory cortex and planum temporale. Outside the auditory regions, object sounds also elicited categorical responses in the left lateral and in the ventral occipitotemporal regions in both groups. These regions also showed response preference for images of objects in the sighted group, thus suggesting a functional specialization that is independent of sensory input and visual experience. Between-group comparisons revealed that, only in the blind group, categorical responses to object sounds extended more posteriorly into the occipital cortex. Functional connectivity analyses evidenced a selective increase in the functional coupling between these reorganized regions and regions of the ventral occipitotemporal cortex in the blind group. In contrast, vocal sounds did not elicit preferential responses in the occipital cortex in either group. Nevertheless, enhanced voice-selective connectivity between the left temporal voice area and the right fusiform gyrus were found in the blind group. Altogether, these findings suggest that, in the absence of developmental vision, separate auditory categories are not equipotent in driving selective auditory recruitment of occipitotemporal regions and highlight the presence of domain-selective constraints on the expression of cross-modal plasticity.

Early visual deprivation severely compromises the auditory sense of space in congenitally blind children

A recent study has shown that congenitally blind adults, who have never had visual experience, are impaired on an auditory spatial bisection task (Gori, Sandini, Martinoli, & Burr, 2014). In this study we investigated how thresholds for auditory spatial bisection and auditory discrimination develop with age in sighted and congenitally blind children (9 to 14 years old). Children performed 2 spatial tasks (minimum audible angle and space bisection) and 1 temporal task (temporal bisection). There was no impairment in the temporal task for blind children but, like adults, they showed severely compromised thresholds for spatial bisection. Interestingly, the blind children also showed lower precision in judging minimum audible angle. These results confirm the adult study and go on to suggest that even simpler auditory spatial tasks are compromised in children, and that this capacity recovers over time. (PsycINFO Database Record

Cross-Modal Plasticity in Higher-Order Auditory Cortex of Congenitally Deaf Cats Does Not Limit Auditory Responsiveness to Cochlear Implants

Congenital sensory deprivation can lead to reorganization of the deprived cortical regions by another sensory system. Such cross-modal reorganization may either compete with or complement the "original" inputs to the deprived area after sensory restoration and can thus be either adverse or beneficial for sensory restoration. In congenital deafness, a previous inactivation study documented that supranormal visual behavior was mediated by higher-order auditory fields in congenitally deaf cats (CDCs). However, both the auditory responsiveness of "deaf" higher-order fields and interactions between the reorganized and the original sensory input remain unknown. Here, we studied a higher-order auditory field responsible for the supranormal visual function in CDCs, the auditory dorsal zone (DZ). Hearing cats and visual cortical areas served as a control. Using mapping with microelectrode arrays, we demonstrate spatially scattered visual (cross-modal) responsiveness in the DZ, but show that this did not interfere substantially with robust auditory responsiveness elicited through cochlear implants. Visually responsive and auditory-responsive neurons in the deaf auditory cortex formed two distinct populations that did not show bimodal interactions. Therefore, cross-modal plasticity in the deaf higher-order auditory cortex had limited effects on auditory inputs. The moderate number of scattered cross-modally responsive neurons could be the consequence of exuberant connections formed during development that were not pruned postnatally in deaf cats. Although juvenile brain circuits are modified extensively by experience, the main driving input to the cross-modally (visually) reorganized higher-order auditory cortex remained auditory in congenital deafness.

SIGNIFICANCE STATEMENT

In a common view, the "unused" auditory cortex of deaf individuals is reorganized to a compensatory sensory function during development. According to this view, cross-modal plasticity takes over the unused cortex and reassigns it to the remaining senses. Therefore, cross-modal plasticity might conflict with restoration of auditory function with cochlear implants. It is unclear whether the cross-modally reorganized auditory areas lose auditory responsiveness. We show that the presence of cross-modal plasticity in a higher-order auditory area does not reduce auditory responsiveness of that area. Visual reorganization was moderate, spatially scattered and there were no interactions between cross-modally reorganized visual and auditory inputs. These results indicate that cross-modal reorganization is less detrimental for neurosensory restoration than previously thought.

Intercepting a sound without vision

Visual information is extremely important to generate internal spatial representations. In the auditory modality, the absence of visual cues during early infancy does not preclude the development of some spatial strategies. However, specific spatial abilities might result impaired. In the current study, we investigated the effect of early visual deprivation on the ability to localize static and moving auditory stimuli by comparing sighted and early blind individuals' performance in different spatial tasks. We also examined perceptual stability in the two groups of participants by matching localization accuracy in a static and a dynamic head condition that involved rotational head movements. Sighted participants accurately localized static and moving sounds. Their localization ability remained unchanged after rotational movements of the head. Conversely, blind participants showed a leftward bias during the localization of static sounds and a little bias for moving sounds. Moreover, head movements induced a significant bias in the direction of head motion during the localization of moving sounds. These results suggest that internal spatial representations might be body-centered in blind individuals and that in sighted people the availability of visual cues during early infancy may affect sensory-motor interactions.

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.

Multimodal MR-imaging reveals large-scale structural and functional connectivity changes in profound early blindness

In the setting of profound ocular blindness, numerous lines of evidence demonstrate the existence of dramatic anatomical and functional changes within the brain. However, previous studies based on a variety of distinct measures have often provided inconsistent findings. To help reconcile this issue, we used a multimodal magnetic resonance (MR)-based imaging approach to provide complementary structural and functional information regarding this neuroplastic reorganization. This included gray matter structural morphometry, high angular resolution diffusion imaging (HARDI) of white matter connectivity and integrity, and resting state functional connectivity MRI (rsfcMRI) analysis. When comparing the brains of early blind individuals to sighted controls, we found evidence of co-occurring decreases in cortical volume and cortical thickness within visual processing areas of the occipital and temporal cortices respectively. Increases in cortical volume in the early blind were evident within regions of parietal cortex. Investigating white matter connections using HARDI revealed patterns of increased and decreased connectivity when comparing both groups. In the blind, increased white matter connectivity (indexed by increased fiber number) was predominantly left-lateralized, including between frontal and temporal areas implicated with language processing. Decreases in structural connectivity were evident involving frontal and somatosensory regions as well as between occipital and cingulate cortices. Differences in white matter integrity (as indexed by quantitative anisotropy, or QA) were also in general agreement with observed pattern changes in the number of white matter fibers. Analysis of resting state sequences showed evidence of both increased and decreased functional connectivity in the blind compared to sighted controls. Specifically, increased connectivity was evident between temporal and inferior frontal areas. Decreases in functional connectivity were observed between occipital and frontal and somatosensory-motor areas and between temporal (mainly fusiform and parahippocampus) and parietal, frontal, and other temporal areas. Correlations in white matter connectivity and functional connectivity observed between early blind and sighted controls showed an overall high degree of association. However, comparing the relative changes in white matter and functional connectivity between early blind and sighted controls did not show a significant correlation. In summary, these findings provide complimentary evidence, as well as highlight potential contradictions, regarding the nature of regional and large scale neuroplastic reorganization resulting from early onset blindness.

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.

Congenital blindness is associated with large-scale reorganization of anatomical networks

Blindness is a unique model for understanding the role of experience in the development of the brain's functional and anatomical architecture. Documenting changes in the structure of anatomical networks for this population would substantiate the notion that the brain's core network-level organization may undergo neuroplasticity as a result of life-long experience. To examine this issue, we compared whole-brain networks of regional cortical-thickness covariance in early blind and matched sighted individuals. This covariance is thought to reflect signatures of integration between systems involved in similar perceptual/cognitive functions. Using graph-theoretic metrics, we identified a unique mode of anatomical reorganization in the blind that differed from that found for sighted. This was seen in that network partition structures derived from subgroups of blind were more similar to each other than they were to partitions derived from sighted. Notably, after deriving network partitions, we found that language and visual regions tended to reside within separate modules in sighted but showed a pattern of merging into shared modules in the blind. Our study demonstrates that early visual deprivation triggers a systematic large-scale reorganization of whole-brain cortical-thickness networks, suggesting changes in how occipital regions interface with other functional networks in the congenitally blind.

Musical expertise is related to neuroplastic changes of multisensory nature within the auditory cortex

Recent neuroscientific evidence indicates that multisensory integration does not only occur in higher level association areas of the cortex as the hierarchical models of sensory perception assumed, but also in regions traditionally thought of as unisensory, such as the auditory cortex. Nevertheless, it is not known whether expertise-induced neuroplasticity can alter the multisensory processing that occurs in these low-level regions. The present study used magnetoencephalography to investigate whether musical training may induce neuroplastic changes of multisensory processing within the human auditory cortex. Magnetoencephalography data of four different experiments were used to demonstrate the effect of long-term and short-term musical training on the integration of auditory, somatosensory and visual stimuli in the auditory cortex. The cross-sectional design of three of the experiments allowed us to infer that long-term musical training is related to a significantly different way of processing multisensory information within the auditory cortex, whereas the short-term training design of the fourth experiment allowed us to causally infer that multisensory music reading training affects the multimodal processing within the auditory cortex.

Reorganization of auditory cortex in early-deaf people: functional connectivity and relationship to hearing aid use

Cross-modal reorganization after sensory deprivation is a model for understanding brain plasticity. Although it is a well-documented phenomenon, we still know little of the mechanisms underlying it or the factors that constrain and promote it. Using fMRI, we identified visual motion-related activity in 17 early-deaf and 17 hearing adults. We found that, in the deaf, the posterior superior temporal gyrus (STG) was responsive to visual motion. We compared functional connectivity of this reorganized cortex between groups to identify differences in functional networks associated with reorganization. In the deaf more than the hearing, the STG displayed increased functional connectivity with a region in the calcarine fissure. We also explored the role of hearing aid use, a factor that may contribute to variability in cross-modal reorganization. We found that both the cross-modal activity in STG and the functional connectivity between STG and calcarine cortex correlated with duration of hearing aid use, supporting the hypothesis that residual hearing affects cross-modal reorganization. We conclude that early auditory deprivation alters not only the organization of auditory regions but also the interactions between auditory and primary visual cortex and that auditory input, as indexed by hearing aid use, may inhibit cross-modal reorganization in early-deaf people.

Intrinsic functional plasticity of the sensory-motor network in patients with cervical spondylotic myelopathy

Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); however, the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown. In this study, functional connectivity strength (FCS), a data-driven degree centrality method based on a theoretical approach, was applied for the first time to investigate changes in the sensory-motor network (SMN) at the voxel level. Comparatively, CSM not only showed significantly decreased FCS in the operculum-integrated regions, which exhibited reduced resting-state functional connectivity (rsFC) around the Rolandic sulcus, but it also showed increased FCS in the premotor, primary somatosensory, and parietal-integrated areas, which primarily showed an enhanced rsFC pattern. Correlation analysis showed that altered FCS (in the left premotor-ventral/precentral-operculum, right operculum-parietale 4, and right S1) was associated with worsening Japanese Orthopaedic Association scores and that the rsFC pattern was influenced by cervical cord micro-structural damage at the C2 level. Together, these findings suggest that during myelopathy, the intrinsic functional plasticity of the SMN responds to the insufficient sensory and motor experience in CSM patients. This knowledge may improve our understanding of the comprehensive functional defects found in CSM patients and may inspire the development of new therapeutic strategies in the future.

Functional connectivity of visual cortex in the blind follows retinotopic organization principles

Although early visual experience is essential for the proper development of visual cortex, Striem-Amit et al. show that the underlying connectivity structure of retinotopic mapping is retained even in congenitally blind individuals. This basic organisational principle emerges independently of visual input and persists despite lifelong experience-dependent plasticity.

Is visual input during critical periods of development crucial for the emergence of the fundamental topographical mapping of the visual cortex? And would this structure be retained throughout life-long blindness or would it fade as a result of plastic, use-based reorganization? We used functional connectivity magnetic resonance imaging based on intrinsic blood oxygen level-dependent fluctuations to investigate whether significant traces of topographical mapping of the visual scene in the form of retinotopic organization, could be found in congenitally blind adults. A group of 11 fully and congenitally blind subjects and 18 sighted controls were studied. The blind demonstrated an intact functional connectivity network structural organization of the three main retinotopic mapping axes: eccentricity (centre-periphery), laterality (left-right), and elevation (upper-lower) throughout the retinotopic cortex extending to high-level ventral and dorsal streams, including characteristic eccentricity biases in face- and house-selective areas. Functional connectivity-based topographic organization in the visual cortex was indistinguishable from the normally sighted retinotopic functional connectivity structure as indicated by clustering analysis, and was found even in participants who did not have a typical retinal development in utero (microphthalmics). While the internal structural organization of the visual cortex was strikingly similar, the blind exhibited profound differences in functional connectivity to other (non-visual) brain regions as compared to the sighted, which were specific to portions of V1. Central V1 was more connected to language areas but peripheral V1 to spatial attention and control networks. These findings suggest that current accounts of critical periods and experience-dependent development should be revisited even for primary sensory areas, in that the connectivity basis for visual cortex large-scale topographical organization can develop without any visual experience and be retained through life-long experience-dependent plasticity. Furthermore, retinotopic divisions of labour, such as that between the visual cortex regions normally representing the fovea and periphery, also form the basis for topographically-unique plastic changes in the blind.

Aural localization of silent objects by active human biosonar: neural representations of virtual echo-acoustic space

Some blind humans have developed the remarkable ability to detect and localize objects through the auditory analysis of self-generated tongue clicks. These echolocation experts show a corresponding increase in 'visual' cortex activity when listening to echo-acoustic sounds. Echolocation in real-life settings involves multiple reflections as well as active sound production, neither of which has been systematically addressed. We developed a virtualization technique that allows participants to actively perform such biosonar tasks in virtual echo-acoustic space during magnetic resonance imaging (MRI). Tongue clicks, emitted in the MRI scanner, are picked up by a microphone, convolved in real time with the binaural impulse responses of a virtual space, and presented via headphones as virtual echoes. In this manner, we investigated the brain activity during active echo-acoustic localization tasks. Our data show that, in blind echolocation experts, activations in the calcarine cortex are dramatically enhanced when a single reflector is introduced into otherwise anechoic virtual space. A pattern-classification analysis revealed that, in the blind, calcarine cortex activation patterns could discriminate left-side from right-side reflectors. This was found in both blind experts, but the effect was significant for only one of them. In sighted controls, 'visual' cortex activations were insignificant, but activation patterns in the planum temporale were sufficient to discriminate left-side from right-side reflectors. Our data suggest that blind and echolocation-trained, sighted subjects may recruit different neural substrates for the same active-echolocation task.

An equal start: absence of group differences in cognitive, social, and neural measures prior to music or sports training in children

Several studies comparing adult musicians and non-musicians have provided compelling evidence for functional and anatomical differences in the brain systems engaged by musical training. It is not known, however, whether those differences result from long-term musical training or from pre-existing traits favoring musicality. In an attempt to begin addressing this question, we have launched a longitudinal investigation of the effects of childhood music training on cognitive, social and neural development. We compared a group of 6- to 7-year old children at the start of intense after-school musical training, with two groups of children: one involved in high intensity sports training but not musical training, another not involved in any systematic training. All children were tested with a comprehensive battery of cognitive, motor, musical, emotional, and social assessments and underwent magnetic resonance imaging and electroencephalography. Our first objective was to determine whether children who participate in musical training were different, prior to training, from children in the control groups in terms of cognitive, motor, musical, emotional, and social behavior measures as well as in structural and functional brain measures. Our second objective was to determine whether musical skills, as measured by a music perception assessment prior to training, correlates with emotional and social outcome measures that have been shown to be associated with musical training. We found no neural, cognitive, motor, emotional, or social differences among the three groups. In addition, there was no correlation between music perception skills and any of the social or emotional measures. These results provide a baseline for an ongoing longitudinal investigation of the effects of music training.

Revisiting the adaptive and maladaptive effects of crossmodal plasticity

One of the most striking demonstrations of experience-dependent plasticity comes from studies of sensory-deprived individuals (e.g., blind or deaf), showing that brain regions deprived of their natural inputs change their sensory tuning to support the processing of inputs coming from the spared senses. These mechanisms of crossmodal plasticity have been traditionally conceptualized as having a double-edged sword effect on behavior. On one side, crossmodal plasticity is conceived as adaptive for the development of enhanced behavioral skills in the remaining senses of early-deaf or blind individuals. On the other side, crossmodal plasticity raises crucial challenges for sensory restoration and is typically conceived as maladaptive since its presence may prevent optimal recovery in sensory-re-afferented individuals. In the present review we stress that this dichotomic vision is oversimplified and we emphasize that the notions of the unavoidable adaptive/maladaptive effects of crossmodal reorganization for sensory compensation/restoration may actually be misleading. For this purpose we critically review the findings from the blind and deaf literatures, highlighting the complementary nature of these two fields of research. The integrated framework we propose here has the potential to impact on the way rehabilitation programs for sensory recovery are carried out, with the promising prospect of eventually improving their final outcomes.

Resting state functional connectivity in early blind humans

Task-based neuroimaging studies in early blind humans (EB) have demonstrated heightened visual cortex responses to non-visual paradigms. Several prior functional connectivity studies in EB have shown altered connections consistent with these task-based results. But these studies generally did not consider behavioral adaptations to lifelong blindness typically observed in EB. Enhanced cognitive abilities shown in EB include greater serial recall and attention to memory. Here, we address the question of the extent to which brain intrinsic activity in EB reflects such adaptations. We performed a resting-state functional magnetic resonance imaging study contrasting 14 EB with 14 age/gender matched normally sighted controls (NS). A principal finding was markedly greater functional connectivity in EB between visual cortex and regions typically associated with memory and cognitive control of attention. In contrast, correlations between visual cortex and non-deprived sensory cortices were significantly lower in EB. Thus, the available data, including that obtained in prior task-based and resting state fMRI studies, as well as the present results, indicate that visual cortex in EB becomes more heavily incorporated into functional systems instantiating episodic recall and attention to non-visual events. Moreover, EB appear to show a reduction in interactions between visual and non-deprived sensory cortices, possibly reflecting suppression of inter-sensory distracting activity.

Brain systems mediating voice identity processing in blind humans

Blind people rely more on vocal cues when they recognize a person's identity than sighted people. Indeed, a number of studies have reported better voice recognition skills in blind than in sighted adults. The present functional magnetic resonance imaging study investigated changes in the functional organization of neural systems involved in voice identity processing following congenital blindness. A group of congenitally blind individuals and matched sighted control participants were tested in a priming paradigm, in which two voice stimuli (S1, S2) were subsequently presented. The prime (S1) and the target (S2) were either from the same speaker (person-congruent voices) or from two different speakers (person-incongruent voices). Participants had to classify the S2 as either a old or a young person. Person-incongruent voices (S2) compared with person-congruent voices elicited an increased activation in the right anterior fusiform gyrus in congenitally blind individuals but not in matched sighted control participants. In contrast, only matched sighted controls showed a higher activation in response to person-incongruent compared with person-congruent voices (S2) in the right posterior superior temporal sulcus. These results provide evidence for crossmodal plastic changes of the person identification system in the brain after visual deprivation.

Visual cortex extrastriate body-selective area activation in congenitally blind people "seeing" by using sounds

Vision is by far the most prevalent sense for experiencing others' body shapes, postures, actions, and intentions, and its congenital absence may dramatically hamper body-shape representation in the brain. We investigated whether the absence of visual experience and limited exposure to others' body shapes could still lead to body-shape selectivity. We taught congenitally fully-blind adults to perceive full-body shapes conveyed through a sensory-substitution algorithm topographically translating images into soundscapes [1]. Despite the limited experience of the congenitally blind with external body shapes (via touch of close-by bodies and for ~10 hr via soundscapes), once the blind could retrieve body shapes via soundscapes, they robustly activated the visual cortex, specifically the extrastriate body area (EBA; [2]). Furthermore, body selectivity versus textures, objects, and faces in both the blind and sighted control groups was not found in the temporal (auditory) or parietal (somatosensory) cortex but only in the visual EBA. Finally, resting-state data showed that the blind EBA is functionally connected to the temporal cortex temporal-parietal junction/superior temporal sulcus Theory-of-Mind areas [3]. Thus, the EBA preference is present without visual experience and with little exposure to external body-shape information, supporting the view that the brain has a sensory-independent, task-selective supramodal organization rather than a sensory-specific organization.