Crossmodal enhancement of visual orientation discrimination by looming sounds requires functional activation of primary visual areas: A case study

Effects of looming audio on transcranial magnetic stimulation-induced phosphene perception

Looming sounds are known to influence visual function in the brain, even as early as the primary visual cortex. However, despite evidence that looming sounds have a larger impact on cortical excitability than stationary sounds, the influence of varying looming strengths on visual ability remains unclear. Here, we aim to understand how these signals influence low-level visual function. Fourteen healthy undergraduate students participated. They were blindfolded and received transcranial magnetic stimulation (TMS) to the primary visual cortex following auditory stimulation with different strength looming sounds. Participants reported whether they perceived a phosphene, or an illusory visual percept, following TMS stimulation. We hypothesized that rates of phosphene activity would increase with increasing levels of looming strength. A linear mixed-effect model showed that phosphene activity was significantly higher at higher strength of looming (F(1, 69) = 5.33, p = .024) and at higher TMS pulse strength (F(1, 18) = 4.71, p = .043). However, there was also a significant interaction between looming strength and pulse strength (F(1, 69) = 4.33, p = .041). At lower levels of TMS strength, phosphene rate increased with looming strength, while at higher levels of TMS strength the effect was reversed. These results suggest a complex relationship between looming strength and cortical activity, potentially reflecting the mixed contribution of total auditory energy and the rate of changes. This work will enhance our ability to predict audiovisual interactions and may help improve auditory warning systems designed to capture visual attention.

Are auditory cues special? Evidence from cross-modal distractor-induced blindness

A target that shares features with preceding distractor stimuli is less likely to be detected due to a distractor-driven activation of a negative attentional set. This transient impairment in perceiving the target (distractor-induced blindness/deafness) can be found within vision and audition. Recently, the phenomenon was observed in a cross-modal setting involving an auditory target and additional task-relevant visual information (cross-modal distractor-induced deafness). In the current study, consisting of three behavioral experiments, a visual target, indicated by an auditory cue, had to be detected despite the presence of visual distractors. Multiple distractors consistently led to reduced target detection if cue and target appeared in close temporal proximity, confirming cross-modal distractor-induced blindness. However, the effect on target detection was reduced compared to the effect of cross-modal distractor-induced deafness previously observed for reversed modalities. The physical features defining cue and target could not account for the diminished distractor effect in the current cross-modal task. Instead, this finding may be attributed to the auditory cue acting as an especially efficient release signal of the distractor-induced inhibition. Additionally, a multisensory enhancement of visual target detection by the concurrent auditory signal might have contributed to the reduced distractor effect.

Visual cortex responds to sound onset and offset during passive listening

Sounds enhance our ability to detect, localize, and respond to co-occurring visual targets. Research suggests that sounds improve visual processing by resetting the phase of ongoing oscillations in visual cortex. However, it remains unclear what information is relayed from the auditory system to visual areas and if sounds modulate visual activity even in the absence of visual stimuli (e.g., during passive listening). Using intracranial electroencephalography (iEEG) in humans, we examined the sensitivity of visual cortex to three forms of auditory information during a passive listening task: auditory onset responses, auditory offset responses, and rhythmic entrainment to sounds. Because some auditory neurons respond to both sound onsets and offsets, visual timing and duration processing may benefit from each. Additionally, if auditory entrainment information is relayed to visual cortex, it could support the processing of complex stimulus dynamics that are aligned between auditory and visual stimuli. Results demonstrate that in visual cortex, amplitude-modulated sounds elicited transient onset and offset responses in multiple areas, but no entrainment to sound modulation frequencies. These findings suggest that activity in visual cortex (as measured with iEEG in response to auditory stimuli) may not be affected by temporally fine-grained auditory stimulus dynamics during passive listening (though it remains possible that this signal may be observable with simultaneous auditory-visual stimuli). Moreover, auditory responses were maximal in low-level visual cortex, potentially implicating a direct pathway for rapid interactions between auditory and visual cortices. This mechanism may facilitate perception by time-locking visual computations to environmental events marked by auditory discontinuities.

Fear-related signals are prioritised in visual, somatosensory and spatial systems

The human brain has evolved a multifaceted fear system, allowing threat detection to enable rapid adaptive responses crucial for survival. Although many cortical and subcortical brain areas are believed to be involved in the survival circuits detecting and responding to threat, the amygdala has reportedly a crucial role in the fear system. Here, we review evidence demonstrating that fearful faces, a specific category of salient stimuli indicating the presence of threat in the surrounding, are preferentially processed in the fear system and in the connected sensory cortices, even when they are presented outside of awareness or are irrelevant to the task. In the visual domain, we discuss evidence showing in hemianopic patients that fearful faces, via a subcortical colliculo-pulvinar-amygdala pathway, have a privileged visual processing even in the absence of awareness and facilitate responses towards visual stimuli in the intact visual field. Moreover, evidence showing that somatosensory cortices prioritise fearful-related signals, to the extent that tactile processing is enhanced in the presence of fearful faces, will be also reported. Finally, we will review evidence revealing that fearful faces have a pivotal role in modulating responses in peripersonal space, in line with the defensive functional definition of PPS.

Compensatory Cross-Modal Plasticity Persists After Sight Restoration

Sensory deprivation prompts extensive structural and functional reorganizations of the cortex resulting in the occupation of space for the lost sense by the intact sensory systems. This process, known as cross-modal plasticity, has been widely studied in individuals with vision or hearing loss. However, little is known on the neuroplastic changes in restoring the deprived sense. Some reports consider the cross-modal functionality maladaptive to the return of the original sense, and others view this as a critical process in maintaining the neurons of the deprived sense active and operational. These controversial views have been challenged in both auditory and vision restoration reports for decades. Recently with the approval of Luxturna as the first retinal gene therapy (GT) drug to reverse blindness, there is a renewed interest for the crucial role of cross-modal plasticity on sight restoration. Employing a battery of task and resting state functional magnetic resonance imaging (rsfMRI), in comparison to a group of sighted controls, we tracked the functional changes in response to auditory and visual stimuli and at rest, in a group of patients with biallelic mutations in the RPE65 gene (“RPE65 patients”) before and 3 years after GT. While the sighted controls did not present any evidence for auditory cross-modal plasticity, robust responses to the auditory stimuli were found in occipital cortex of the RPE65 patients overlapping visual responses and significantly elevated 3 years after GT. The rsfMRI results showed significant connectivity between the auditory and visual areas for both groups albeit attenuated in patients at baseline but enhanced 3 years after GT. Taken together, these findings demonstrate that (1) RPE65 patients present with an auditory cross-modal component; (2) visual and non-visual responses of the visual cortex are considerably enhanced after vision restoration; and (3) auditory cross-modal functions did not adversely affect the success of vision restitution. We hypothesize that following GT, to meet the demand for the newly established retinal signals, remaining or dormant visual neurons are revived or unmasked for greater participation. These neurons or a subset of these neurons respond to both the visual and non-visual demands and further strengthen connectivity between the auditory and visual cortices.

Shaping the visual system: cortical and subcortical plasticity in the intact and the lesioned brain

Visual system is endowed with an incredibly complex organization composed of multiple visual pathway affording both hierarchical and parallel processing. Even if most of the visual information is conveyed by the retina to the lateral geniculate nucleus of the thalamus and then to primary visual cortex, a wealth of alternative subcortical pathways is present. This complex organization is experience dependent and retains plastic properties throughout the lifespan enabling the system with a continuous update of its functions in response to variable external needs. Changes can be induced by several factors including learning and experience but can also be promoted by the use non-invasive brain stimulation techniques. Furthermore, besides the astonishing ability of our visual system to spontaneously reorganize after injuries, we now know that the exposure to specific rehabilitative training can produce not only important functional modifications but also long-lasting changes within cortical and subcortical structures. The present review aims to update and address the current state of the art on these topics gathering studies that reported relevant modifications of visual functioning together with plastic changes within cortical and subcortical structures both in the healthy and in the lesioned visual system.

An unperceived acoustic stimulus decreases reaction time to visual information in a patient with cortical deafness

Responding to multiple stimuli of different modalities has been shown to reduce reaction time (RT), yet many different processes can potentially contribute to multisensory response enhancement. To investigate the neural circuits involved in voluntary response initiation, an acoustic stimulus of varying intensities (80, 105, or 120 dB) was presented during a visual RT task to a patient with profound bilateral cortical deafness and an intact auditory brainstem response. Despite being unable to consciously perceive sound, RT was reliably shortened (~100 ms) on trials where the unperceived acoustic stimulus was presented, confirming the presence of multisensory response enhancement. Although the exact locus of this enhancement is unclear, these results cannot be attributed to involvement of the auditory cortex. Thus, these data provide new and compelling evidence that activation from subcortical auditory processing circuits can contribute to other cortical or subcortical areas responsible for the initiation of a response, without the need for conscious perception.

Impairments in Multisensory Integration after Stroke

The integration of information from multiple senses leads to a plethora of behavioral benefits, most predominantly to faster and better detection, localization, and identification of events in the environment. Although previous studies of multisensory integration (MSI) in humans have provided insights into the neural underpinnings of MSI, studies of MSI at a behavioral level in individuals with brain damage are scarce. Here, a well-known psychophysical paradigm (the redundant target paradigm) was employed to quantify MSI in a group of stroke patients. The relation between MSI and lesion location was analyzed using lesion subtraction analysis. Twenty-one patients with ischemic infarctions and 14 healthy control participants responded to auditory, visual, and audiovisual targets in the left and right visual hemifield. Responses to audiovisual targets were faster than to unisensory targets. This could be due to MSI or statistical facilitation. Comparing the audiovisual RTs to the winner of a race between unisensory signals allowed us to determine whether participants could integrate auditory and visual information. The results indicated that (1) 33% of the patients showed an impairment in MSI; (2) patients with MSI impairment had left hemisphere and brainstem/cerebellar lesions; and (3) the left caudate, left pallidum, left putamen, left thalamus, left insula, left postcentral and precentral gyrus, left central opercular cortex, left amygdala, and left OFC were more often damaged in patients with MSI impairments. These results are the first to demonstrate the impact of brain damage on MSI in stroke patients using a well-established psychophysical paradigm.

Being First Matters: Topographical Representational Similarity Analysis of ERP Signals Reveals Separate Networks for Audiovisual Temporal Binding Depending on the Leading Sense

In multisensory integration, processing in one sensory modality is enhanced by complementary information from other modalities. Intersensory timing is crucial in this process because only inputs reaching the brain within a restricted temporal window are perceptually bound. Previous research in the audiovisual field has investigated various features of the temporal binding window, revealing asymmetries in its size and plasticity depending on the leading input: auditory–visual (AV) or visual–auditory (VA). Here, we tested whether separate neuronal mechanisms underlie this AV–VA dichotomy in humans. We recorded high-density EEG while participants performed an audiovisual simultaneity judgment task including various AV–VA asynchronies and unisensory control conditions (visual-only, auditory-only) and tested whether AV and VA processing generate different patterns of brain activity. After isolating the multisensory components of AV–VA event-related potentials (ERPs) from the sum of their unisensory constituents, we ran a time-resolved topographical representational similarity analysis (tRSA) comparing the AV and VA ERP maps. Spatial cross-correlation matrices were built from real data to index the similarity between the AV and VA maps at each time point (500 ms window after stimulus) and then correlated with two alternative similarity model matrices: AV_maps = VA_maps versus AV_maps ≠ VA_maps. The tRSA results favored the AV_maps ≠ VA_maps model across all time points, suggesting that audiovisual temporal binding (indexed by synchrony perception) engages different neural pathways depending on the leading sense. The existence of such dual route supports recent theoretical accounts proposing that multiple binding mechanisms are implemented in the brain to accommodate different information parsing strategies in auditory and visual sensory systems.

SIGNIFICANCE STATEMENT Intersensory timing is a crucial aspect of multisensory integration, determining whether and how inputs in one modality enhance stimulus processing in another modality. Our research demonstrates that evaluating synchrony of auditory-leading (AV) versus visual-leading (VA) audiovisual stimulus pairs is characterized by two distinct patterns of brain activity. This suggests that audiovisual integration is not a unitary process and that different binding mechanisms are recruited in the brain based on the leading sense. These mechanisms may be relevant for supporting different classes of multisensory operations, for example, auditory enhancement of visual attention (AV) and visual enhancement of auditory speech (VA).

Compensatory Recovery after Multisensory Stimulation in Hemianopic Patients: Behavioral and Neurophysiological Components

Lateralized post-chiasmatic lesions of the primary visual pathway result in loss of visual perception in the field retinotopically corresponding to the damaged cortical area. However, patients with visual field defects have shown enhanced detection and localization of multisensory audio-visual pairs presented in the blind field. This preserved multisensory integrative ability (i.e., crossmodal blindsight) seems to be subserved by the spared retino-colliculo-dorsal pathway. According to this view, audio-visual integrative mechanisms could be used to increase the functionality of the spared circuit and, as a consequence, might represent an important tool for the rehabilitation of visual field defects. The present study tested this hypothesis, investigating whether exposure to systematic multisensory audio-visual stimulation could induce long-lasting improvements in the visual performance of patients with visual field defects. A group of 10 patients with chronic visual field defects were exposed to audio-visual training for 4 h daily, over a period of 2 weeks. Behavioral, oculomotor and electroencephalography (EEG) measures were recorded during several visual tasks before and after audio-visual training. After audio-visual training, improvements in visual search abilities, visual detection, self-perceived disability in daily life activities and oculomotor parameters were found, suggesting the implementation of more effective visual exploration strategies. At the electrophysiological level, after training, patients showed a significant reduction of the P3 amplitude in response to stimuli presented in the intact field, reflecting a reduction in attentional resources allocated to the intact field, which might co-occur with a shift of spatial attention towards the blind field. More interestingly, both the behavioral improvements and the electrophysiological changes observed after training were found to be stable at a follow-up session (on average, 8 months after training), suggesting long-term effects of multisensory audio-visual training. These long-lasting effects seem to be subserved by the activation of the spared retino-colliculo-dorsal pathway, which promotes orienting responses towards the blind field, able to both compensate for the visual field loss and concurrently attenuate visual attention towards the intact field. These results add to previous findings the knowledge that audio-visual multisensory stimulation promote long-term plastic changes in hemianopics, resulting in stable and long-lasting ameliorations in behavioral and electrophysiological measures.

Behavioural evidence for separate mechanisms of audiovisual temporal binding as a function of leading sensory modality

The ability to integrate auditory and visual information is critical for effective perception and interaction with the environment, and is thought to be abnormal in some clinical populations. Several studies have investigated the time window over which audiovisual events are integrated, also called the temporal binding window, and revealed asymmetries depending on the order of audiovisual input (i.e. the leading sense). When judging audiovisual simultaneity, the binding window appears narrower and non-malleable for auditory-leading stimulus pairs and wider and trainable for visual-leading pairs. Here we specifically examined the level of independence of binding mechanisms when auditory-before-visual vs. visual-before-auditory input is bound. Three groups of healthy participants practiced audiovisual simultaneity detection with feedback, selectively training on auditory-leading stimulus pairs (group 1), visual-leading stimulus pairs (group 2) or both (group 3). Subsequently, we tested for learning transfer (crossover) from trained stimulus pairs to non-trained pairs with opposite audiovisual input. Our data confirmed the known asymmetry in size and trainability for auditory-visual vs. visual-auditory binding windows. More importantly, practicing one type of audiovisual integration (e.g. auditory-visual) did not affect the other type (e.g. visual-auditory), even if trainable by within-condition practice. Together, these results provide crucial evidence that audiovisual temporal binding for auditory-leading vs. visual-leading stimulus pairs are independent, possibly tapping into different circuits for audiovisual integration due to engagement of different multisensory sampling mechanisms depending on leading sense. Our results have implications for informing the study of multisensory interactions in healthy participants and clinical populations with dysfunctional multisensory integration.

Audio-visual multisensory training enhances visual processing of motion stimuli in healthy participants: an electrophysiological study

Evidence from electrophysiological and imaging studies suggests that audio-visual (AV) stimuli presented in spatial coincidence enhance activity in the subcortical colliculo-dorsal extrastriate pathway. To test whether repetitive AV stimulation might specifically activate this neural circuit underlying multisensory integrative processes, electroencephalographic data were recorded before and after 2 h of AV training, during the execution of two lateralized visual tasks: a motion discrimination task, relying on activity in the colliculo-dorsal MT pathway, and an orientation discrimination task, relying on activity in the striate and early ventral extrastriate cortices. During training, participants were asked to detect and perform a saccade towards AV stimuli that were disproportionally allocated to one hemifield (the trained hemifield). Half of the participants underwent a training in which AV stimuli were presented in spatial coincidence, while the remaining half underwent a training in which AV stimuli were presented in spatial disparity (32°). Participants who received AV training with stimuli in spatial coincidence had a post-training enhancement of the anterior N1 component in the motion discrimination task, but only in response to stimuli presented in the trained hemifield. However, no effect was found in the orientation discrimination task. In contrast, participants who received AV training with stimuli in spatial disparity showed no effects on either task. The observed N1 enhancement might reflect enhanced discrimination for motion stimuli, probably due to increased activity in the colliculo-dorsal MT pathway induced by multisensory training.

The COGs (context, object, and goals) in multisensory processing

Our understanding of how perception operates in real-world environments has been substantially advanced by studying both multisensory processes and "top-down" control processes influencing sensory processing via activity from higher-order brain areas, such as attention, memory, and expectations. As the two topics have been traditionally studied separately, the mechanisms orchestrating real-world multisensory processing remain unclear. Past work has revealed that the observer's goals gate the influence of many multisensory processes on brain and behavioural responses, whereas some other multisensory processes might occur independently of these goals. Consequently, other forms of top-down control beyond goal dependence are necessary to explain the full range of multisensory effects currently reported at the brain and the cognitive level. These forms of control include sensitivity to stimulus context as well as the detection of matches (or lack thereof) between a multisensory stimulus and categorical attributes of naturalistic objects (e.g. tools, animals). In this review we discuss and integrate the existing findings that demonstrate the importance of such goal-, object- and context-based top-down control over multisensory processing. We then put forward a few principles emerging from this literature review with respect to the mechanisms underlying multisensory processing and discuss their possible broader implications.

Multisensory Stimulation to Improve Low- and Higher-Level Sensory Deficits after Stroke: A Systematic Review

The aim of this systematic review was to integrate and assess evidence for the effectiveness of multisensory stimulation (i.e., stimulating at least two of the following sensory systems: visual, auditory, and somatosensory) as a possible rehabilitation method after stroke. Evidence was considered with a focus on low-level, perceptual (visual, auditory and somatosensory deficits), as well as higher-level, cognitive, sensory deficits. We referred to the electronic databases Scopus and PubMed to search for articles that were published before May 2015. Studies were included which evaluated the effects of multisensory stimulation on patients with low- or higher-level sensory deficits caused by stroke. Twenty-one studies were included in this review and the quality of these studies was assessed (based on eight elements: randomization, inclusion of control patient group, blinding of participants, blinding of researchers, follow-up, group size, reporting effect sizes, and reporting time post-stroke). Twenty of the twenty-one included studies demonstrate beneficial effects on low- and/or higher-level sensory deficits after stroke. Notwithstanding these beneficial effects, the quality of the studies is insufficient for valid conclusion that multisensory stimulation can be successfully applied as an effective intervention. A valuable and necessary next step would be to set up well-designed randomized controlled trials to examine the effectiveness of multisensory stimulation as an intervention for low- and/or higher-level sensory deficits after stroke. Finally, we consider the potential mechanisms of multisensory stimulation for rehabilitation to guide this future research.

The multisensory function of the human primary visual cortex

It has been nearly 10 years since Ghazanfar and Schroeder (2006) proposed that the neocortex is essentially multisensory in nature. However, it is only recently that sufficient and hard evidence that supports this proposal has accrued. We review evidence that activity within the human primary visual cortex plays an active role in multisensory processes and directly impacts behavioural outcome. This evidence emerges from a full pallet of human brain imaging and brain mapping methods with which multisensory processes are quantitatively assessed by taking advantage of particular strengths of each technique as well as advances in signal analyses. Several general conclusions about multisensory processes in primary visual cortex of humans are supported relatively solidly. First, haemodynamic methods (fMRI/PET) show that there is both convergence and integration occurring within primary visual cortex. Second, primary visual cortex is involved in multisensory processes during early post-stimulus stages (as revealed by EEG/ERP/ERFs as well as TMS). Third, multisensory effects in primary visual cortex directly impact behaviour and perception, as revealed by correlational (EEG/ERPs/ERFs) as well as more causal measures (TMS/tACS). While the provocative claim of Ghazanfar and Schroeder (2006) that the whole of neocortex is multisensory in function has yet to be demonstrated, this can now be considered established in the case of the human primary visual cortex.