New light from the dark: what blindness can teach us about brain function

Developing cortex is functionally pluripotent: Evidence from blindness

How rigidly does innate architecture constrain function of developing cortex? What is the contribution of early experience? We review insights into these questions from visual cortex function in people born blind. In blindness, occipital cortices are active during auditory and tactile tasks. What 'cross-modal' plasticity tells us about cortical flexibility is debated. On the one hand, visual networks of blind people respond to higher cognitive information, such as sentence grammar, suggesting drastic repurposing. On the other, in line with 'metamodal' accounts, sighted and blind populations show shared domain preferences in ventral occipito-temporal cortex (vOTC), suggesting visual areas switch input modality but perform the same or similar perceptual functions (e.g., face recognition) in blindness. Here we bring these disparate literatures together, reviewing and synthesizing evidence that speaks to whether visual cortices have similar or different functions in blind and sighted people. Together, the evidence suggests that in blindness, visual cortices are incorporated into higher-cognitive (e.g., fronto-parietal) networks, which are a major source long-range input to the visual system. We propose the connectivity-constrained experience-dependent account. Functional development is constrained by innate anatomical connectivity, experience and behavioral needs. Infant cortex is pluripotent, the same anatomical constraints develop into different functional outcomes.

Functional relevance of the extrastriate body area for visual and haptic object recognition: a preregistered fMRI-guided TMS study

The extrastriate body area (EBA) is a region in the lateral occipito-temporal cortex (LOTC), which is sensitive to perceived body parts. Neuroimaging studies suggested that EBA is related to body and tool processing, regardless of the sensory modalities. However, how essential this region is for visual tool processing and nonvisual object processing remains a matter of controversy. In this preregistered fMRI-guided repetitive transcranial magnetic stimulation (rTMS) study, we examined the causal involvement of EBA in multisensory body and tool recognition. Participants used either vision or haptics to identify 3 object categories: hands, teapots (tools), and cars (control objects). Continuous theta-burst stimulation (cTBS) was applied over left EBA, right EBA, or vertex (control site). Performance for visually perceived hands and teapots (relative to cars) was more strongly disrupted by cTBS over left EBA than over the vertex, whereas no such object-specific effect was observed in haptics. The simulation of the induced electric fields confirmed that the cTBS affected regions including EBA. These results indicate that the LOTC is functionally relevant for visual hand and tool processing, whereas the rTMS over EBA may differently affect object recognition between the 2 sensory modalities.

Multisensory representations of space and time in sensory cortices

Clear evidence demonstrated a supramodal organization of sensory cortices with multisensory processing occurring even at early stages of information encoding. Within this context, early recruitment of sensory areas is necessary for the development of fine domain-specific (i.e., spatial or temporal) skills regardless of the sensory modality involved, with auditory areas playing a crucial role in temporal processing and visual areas in spatial processing. Given the domain-specificity and the multisensory nature of sensory areas, in this study, we hypothesized that preferential domains of representation (i.e., space and time) of visual and auditory cortices are also evident in the early processing of multisensory information. Thus, we measured the event-related potential (ERP) responses of 16 participants while performing multisensory spatial and temporal bisection tasks. Audiovisual stimuli occurred at three different spatial positions and time lags and participants had to evaluate whether the second stimulus was spatially (spatial bisection task) or temporally (temporal bisection task) farther from the first or third audiovisual stimulus. As predicted, the second audiovisual stimulus of both spatial and temporal bisection tasks elicited an early ERP response (time window 50-90 ms) in visual and auditory regions. However, this early ERP component was more substantial in the occipital areas during the spatial bisection task, and in the temporal regions during the temporal bisection task. Overall, these results confirmed the domain specificity of visual and auditory cortices and revealed that this aspect selectively modulates also the cortical activity in response to multisensory stimuli.

Impact of blindness onset on the representation of sound categories in occipital and temporal cortices

The ventral occipito-temporal cortex (VOTC) reliably encodes auditory categories in people born blind using a representational structure partially similar to the one found in vision (Mattioni et al.,2020). Here, using a combination of uni- and multivoxel analyses applied to fMRI data, we extend our previous findings, comprehensively investigating how early and late acquired blindness impact on the cortical regions coding for the deprived and the remaining senses. First, we show enhanced univariate response to sounds in part of the occipital cortex of both blind groups that is concomitant to reduced auditory responses in temporal regions. We then reveal that the representation of the sound categories in the occipital and temporal regions is more similar in blind subjects compared to sighted subjects. What could drive this enhanced similarity? The multivoxel encoding of the ‘human voice’ category that we observed in the temporal cortex of all sighted and blind groups is enhanced in occipital regions in blind groups , suggesting that the representation of vocal information is more similar between the occipital and temporal regions in blind compared to sighted individuals. We additionally show that blindness does not affect the encoding of the acoustic properties of our sounds (e.g. pitch, harmonicity) in occipital and in temporal regions but instead selectively alter the categorical coding of the voice category itself. These results suggest a functionally congruent interplay between the reorganization of occipital and temporal regions following visual deprivation, across the lifespan.

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.

Dance Is More Than Meets the Eye-How Can Dance Performance Be Made Accessible for a Non-sighted Audience?

Dance is regarded as visual art form by common arts and science perspectives. Definitions of dance as means of communication agree that its message is conveyed by the dancer/choreographer via the human body for the observer, leaving no doubt that dance is performed to be watched. Brain activation elicited by the visual perception of dance has also become a topic of interest in cognitive neuroscience, with regards to action observation in the context of learning, expertise and aesthetics. The view that the aesthetic experience of dance is primarily a visual one is still shared by many artists and cultural institutions, yet there is growing interest in making dance performances accessible for individuals with visual impairment / blindness. Means of supporting the non-visual experience of dance include verbal (audio description), auditive (choreographed body sounds, movement sonification), and haptic (touch tour) techniques, applied for different purposes by artists and researchers, with three main objectives: to strengthen the cultural participation of a non-sighted audience in the cultural and aesthetic experience of dance; to expand the scope of dance as an artistic research laboratory toward novel ways of perceiving what dance can convey; and to inspire new lines of (neuro-cognitive) research beyond watching dance. Reviewing literature from different disciplines and drawing on the personal experience of an inclusive performance of Simon Mayer's "Sons of Sissy," we argue that a non-exclusively visual approach can be enriching and promising for all three perspectives and conclude by proposing hypotheses for multidisciplinary lines of research.

Multisensory inclusive design with sensory substitution

Sensory substitution techniques are perceptual and cognitive phenomena used to represent one sensory form with an alternative. Current applications of sensory substitution techniques are typically focused on the development of assistive technologies whereby visually impaired users can acquire visual information via auditory and tactile cross-modal feedback. But despite their evident success in scientific research and furthering theory development in cognition, sensory substitution techniques have not yet gained widespread adoption within sensory-impaired populations. Here we argue that shifting the focus from assistive to mainstream applications may resolve some of the current issues regarding the use of sensory substitution devices to improve outcomes for those with disabilities. This article provides a tutorial guide on how to use research into multisensory processing and sensory substitution techniques from the cognitive sciences to design new inclusive cross-modal displays. A greater focus on developing inclusive mainstream applications could lead to innovative technologies that could be enjoyed by every person.

Mixing up the Senses: Sensory Substitution Is Not a Form of Artificially Induced Synaesthesia

Sensory Substitution Devices (SSDs) are typically used to restore functionality of a sensory modality that has been lost, like vision for the blind, by recruiting another sensory modality such as touch or audition. Sensory substitution has given rise to many debates in psychology, neuroscience and philosophy regarding the nature of experience when using SSDs. Questions first arose as to whether the experience of sensory substitution is represented by the substituted information, the substituting information, or a multisensory combination of the two. More recently, parallels have been drawn between sensory substitution and synaesthesia, a rare condition in which individuals involuntarily experience a percept in one sensory or cognitive pathway when another one is stimulated. Here, we explore the efficacy of understanding sensory substitution as a form of 'artificial synaesthesia'. We identify several problems with previous suggestions for a link between these two phenomena. Furthermore, we find that sensory substitution does not fulfil the essential criteria that characterise synaesthesia. We conclude that sensory substitution and synaesthesia are independent of each other and thus, the 'artificial synaesthesia' view of sensory substitution should be rejected.

The Role of Binocular Vision in Driving Pseudoneglect in Visual and Haptic Bisection: Evidence From Strabismic and Monocular Blind Individuals

Prior studies have shown that strabismic amblyopes do not exhibit pseudoneglect in visual line bisection, suggesting that the right-hemisphere dominance in the control of spatial attention may depend on a normally developing binocular vision. In this study, we aimed to investigate whether an abnormal binocular childhood experience also affects spatial attention in the haptic modality, thus reflecting a supramodal effect. To this aim, we compared the performance of normally sighted, strabismic and early monocular blind participants in a visual and a haptic line bisection task. In visual line bisection, strabismic individuals tended to err to the right of the veridical midpoint, in contrast with normally sighted participants who showed pseudoneglect. Monocular blind participants exhibited high variability in their visual performance, with a tendency to bisect toward the direction of the functioning eye. In turn, in haptic bisection, all participants consistently erred towards the left of the veridical midpoint. Taken together, our findings support the view that pseudoneglect in the visual and haptic modality relies on different functional and neural mechanisms.

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.

Neuroplasticity in cerebral visual impairment (CVI): Assessing functional vision and the neurophysiological correlates of dorsal stream dysfunction

Cerebral visual impairment (CVI) results from perinatal injury to visual processing structures and pathways and is the most common individual cause of pediatric visual impairment and blindness in developed countries. While there is mounting evidence demonstrating extensive neuroplastic reorganization in early onset, profound ocular blindness, how the brain reorganizes in the setting of congenital damage to cerebral (i.e. retro-geniculate) visual pathways remains comparatively poorly understood. Individuals with CVI exhibit a wide range of visual deficits and, in particular, present with impairments of higher order visual spatial processing (referred to as "dorsal stream dysfunction") as well as object recognition (associated with processing along the ventral stream). In this review, we discuss the need for ongoing work to develop novel, neuroscience-inspired approaches to investigate functional visual deficits in this population. We also outline the role played by advanced structural and functional neuroimaging in helping to elucidate the underlying neurophysiology of CVI, and highlight key differences with regard to patterns of neural reorganization previously described in ocular blindness.

Brain (re)organization following visual loss

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

[Changes in walking in the elderly]

The article addresses gait disturbances in the elderly. It emphasizes that the system that maintains the balance in resting conditions and gait is based on the hierarchical principle and its function depends on the maintenance of integration between vestibular, visual and somatosensory information as well as on cognitive functions. Walking depends on the integrity of frontal-subcortical neuronal circles that support regulatory functions. The main pathogenetic mechanisms of age-related disturbances of balance and gait are a decrease in the efficacy of spinal motorneurons activation caused by Ia-afferentation, a decrease in cortical activation and excitability of corticospinal pathways and in the intensity of intracortical inhibition. The causes of age-related changes in walking are not confined to a single system (e.g., one sensory modality) but have a multisystem character and are involved in many structures. The author analyses the results of recent studies that use functional neuroimaging methods.

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.

Peripersonal space representation develops independently from visual experience

Our daily-life actions are typically driven by vision. When acting upon an object, we need to represent its visual features (e.g. shape, orientation, etc.) and to map them into our own peripersonal space. But what happens with people who have never had any visual experience? How can they map object features into their own peripersonal space? Do they do it differently from sighted agents? To tackle these questions, we carried out a series of behavioral experiments in sighted and congenitally blind subjects. We took advantage of a spatial alignment effect paradigm, which typically refers to a decrease of reaction times when subjects perform an action (e.g., a reach-to-grasp pantomime) congruent with that afforded by a presented object. To systematically examine peripersonal space mapping, we presented visual or auditory affording objects both within and outside subjects’ reach. The results showed that sighted and congenitally blind subjects did not differ in mapping objects into their own peripersonal space. Strikingly, this mapping occurred also when objects were presented outside subjects’ reach, but within the peripersonal space of another agent. This suggests that (the lack of) visual experience does not significantly affect the development of both one’s own and others’ peripersonal space representation.

Modality-independent encoding of individual concepts in the left parietal cortex

The organization of semantic information in the brain has been mainly explored through category-based models, on the assumption that categories broadly reflect the organization of conceptual knowledge. However, the analysis of concepts as individual entities, rather than as items belonging to distinct superordinate categories, may represent a significant advancement in the comprehension of how conceptual knowledge is encoded in the human brain. Here, we studied the individual representation of thirty concrete nouns from six different categories, across different sensory modalities (i.e., auditory and visual) and groups (i.e., sighted and congenitally blind individuals) in a core hub of the semantic network, the left angular gyrus, and in its neighboring regions within the lateral parietal cortex. Four models based on either perceptual or semantic features at different levels of complexity (i.e., low- or high-level) were used to predict fMRI brain activity using representational similarity encoding analysis. When controlling for the superordinate component, high-level models based on semantic and shape information led to significant encoding accuracies in the intraparietal sulcus only. This region is involved in feature binding and combination of concepts across multiple sensory modalities, suggesting its role in high-level representation of conceptual knowledge. Moreover, when the information regarding superordinate categories is retained, a large extent of parietal cortex is engaged. This result indicates the need to control for the coarse-level categorial organization when performing studies on higher-level processes related to the retrieval of semantic information.

Anticipatory action planning in blind and sighted individuals

Several studies on visually guided reach-to-grasp movements have documented that how objects are grasped differs depending on the actions one intends to perform subsequently. However, no previous study has examined whether this differential grasping may also occur without visual input. In this study, we used motion capture technology to investigate the influence of visual feedback and prior visual experience on the modulation of kinematics by intention in sighted (in both full-vision and no-vision conditions), early-blind and late-blind participants. Results provide evidence of modulation of kinematics by intention to a similar degree under both full-vision and no-vision conditions. Moreover, they demonstrate that prior visual experience has little impact on the tailoring of grasping movements to intention. This suggests that sequential action planning does not depend on visual input, and may instead be ascribed to the function of multisensory-motor cortical network that operates and develops not only in light, but also in darkness.

Are Supramodality and Cross-Modal Plasticity the Yin and Yang of Brain Development? From Blindness to Rehabilitation

Research in blind individuals has primarily focused for a long time on the brain plastic reorganization that occurs in early visual areas. Only more recently, scientists have developed innovative strategies to understand to what extent vision is truly a mandatory prerequisite for the brain's fine morphological architecture to develop and function. As a whole, the studies conducted to date in sighted and congenitally blind individuals have provided ample evidence that several "visual" cortical areas develop independently from visual experience and do process information content regardless of the sensory modality through which a particular stimulus is conveyed: a property named supramodality. At the same time, lack of vision leads to a structural and functional reorganization within "visual" brain areas, a phenomenon known as cross-modal plasticity. Cross-modal recruitment of the occipital cortex in visually deprived individuals represents an adaptative compensatory mechanism that mediates processing of non-visual inputs. Supramodality and cross-modal plasticity appears to be the "yin and yang" of brain development: supramodal is what takes place despite the lack of vision, whereas cross-modal is what happens because of lack of vision. Here we provide a critical overview of the research in this field and discuss the implications that these novel findings have for the development of educative/rehabilitation approaches and sensory substitution devices (SSDs) in sensory-impaired individuals.

Other ways of seeing: From behavior to neural mechanisms in the online "visual" control of action with sensory substitution

Vision is the dominant sense for perception-for-action in humans and other higher primates. Advances in sight restoration now utilize the other intact senses to provide information that is normally sensed visually through sensory substitution to replace missing visual information. Sensory substitution devices translate visual information from a sensor, such as a camera or ultrasound device, into a format that the auditory or tactile systems can detect and process, so the visually impaired can see through hearing or touch. Online control of action is essential for many daily tasks such as pointing, grasping and navigating, and adapting to a sensory substitution device successfully requires extensive learning. Here we review the research on sensory substitution for vision restoration in the context of providing the means of online control for action in the blind or blindfolded. It appears that the use of sensory substitution devices utilizes the neural visual system; this suggests the hypothesis that sensory substitution draws on the same underlying mechanisms as unimpaired visual control of action. Here we review the current state of the art for sensory substitution approaches to object recognition, localization, and navigation, and the potential these approaches have for revealing a metamodal behavioral and neural basis for the online control of action.

When Neuroscience 'Touches' Architecture: From Hapticity to a Supramodal Functioning of the Human Brain

In the last decades, the rapid growth of functional brain imaging methodologies allowed cognitive neuroscience to address open questions in philosophy and social sciences. At the same time, novel insights from cognitive neuroscience research have begun to influence various disciplines, leading to a turn to cognition and emotion in the fields of planning and architectural design. Since 2003, the Academy of Neuroscience for Architecture has been supporting 'neuro-architecture' as a way to connect neuroscience and the study of behavioral responses to the built environment. Among the many topics related to multisensory perceptual integration and embodiment, the concept of hapticity was recently introduced, suggesting a pivotal role of tactile perception and haptic imagery in architectural appraisal. Arguments have thus risen in favor of the existence of shared cognitive foundations between hapticity and the supramodal functional architecture of the human brain. Precisely, supramodality refers to the functional feature of defined brain regions to process and represent specific information content in a more abstract way, independently of the sensory modality conveying such information to the brain. Here, we highlight some commonalities and differences between the concepts of hapticity and supramodality according to the distinctive perspectives of architecture and cognitive neuroscience. This comparison and connection between these two different approaches may lead to novel observations in regard to people-environment relationships, and even provide empirical foundations for a renewed evidence-based design theory.

Auditory motion in the sighted and blind: Early visual deprivation triggers a large-scale imbalance between auditory and "visual" brain regions

How early blindness reorganizes the brain circuitry that supports auditory motion processing remains controversial. We used fMRI to characterize brain responses to in-depth, laterally moving, and static sounds in early blind and sighted individuals. Whole-brain univariate analyses revealed that the right posterior middle temporal gyrus and superior occipital gyrus selectively responded to both in-depth and laterally moving sounds only in the blind. These regions overlapped with regions selective for visual motion (hMT+/V5 and V3A) that were independently localized in the sighted. In the early blind, the right planum temporale showed enhanced functional connectivity with right occipito-temporal regions during auditory motion processing and a concomitant reduced functional connectivity with parietal and frontal regions. Whole-brain searchlight multivariate analyses demonstrated higher auditory motion decoding in the right posterior middle temporal gyrus in the blind compared to the sighted, while decoding accuracy was enhanced in the auditory cortex bilaterally in the sighted compared to the blind. Analyses targeting individually defined visual area hMT+/V5 however indicated that auditory motion information could be reliably decoded within this area even in the sighted group. Taken together, the present findings demonstrate that early visual deprivation triggers a large-scale imbalance between auditory and "visual" brain regions that typically support the processing of motion information.

Impact of Early and Late Visual Deprivation on the Structure of the Corpus Callosum: A Study Combining Thickness Profile with Surface Tensor-Based Morphometry

Blindness represents a unique model to study how visual experience may shape the development of brain organization. Exploring how the structure of the corpus callosum (CC) reorganizes ensuing visual deprivation is of particular interest due to its important functional implication in vision (e.g., via the splenium of the CC). Moreover, comparing early versus late visually deprived individuals has the potential to unravel the existence of a sensitive period for reshaping the CC structure. Here, we develop a novel framework to capture a complete set of shape differences in the CC between congenitally blind (CB), late blind (LB) and sighted control (SC) groups. The CCs were manually segmented from T1-weighted brain MRI and modeled by 3D tetrahedral meshes. We statistically compared the combination of local area and thickness at each point between subject groups. Differences in area are found using surface tensor-based morphometry; thickness is estimated by tracing the streamlines in the volumetric harmonic field. Group differences were assessed on this combined measure using Hotelling's T(2) test. Interestingly, we observed that the total callosal volume did not differ between the groups. However, our fine-grained analysis reveals significant differences mostly localized around the splenium areas between both blind groups and the sighted group (general effects of blindness) and, importantly, specific dissimilarities between the LB and CB groups, illustrating the existence of a sensitive period for reorganization. The new multivariate statistics also gave better effect sizes for detecting morphometric differences, relative to other statistics. They may boost statistical power for CC morphometric analyses.

Object Domain and Modality in the Ventral Visual Pathway

The nature of domain-specific organization in higher-order visual cortex (ventral occipital temporal cortex, VOTC) has been investigated both in the case of visual experience deprivation and of modality of stimulation in sighted individuals. Object domain interacts in an intriguing and revelatory way with visual experience and modality of stimulation: selectivity for artifacts and scene domains is largely immune to visual deprivation and is multi-modal, whereas selectivity for animate items in lateral posterior fusiform gyrus is present only with visual stimulation. This domain-by-modality interaction is not readily accommodated by existing theories of VOTC representation. We conjecture that these effects reflect a distinction between the visual features that characterize different object domains and their interaction with different types of downstream computational systems.

Is there a future for sensory substitution outside academic laboratories?

Sensory substitution devices (SSDs) have been developed with the ultimate purpose of supporting sensory deprived individuals in their daily activities. However, more than forty years after their first appearance in the scientific literature, SSDs still remain more common in research laboratories than in the daily life of people with sensory deprivation. Here, we seek to identify the reasons behind the limited diffusion of SSDs among the blind community by discussing the ergonomic, neurocognitive and psychosocial issues potentially associated with the use of these systems. We stress that these issues should be considered together when developing future devices or improving existing ones. We provide some examples of how to achieve this by adopting a multidisciplinary and participatory approach. These efforts would contribute not solely to address fundamental theoretical research questions, but also to better understand the everyday needs of blind people and eventually promote the use of SSDs outside laboratories.

Inborn and experience-dependent models of categorical brain organization. A position paper

The present review aims to summarize the debate in contemporary neuroscience between inborn and experience-dependent models of conceptual representations that goes back to the description of category-specific semantic disorders for biological and artifact categories. Experience-dependent models suggest that categorical disorders are the by-product of the differential weighting of different sources of knowledge in the representation of biological and artifact categories. These models maintain that semantic disorders are not really category-specific, because they do not respect the boundaries between different categories. They also argue that the brain structures which are disrupted in a given type of category-specific semantic disorder should correspond to the areas of convergence of the sensory-motor information which play a major role in the construction of that category. Furthermore, they provide a simple interpretation of gender-related categorical effects and are supported by studies assessing the importance of prior experience in the cortical representation of objects On the other hand, inborn models maintain that category-specific semantic disorders reflect the disruption of innate brain networks, which are shaped by natural selection to allow rapid identification of objects that are very relevant for survival. From the empirical point of view, these models are mainly supported by observations of blind subjects, which suggest that visual experience is not necessary for the emergence of category-specificity in the ventral stream of visual processing. The weight of the data supporting experience-dependent and inborn models is thoroughly discussed, stressing the fact observations made in blind subjects are still the subject of intense debate. It is concluded that at the present state of knowledge it is not possible to choose between experience-dependent and inborn models of conceptual representations.

Spatial imagery relies on a sensory independent, though sensory sensitive, functional organization within the parietal cortex: a fMRI study of angle discrimination in sighted and congenitally blind individuals

Although vision offers distinctive information to space representation, individuals who lack vision since birth often show perceptual and representational skills comparable to those found in sighted individuals. However, congenitally blind individuals may result in impaired spatial analysis, when engaging in 'visual' spatial features (e.g., perspective or angle representation) or complex spatial mental abilities. In the present study, we measured behavioral and brain responses using functional magnetic resonance imaging in sighted and congenitally blind individuals during spatial imagery based on a modified version of the mental clock task (e.g., angle discrimination) and a simple recognition control condition, as conveyed across distinct sensory modalities: visual (sighted individuals only), tactile and auditory. Blind individuals were significantly less accurate during the auditory task, but comparable-to-sighted during the tactile task. As expected, both groups showed common neural activations in intraparietal and superior parietal regions across visual and non-visual spatial perception and imagery conditions, indicating the more abstract, sensory independent functional organization of these cortical areas, a property that we named supramodality. At the same time, however, comparisons in brain responses and functional connectivity patterns across experimental conditions demonstrated also a functional lateralization, in a way that correlated with the distinct behavioral performance in blind and sighted individuals. Specifically, blind individuals relied more on right parietal regions, mainly in the tactile and less in the auditory spatial processing. In sighted, spatial representation across modalities relied more on left parietal regions. In conclusions, intraparietal and superior parietal regions subserve supramodal spatial representations in sighted and congenitally blind individuals. Differences in their recruitment across non-visual spatial processing in sighted and blind individuals may be related to distinctive behavioral performance and/or mental strategies adopted when they deal with the same spatial representation as conveyed through different sensory modalities.

[On the question of the organization of brain function: cortical associations, «disconnection» syndrome and higher brain functions]

The review considers the structural/functional brain organization, the disturbance of which is accompanied by the development of cognitive and behavioral disorders. The significance of the disruption of parallel circuits connecting frontal lobes with subcortical structures (the basal ganglia, thalamus, cerebellum) is highlighted. This disruption is clinically described as "disconnection" syndrome. The associations between the basal ganglia and the cortex of the large cerebral hemispheres responsible for motor, cognitive and emotional/behavioral functions do not restricted to these spheres and is characteristic not only of frontal brain areas. There are circuits connecting other brain compartments and the basal ganglia that provide perception, and are involved in decision making on the basis of input information of different modalities.The improvement of understanding of the pathophysiology and neurochemistry of these structures opens new possibilities for selective action on some or other circuit to achieve the best therapeutic result.

Tracking the evolution of crossmodal plasticity and visual functions before and after sight restoration

Visual deprivation leads to massive reorganization in both the structure and function of the occipital cortex, raising crucial challenges for sight restoration. We tracked the behavioral, structural, and neurofunctional changes occurring in an early and severely visually impaired patient before and 1.5 and 7 mo after sight restoration with magnetic resonance imaging. Robust presurgical auditory responses were found in occipital cortex despite residual preoperative vision. In primary visual cortex, crossmodal auditory responses overlapped with visual responses and remained elevated even 7 mo after surgery. However, these crossmodal responses decreased in extrastriate occipital regions after surgery, together with improved behavioral vision and with increases in both gray matter density and neural activation in low-level visual regions. Selective responses in high-level visual regions involved in motion and face processing were observable even before surgery and did not evolve after surgery. Taken together, these findings demonstrate that structural and functional reorganization of occipital regions are present in an individual with a long-standing history of severe visual impairment and that such reorganizations can be partially reversed by visual restoration in adulthood.

Morphometric changes of the corpus callosum in congenital blindness

We examined the effects of visual deprivation at birth on the development of the corpus callosum in a large group of congenitally blind individuals. We acquired high-resolution T1-weighted MRI scans in 28 congenitally blind and 28 normal sighted subjects matched for age and gender. There was no overall group effect of visual deprivation on the total surface area of the corpus callosum. However, subdividing the corpus callosum into five subdivisions revealed significant regional changes in its three most posterior parts. Compared to the sighted controls, congenitally blind individuals showed a 12% reduction in the splenium, and a 20% increase in the isthmus and the posterior part of the body. A shape analysis further revealed that the bending angle of the corpus callosum was more convex in congenitally blind compared to the sighted control subjects. The observed morphometric changes in the corpus callosum are in line with the well-described cross-modal functional and structural neuroplastic changes in congenital blindness.

Where there is a goal, there is a way: what, why and how the parieto-frontal mirror network can mediate imitative behaviours

The relationships between mirror neurons (MNs) and motor imitation, and its clinical implications in autism spectrum disorder (ASD) have been widely investigated; however, the literature remains—at least partially—controversial. In this review we support a multi-level action understanding model focusing on the mirror-based understanding. We review the functional role of the parieto-frontal MNs (PFMN) network claiming that PFMNs function cannot be limited to imitation nor can imitation be explained solely by the activity of PFMNs. The distinction between movement, motor act and motor action is useful to characterize deeply both act(ion) understanding and imitation of act(ion). A more abstract representation of act(ion) may be crucial for clarifying what, why and how an imitator is imitating. What counts in social interactions is achieving goals: it does not matter which effector or string of motor acts you eventually use for achieving (proximal and distal) goals. Similarly, what counts is the ability to recognize/imitate the style of act(ion) regardless of the way in which it is expressed. We address this crucial point referring to its potential implications in ASD.

Recognizing familiar objects by hand and foot: Haptic shape perception generalizes to inputs from unusual locations and untrained body parts

The limits of generalization of our 3-D shape recognition system to identifying objects by touch was investigated by testing exploration at unusual locations and using untrained effectors. In Experiments 1 and 2, people found identification by hand of real objects, plastic 3-D models of objects, and raised line drawings placed in front of themselves no easier than when exploration was behind their back. Experiment 3 compared one-handed, two-handed, one-footed, and two-footed haptic object recognition of familiar objects. Recognition by foot was slower (7 vs. 13 s) and much less accurate (9 % vs. 47 % errors) than recognition by either one or both hands. Nevertheless, item difficulty was similar across hand and foot exploration, and there was a strong correlation between an individual's hand and foot performance. Furthermore, foot recognition was better with the largest 20 of the 80 items (32 % errors), suggesting that physical limitations hampered exploration by foot. Thus, object recognition by hand generalized efficiently across the spatial location of stimuli, while object recognition by foot seemed surprisingly good given that no prior training was provided. Active touch (haptics) thus efficiently extracts 3-D shape information and accesses stored representations of familiar objects from novel modes of input.

The blind brain: How (lack of) vision shapes the morphological and functional architecture of the human brain

Since the early days, how we represent the world around us has been a matter of philosophical speculation. Over the last few decades, modern neuroscience, and specifically the development of methodologies for the structural and the functional exploration of the brain have made it possible to investigate old questions with an innovative approach. In this brief review, we discuss the main findings from a series of brain anatomical and functional studies conducted in sighted and congenitally blind individuals by our’s and others' laboratories. Historically, research on the ‘blind brain’ has focused mainly on the cross-modal plastic changes that follow sensory deprivation. More recently, a novel line of research has been developed to determine to what extent visual experience is truly required to achieve a representation of the surrounding environment. Overall, the results of these studies indicate that most of the brain fine morphological and functional architecture is programmed to develop and function independently from any visual experience. Distinct cortical areas are able to process information in a supramodal fashion, that is, independently from the sensory modality that carries that information to the brain. These observations strongly support the hypothesis of a modality-independent, i.e. more abstract, cortical organization, and may contribute to explain how congenitally blind individuals may interact efficiently with an external world that they have never seen.

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.

Early auditory processing in area V5/MT+ of the congenitally blind brain

Previous imaging studies of congenital blindness have studied individuals with heterogeneous causes of blindness, which may influence the nature and extent of cross-modal plasticity. Here, we scanned a homogeneous group of blind people with bilateral congenital anophthalmia, a condition in which both eyes fail to develop, and, as a result, the visual pathway is not stimulated by either light or retinal waves. This model of congenital blindness presents an opportunity to investigate the effects of very early visual deafferentation on the functional organization of the brain. In anophthalmic animals, the occipital cortex receives direct subcortical auditory input. We hypothesized that this pattern of subcortical reorganization ought to result in a topographic mapping of auditory frequency information in the occipital cortex of anophthalmic people. Using functional MRI, we examined auditory-evoked activity to pure tones of high, medium, and low frequencies. Activity in the superior temporal cortex was significantly reduced in anophthalmic compared with sighted participants. In the occipital cortex, a region corresponding to the cytoarchitectural area V5/MT+ was activated in the anophthalmic participants but not in sighted controls. Whereas previous studies in the blind indicate that this cortical area is activated to auditory motion, our data show it is also active for trains of pure tone stimuli and in some anophthalmic participants shows a topographic mapping (tonotopy). Therefore, this region appears to be performing early sensory processing, possibly served by direct subcortical input from the pulvinar to V5/MT+.

Feeling better: separate pathways for targeted enhancement of spatial and temporal touch

People perceive spatial form and temporal frequency through touch. Although distinct somatosensory neurons represent spatial and temporal information, these neural populations are intermixed throughout the somatosensory system. Here, we show that spatial and temporal touch can be dissociated and separately enhanced via cortical pathways that are normally associated with vision and audition. In Experiments 1 and 2, we found that anodal transcranial direct current stimulation (tDCS) applied over visual cortex, but not auditory cortex, enhances tactile perception of spatial orientation. In Experiments 3 and 4, we found that anodal tDCS over auditory cortex, but not visual cortex, enhances tactile perception of temporal frequency. This double dissociation reveals separate cortical pathways that selectively support spatial and temporal channels. These results bolster the emerging view that sensory areas process multiple modalities and suggest that supramodal domains may be more fundamental to cortical organization.

Sensory substitution: closing the gap between basic research and widespread practical visual rehabilitation

Sensory substitution devices (SSDs) have come a long way since first developed for visual rehabilitation. They have produced exciting experimental results, and have furthered our understanding of the human brain. Unfortunately, they are still not used for practical visual rehabilitation, and are currently considered as reserved primarily for experiments in controlled settings. Over the past decade, our understanding of the neural mechanisms behind visual restoration has changed as a result of converging evidence, much of which was gathered with SSDs. This evidence suggests that the brain is more than a pure sensory-machine but rather is a highly flexible task-machine, i.e., brain regions can maintain or regain their function in vision even with input from other senses. This complements a recent set of more promising behavioral achievements using SSDs and new promising technologies and tools. All these changes strongly suggest that the time has come to revive the focus on practical visual rehabilitation with SSDs and we chart several key steps in this direction such as training protocols and self-train tools.

How can audiovisual pathways enhance the temporal resolution of time-compressed speech in blind subjects?

In blind people, the visual channel cannot assist face-to-face communication via lipreading or visual prosody. Nevertheless, the visual system may enhance the evaluation of auditory information due to its cross-links to (1) the auditory system, (2) supramodal representations, and (3) frontal action-related areas. Apart from feedback or top-down support of, for example, the processing of spatial or phonological representations, experimental data have shown that the visual system can impact auditory perception at more basic computational stages such as temporal signal resolution. For example, blind as compared to sighted subjects are more resistant against backward masking, and this ability appears to be associated with activity in visual cortex. Regarding the comprehension of continuous speech, blind subjects can learn to use accelerated text-to-speech systems for "reading" texts at ultra-fast speaking rates (>16 syllables/s), exceeding by far the normal range of 6 syllables/s. A functional magnetic resonance imaging study has shown that this ability, among other brain regions, significantly covaries with BOLD responses in bilateral pulvinar, right visual cortex, and left supplementary motor area. Furthermore, magnetoencephalographic measurements revealed a particular component in right occipital cortex phase-locked to the syllable onsets of accelerated speech. In sighted people, the "bottleneck" for understanding time-compressed speech seems related to higher demands for buffering phonological material and is, presumably, linked to frontal brain structures. On the other hand, the neurophysiological correlates of functions overcoming this bottleneck, seem to depend upon early visual cortex activity. The present Hypothesis and Theory paper outlines a model that aims at binding these data together, based on early cross-modal pathways that are already known from various audiovisual experiments on cross-modal adjustments during space, time, and object recognition.

Impact of blindness onset on the functional organization and the connectivity of the occipital cortex

Contrasting the impact of congenital versus late-onset acquired blindness provides a unique model to probe how experience at different developmental periods shapes the functional organization of the occipital cortex. We used functional magnetic resonance imaging to characterize brain activations of congenitally blind, late-onset blind and two groups of sighted control individuals while they processed either the pitch or the spatial attributes of sounds. Whereas both blind groups recruited occipital regions for sound processing, activity in bilateral cuneus was only apparent in the congenitally blind, highlighting the existence of region-specific critical periods for crossmodal plasticity. Most importantly, the preferential activation of the right dorsal stream (middle occipital gyrus and cuneus) for the spatial processing of sounds was only observed in the congenitally blind. This demonstrates that vision has to be lost during an early sensitive period in order to transfer its functional specialization for space processing toward a non-visual modality. We then used a combination of dynamic causal modelling with Bayesian model selection to demonstrate that auditory-driven activity in primary visual cortex is better explained by direct connections with primary auditory cortex in the congenitally blind whereas it relies more on feedback inputs from parietal regions in the late-onset blind group. Taken together, these results demonstrate the crucial role of the developmental period of visual deprivation in (re)shaping the functional architecture and the connectivity of the occipital cortex. Such findings are clinically important now that a growing number of medical interventions may restore vision after a period of visual deprivation.