Blindness and Human Brain Plasticity

Longitudinal stability of individual brain plasticity patterns in blindness

The primary visual cortex (V1) in blindness 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 specific to task demands. This would suggest that reorganized V1 assumes a role like multiple-demand system regions. Alternatively, varying patterns of plasticity in blind V1 may be attributed to individual factors, with different blind individuals recruiting V1 preferentially for different functions. In support of this, we recently showed that V1 functional connectivity (FC) varies greatly across blind individuals. But do these represent stable individual patterns of plasticity, or are they driven more by instantaneous changes, like a multiple-demand system now inhabiting V1? Here, we tested whether individual FC patterns from the V1 of blind individuals are stable over time. We show that over two years, FC from the V1 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 V1 connectivity, this indicates that there may be a consistent role for V1 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.

Neural networks associated with eye movements in congenital blindness

Recent studies have shown that during the typical resting-state, echo planar imaging (EPI) time series obtained from the eye orbit area correlate with brain regions associated with oculomotor control and lower-level visual cortex. Here, we asked whether congenitally blind (CB) shows similar patterns, suggesting a hard-wired constraint on connectivity. We find that orbital EPI signals in CB do correlate with activity in the motor cortex, but less so with activity in the visual cortex. However, the temporal patterns of this eye movement-related signal differed strongly between CB and sighted controls. Furthermore, in CB, a few participants showed uncoordinated orbital EPI signals between the two eyes, each correlated with activity in different brain networks. Our findings suggest a retained circuitry between motor cortex and eye movements in blind, but also a moderate reorganization due to the absence of visual input, and the inability of CB to control their eye movements or sense their positions.

Reading instruction causes changes in category-selective visual cortex

Education sculpts specialized neural circuits for skills like reading that are critical to success in modern society but were not anticipated by the selective pressures of evolution. Does the emergence of brain regions that selectively process novel visual stimuli like words occur at the expense of cortical representations of other stimuli like faces and objects? "Neuronal Recycling" predicts that learning to read should enhance the response to words in ventral occipitotemporal cortex (VOTC) and decrease the response to other visual categories such as faces and objects. To test this hypothesis, and more broadly to understand the changes that are induced by the early stages of literacy instruction, we conducted a randomized controlled trial with pre-school children (five years of age). Children were randomly assigned to intervention programs focused on either reading skills or oral language skills and magnetoencephalography (MEG) data collected before and after the intervention was used to measure visual responses to images of text, faces, and objects. We found that being taught reading versus oral language skills induced different patterns of change in category-selective regions of visual cortex, but that there was not a clear tradeoff between the response to words versus other categories. Within a predefined region of VOTC corresponding to the visual word form area (VWFA) we found that the relative amplitude of responses to text, faces, and objects changed, but increases in the response to words were not linked to decreases in the response to faces or objects. How these changes play out over a longer timescale is still unknown but, based on these data, we can surmise that high-level visual cortex undergoes rapid changes as children enter school and begin establishing new skills like literacy.

Blindness influences emotional authenticity perception in voices: Behavioral and ERP evidence

The ability to distinguish spontaneous from volitional emotional expressions is an important social skill. How do blind individuals perceive emotional authenticity? Unlike sighted individuals, they cannot rely on facial and body language cues, relying instead on vocal cues alone. Here, we combined behavioral and ERP measures to investigate authenticity perception in laughter and crying in individuals with early- or late-blindness onset. Early-blind, late-blind, and sighted control participants (n = 17 per group, N = 51) completed authenticity and emotion discrimination tasks while EEG data were recorded. The stimuli consisted of laughs and cries that were either spontaneous or volitional. The ERP analysis focused on the N1, P2, and late positive potential (LPP). Behaviorally, early-blind participants showed intact authenticity perception, but late-blind participants performed worse than controls. There were no group differences in the emotion discrimination task. In brain responses, all groups were sensitive to laughter authenticity at the P2 stage, and to crying authenticity at the early LPP stage. Nevertheless, only early-blind participants were sensitive to crying authenticity at the N1 and middle LPP stages, and to laughter authenticity at the early LPP stage. Furthermore, early-blind and sighted participants were more sensitive than late-blind ones to crying authenticity at the P2 and late LPP stages. Altogether, these findings suggest that early blindness relates to facilitated brain processing of authenticity in voices, both at early sensory and late cognitive-evaluative stages. Late-onset blindness, in contrast, relates to decreased sensitivity to authenticity at behavioral and brain levels.

A unified model for cross-modal plasticity and skill acquisition

Historically, cross-modal plasticity following early blindness has been largely studied in the context of visual deprivation. However, more recently, there has been a shift in focus towards understanding cross-modal plasticity from the perspective of skill acquisition: the striking plasticity observed in early blind individuals reflects the extraordinary perceptual and cognitive challenges they solve. Here, inspired by two seminal papers on skill learning (the "cortical recycling" theory) and cross-modal plasticity (the "metamodal" hypothesis) respectively, we present a unified hypothesis of cortical specialization that describes how shared functional, algorithmic, and structural constraints might mediate both types of plasticity.

Congenital Malformations of the Eye: A Pictorial Review and Clinico-Radiological Correlations

Congenital malformations of the eye represent a wide and heterogeneous spectrum of abnormalities that may be part of a complex syndrome or be isolated. Ocular malformation severity depends on the timing of the causative event during eye formation, ranging from the complete absence of the eye if injury occurs during the first weeks of gestation, to subtle abnormalities if the cause occurs later on. Knowledge of ocular malformations is crucial to performing a tailored imaging protocol and correctly reporting imaging findings. Together with the ophthalmologic evaluation, imaging may help frame ocular malformations and identify underlying genetic conditions. The purpose of this pictorial review is to describe the imaging features of the main ocular malformations and the related ophthalmologic findings in order to provide a clinico-radiological overview of these abnormalities to the clinical radiologist. Sight is a crucial sense for children to explore the world and relate with their parents from birth. Vision impairment or even blindness secondary to ocular malformations deeply affects children's growth and quality of life.

Sound-encoded faces activate the left fusiform face area in the early blind

Face perception in humans and nonhuman primates is accomplished by a patchwork of specialized cortical regions. How these regions develop has remained controversial. In sighted individuals, facial information is primarily conveyed via the visual modality. Early blind individuals, on the other hand, can recognize shapes using auditory and tactile cues. Here we demonstrate that such individuals can learn to distinguish faces from houses and other shapes by using a sensory substitution device (SSD) presenting schematic faces as sound-encoded stimuli in the auditory modality. Using functional MRI, we then asked whether a face-selective brain region like the fusiform face area (FFA) shows selectivity for faces in the same subjects, and indeed, we found evidence for preferential activation of the left FFA by sound-encoded faces. These results imply that FFA development does not depend on experience with visual faces per se but may instead depend on exposure to the geometry of facial configurations.

Against cortical reorganisation

Neurological insults, such as congenital blindness, deafness, amputation, and stroke, often result in surprising and impressive behavioural changes. Cortical reorganisation, which refers to preserved brain tissue taking on a new functional role, is often invoked to account for these behavioural changes. Here, we revisit many of the classical animal and patient cortical remapping studies that spawned this notion of reorganisation. We highlight empirical, methodological, and conceptual problems that call this notion into doubt. We argue that appeal to the idea of reorganisation is attributable in part to the way that cortical maps are empirically derived. Specifically, cortical maps are often defined based on oversimplified assumptions of 'winner-takes-all', which in turn leads to an erroneous interpretation of what it means when these maps appear to change. Conceptually, remapping is interpreted as a circuit receiving novel input and processing it in a way unrelated to its original function. This implies that neurons are either pluripotent enough to change what they are tuned to or that a circuit can change what it computes. Instead of reorganisation, we argue that remapping is more likely to occur due to potentiation of pre-existing architecture that already has the requisite representational and computational capacity pre-injury. This architecture can be facilitated via Hebbian and homeostatic plasticity mechanisms. Crucially, our revised framework proposes that opportunities for functional change are constrained throughout the lifespan by the underlying structural 'blueprint'. At no period, including early in development, does the cortex offer structural opportunities for functional pluripotency. We conclude that reorganisation as a distinct form of cortical plasticity, ubiquitously evoked with words such as 'take-over'' and 'rewiring', does not exist.

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.

Does visual experience influence arm proprioception and its lateralization? Evidence from passive matching performance in congenitally-blind and sighted adults

In humans, body segments' position and movement can be estimated from multiple senses such as vision and proprioception. It has been suggested that vision and proprioception can influence each other and that upper-limb proprioception is asymmetrical, with proprioception of the non-dominant arm being more accurate and/or precise than proprioception of the dominant arm. However, the mechanisms underlying the lateralization of proprioceptive perception are not yet understood. Here we tested the hypothesis that early visual experience influences the lateralization of arm proprioceptive perception by comparing 8 congenitally-blind and 8 matched, sighted right-handed adults. Their proprioceptive perception was assessed at the elbow and wrist joints of both arms using an ipsilateral passive matching task. Results support and extend the view that proprioceptive precision is better at the non-dominant arm for blindfolded sighted individuals. While this finding was rather systematic across sighted individuals, proprioceptive precision of congenitally-blind individuals was not lateralized as systematically, suggesting that lack of visual experience during ontogenesis influences the lateralization of arm proprioception.

Contingent negative variation to tactile stimuli - differences in anticipatory and preparatory processes between participants with and without blindness

People who are blind demonstrate remarkable abilities within the spared senses and compensatory enhancement of cognitive skills, underscored by substantial plastic reorganization in relevant neural areas. However, little is known about whether people with blindness form top-down models of the world on short timescales more efficiently to guide goal-oriented behavior. This electroencephalography study investigates this hypothesis at the neurophysiological level, focusing on contingent negative variation (CNV) as a marker of anticipatory and preparatory processes prior to expected events. In sum, 20 participants with blindness and 27 sighted participants completed a classic CNV task and a memory CNV task, both containing tactile stimuli to exploit the expertise of the former group. Although the reaction times in the classic CNV task did not differ between groups, participants who are blind reached higher performance rates in the memory task. This superior performance co-occurred with a distinct neurophysiological profile, relative to controls: greater late CNV amplitudes over central areas, suggesting enhanced stimulus expectancy and motor preparation prior to key events. Controls, in contrast, recruited more frontal sites, consistent with inefficient sensory-aligned control. We conclude that in more demanding cognitive contexts exploiting the spared senses, people with blindness efficiently generate task-relevant internal models to facilitate behavior.

Effect of Perceptual Training with Sound-Guided and Kinesthetic Feedback on Human 3D Sound Localization Capabilities

In this paper, we experimentally investigate how the 3D sound localization capabilities of the blind can improve through perceptual training. To this end, we develop a novel perceptual training method with sound-guided feedback and kinesthetic assistance to evaluate its effectiveness compared to conventional training methods. In perceptual training, we exclude visual perception by blindfolding the subjects to apply the proposed method to the visually impaired. Subjects used a specially designed pointing stick to generate a sound at the tip, indicating localization error and tip position. The proposed perceptual training aims to evaluate the training effect on 3D sound localization, including variations in azimuth, elevation, and distance. The six days of training based on six subjects resulted in the following outcomes: (1) In general, accuracy in full 3D sound localization can be improved based on training. (2) Training based on relative error feedback is more effective than absolute error feedback. (3) Subjects tend to underestimate distance when the sound source is near, less than 1000 mm, or larger than 15° to the left, and overestimate the elevation when the sound source is near or in the center, and within ±15° in azimuth estimations.

Crossmodal plasticity in hearing loss

Crossmodal plasticity is a textbook example of the ability of the brain to reorganize based on use. We review evidence from the auditory system showing that such reorganization has significant limits, is dependent on pre-existing circuitry and top-down interactions, and that extensive reorganization is often absent. We argue that the evidence does not support the hypothesis that crossmodal reorganization is responsible for closing critical periods in deafness, and crossmodal plasticity instead represents a neuronal process that is dynamically adaptable. We evaluate the evidence for crossmodal changes in both developmental and adult-onset deafness, which start as early as mild-moderate hearing loss and show reversibility when hearing is restored. Finally, crossmodal plasticity does not appear to affect the neuronal preconditions for successful hearing restoration. Given its dynamic and versatile nature, we describe how this plasticity can be exploited for improving clinical outcomes after neurosensory restoration.

Loss of action-related function and connectivity in the blind extrastriate body area

The Extrastriate Body Area (EBA) participates in the visual perception and motor actions of body parts. We recently showed that EBA’s perceptual function develops independently of visual experience, responding to stimuli with body-part information in a supramodal fashion. However, it is still unclear if the EBA similarly maintains its action-related function. Here, we used fMRI to study motor-evoked responses and connectivity patterns in the congenitally blind brain. We found that, unlike the case of perception, EBA does not develop an action-related response without visual experience. In addition, we show that congenital blindness alters EBA’s connectivity profile in a counterintuitive way—functional connectivity with sensorimotor cortices dramatically decreases, whereas connectivity with perception-related visual occipital cortices remains high. To the best of our knowledge, we show for the first time that action-related functions and connectivity in the visual cortex could be contingent on visuomotor experience. We further discuss the role of the EBA within the context of visuomotor control and predictive coding theory.

Diverging patterns of plasticity in the nucleus basalis of Meynert in early- and late-onset blindness

Plasticity in the brain is impacted by an individual's age at the onset of the blindness. However, what drives the varying degrees of plasticity remains largely unclear. One possible explanation attributes the mechanisms for the differing levels of plasticity to the cholinergic signals originating in the nucleus basalis of Meynert. This explanation is based on the fact that the nucleus basalis of Meynert can modulate cortical processes such as plasticity and sensory encoding through its widespread cholinergic projections. Nevertheless, there is no direct evidence indicating that the nucleus basalis of Meynert undergoes plastic changes following blindness. Therefore, using multiparametric magnetic resonance imaging, we examined if the structural and functional properties of the nucleus basalis of Meynert differ between early blind, late blind and sighted individuals. We observed that early and late blind individuals had a preserved volumetric size and cerebrovascular reactivity in the nucleus basalis of Meynert. However, we observed a reduction in the directionality of water diffusion in both early and late blind individuals compared to sighted individuals. Notably, the nucleus basalis of Meynert presented diverging patterns of functional connectivity between early and late blind individuals. This functional connectivity was enhanced at both global and local (visual, language and default-mode networks) levels in the early blind individuals, but there were little-to-no changes in the late blind individuals when compared to sighted controls. Furthermore, the age at onset of blindness predicted both global and local functional connectivity. These results suggest that upon reduced directionality of water diffusion in the nucleus basalis of Meynert, cholinergic influence may be stronger for the early blind compared to the late blind individuals. Our findings are important to unravelling why early blind individuals present stronger and more widespread cross-modal plasticity compared to late blind individuals.

The impact of low vision on social function: The potential importance of lost visual social cues

Visual cues usually play a vital role in social interaction. As well as being the primary cue for identifying other people, visual cues also provide crucial non-verbal social information via both facial expressions and body language. One consequence of vision loss is the need to rely on non-visual cues during social interaction. Although verbal cues can carry a significant amount of information, this information is often not available to an untrained listener. Here, we review the current literature examining potential ways that the loss of social information due to vision loss might impact social functioning. A large number of studies suggest that low vision and blindness is a risk factor for anxiety and depression. This relationship has been attributed to multiple factors, including anxiety about disease progression, and impairments to quality of life that include difficulties reading, and a lack of access to work and social activities. However, our review suggests a potential additional contributing factor to reduced quality of life that has been hitherto overlooked: blindness may make it more difficult to effectively engage in social interactions, due to a loss of visual information. The current literature suggests it might be worth considering training in voice discrimination and/or recognition when carrying out rehabilitative training in late blind individuals.

Calibrating Vision: Concepts and Questions

The idea that visual coding and perception are shaped by experience and adjust to changes in the environment or the observer is universally recognized as a cornerstone of visual processing, yet the functions and processes mediating these calibrations remain in many ways poorly understood. In this article we review a number of facets and issues surrounding the general notion of calibration, with a focus on plasticity within the encoding and representational stages of visual processing. These include how many types of calibrations there are - and how we decide; how plasticity for encoding is intertwined with other principles of sensory coding; how it is instantiated at the level of the dynamic networks mediating vision; how it varies with development or between individuals; and the factors that may limit the form or degree of the adjustments. Our goal is to give a small glimpse of an enormous and fundamental dimension of vision, and to point to some of the unresolved questions in our understanding of how and why ongoing calibrations are a pervasive and essential element of vision.

The detrimental effects of progression of retinal degeneration in the visual cortex

The leading cause of blindness in inherited and age-related retinal degeneration (RD) is the death of retinal photoreceptors such as rods and cones. The most prevalent form of RD is age-related macular degeneration (AMD) which affects the macula resulting in an irreversible loss of vision. The other is a heterogenous group of inherited disorders known as Retinitis Pigmentosa (RP) caused by the progressive loss of photoreceptors. Several approaches have been developed in recent years to artificially stimulate the remaining retinal neurons using optogenetics, retinal prostheses, and chemical photoswitches. However, the outcome of these strategies has been limited. The success of these treatments relies on the morphology, physiology, and proper functioning of the remaining intact structures in the downstream visual pathway. It is not completely understood what all alterations occur in the visual cortex during RD. In this review, I will discuss the known information in the literature about morphological and functional changes that occur in the visual cortex in rodents and humans during RD. The aim is to highlight the changes in the visual cortex that will be helpful for developing tools and strategies directed toward the restoration of high-resolution vision in patients with visual impairment.

What makes somatosensory short-term memory maintenance effective? An EEG study comparing contralateral delay activity between sighted participants and participants who are blind

Somatosensory short-term memory is essential for object recognition, sensorimotor learning, and, especially, Braille reading for people who are blind. This study examined how visual sensory deprivation and a compensatory focus on somatosensory information influences memory processes in this domain. We measured slow cortical negativity developing during short-term tactile memory maintenance (tactile contralateral delay activity, tCDA) in frontal and somatosensory areas while a sample of 24 sighted participants and 22 participants who are blind completed a tactile change-detection task where varying loads of Braille pin patterns served as stimuli. Auditory cues, appearing at varying latencies between sample arrays, could be used to reduce memory demands during maintenance. Participants who are blind (trained Braille readers) outperformed sighted participants behaviorally. In addition, while task-related frontal activation featured in both groups, participants who are blind uniquely showed higher tCDA amplitudes specifically over somatosensory areas. The site specificity of this component's functional relevance in short-term memory maintenance was further supported by somatosensory tCDA amplitudes first correlating across the whole sample with behavioral performance, and secondly showing sensitivity to varying memory load. The results substantiate sensory recruitment models and provide new insights into the effects of visual sensory deprivation on tactile processing. Between-group differences in the interplay between frontal and somatosensory areas during somatosensory maintenance also suggest that efficient maintenance of complex tactile stimuli in short-term memory is primarily facilitated by lateralized activity in somatosensory cortex.

Viewing Strategies in Children With Visual Impairment and Children With Normal Vision: A Systematic Scoping Review

Viewing strategies are strategies used to support visual information processing. These strategies may differ between children with cerebral visual impairment (CVI), children with ocular visual impairment, and children with normal vision since visual impairment might have an impact on viewing behavior. In current visual rehabilitation practice a variety of strategies is used without consideration of the differences in etiology of the visual impairment or in the spontaneous viewing strategies used. This systematic scoping review focuses on viewing strategies used during near school-based tasks like reading and on possible interventions aimed at viewing strategies. The goal is threefold: (1) creating a clear concept of viewing strategies, (2) mapping differences in viewing strategies between children with ocular visual impairment, children with CVI and children with normal vision, and (3) identifying interventions that can improve visual processing by targeting viewing strategies. Four databases were used to conduct the literature search: PubMed, Embase, PsycINFO and Cochrane. Seven hundred and ninety-nine articles were screened by two independent reviewers using PRISMA reporting guidelines of which 30 were included for qualitative analysis. Only five studies explicitly mentioned strategies used during visual processing, namely gaze strategies, reading strategies and search strategies. We define a viewing strategy as a conscious and systematic way of viewing during task performance. The results of this review are integrated with different attention network systems, which provide direction on how to design future interventions targeting the use of viewing strategies to improve different aspects of visual processing.

Deductive Reasoning and Working Memory Skills in Individuals with Blindness

Deductive reasoning and working memory are integral parts of executive functioning and are important skills for blind people in everyday life. Despite the importance of these skills, the influence of visual experience on reasoning and working memory skills, as well as on the relationship between these, is unknown. In this study, fifteen participants with congenital blindness (CB), fifteen with late blindness (LB), fifteen sighted blindfolded controls (SbfC), and fifteen sighted participants performed two tasks of deductive reasoning and two of working memory. We found that while the CB and LB participants did not differ in their deductive reasoning abilities, the CB group performed worse than the sighted controls, and the LB group performed better than the SbfC group. Those with CB outperformed all the other groups in both of the working memory tests. Working memory is associated with deductive reasoning in all three visually impaired groups, but not in the sighted group. These findings suggest that deductive reasoning is not a uniform skill, and that it is associated with visual impairment onset, the level of reasoning difficulty, and the degree of working memory load.

Impairing one sensory modality enhances another by reconfiguring peptidergic signalling in Caenorhabditis elegans

Animals that lose one sensory modality often show augmented responses to other sensory inputs. The mechanisms underpinning this cross-modal plasticity are poorly understood. We probe such mechanisms by performing a forward genetic screen for mutants with enhanced O₂ perception in Caenorhabditis elegans. Multiple mutants exhibiting increased O₂ responsiveness concomitantly show defects in other sensory responses. One mutant, qui-1, defective in a conserved NACHT/WD40 protein, abolishes pheromone-evoked Ca²⁺ responses in the ADL pheromone-sensing neurons. At the same time, ADL responsiveness to pre-synaptic input from O₂-sensing neurons is heightened in qui-1, and other sensory defective mutants, resulting in enhanced neurosecretion although not increased Ca²⁺ responses. Expressing qui-1 selectively in ADL rescues both the qui-1 ADL neurosecretory phenotype and enhanced escape from 21% O₂. Profiling ADL neurons in qui-1 mutants highlights extensive changes in gene expression, notably of many neuropeptide receptors. We show that elevated ADL expression of the conserved neuropeptide receptor NPR-22 is necessary for enhanced ADL neurosecretion in qui-1 mutants, and is sufficient to confer increased ADL neurosecretion in control animals. Sensory loss can thus confer cross-modal plasticity by changing the peptidergic connectome.

Altered Spontaneous Brain Activity and Network Property in Patients With Congenital Monocular Blindness

Individuals with congenital monocular blindness may have specific brain changes since the brain is prenatally deprived of half the normal visual input. To explore characteristic brain functional changes of congenital monocular blindness, we analyzed resting-state functional MRI (rs-fMRI) data of 16 patients with unilateral congenital microphthalmia and 16 healthy subjects with normal vision to compare intergroup differences of amplitude of low frequency fluctuations (ALFFs), functional connectivity (FC), and network topolgoical properties. Compared with controls, patients with microphthalmia exhibited significantly lower ALFF values in the left inferior occipital and temporal gyri, superior temporal gyrus, inferior parietal lobe and post-central gyrus, whereas higher ALFF in the right middle and inferior temporal gyri, middle and superior frontal gyri, left superior frontal, and temporal gyri, such as angular gyrus. Meanwhile, FC between left medial superior frontal gyrus and angular gyrus, FC between left superior temporal gyrus and inferior parietal lobe and post-central gyrus decreased in the patients with congenital microphthalmia. In addition, a graph theory-analysis revealed increased regional network metrics (degree centrality and nodal efficiency) in the middle and inferior temporal gyri and middle and superior frontal gyri, while decreased values in the inferior occipital and temporal gyri, inferior parietal lobule, post-central gyrus, and angular gyrus. Taken together, patients with congenital microphthalmia had widespread abnormal activities within neural networks involving the vision and language and language-related regions played dominant roles in their brain networks. These findings may provide clues for functional reorganization of vision and language networks induced by the congenital monocular blindness.

Altered Regional Homogeneity in Patients With Congenital Blindness: A Resting-State Functional Magnetic Resonance Imaging Study

In patients with congenital blindness (CB), the lack of any visual experience may affect brain development resulting in functional, structural, or even psychological changes. Few studies to date have addressed or focused on the synchronicity of regional brain activity in patients with CB. Our study aimed to investigate regional brain activity in patients with CB in a resting state and try to explain the possible causes and effects of any anomalies. Twenty-three CB patients and 23 healthy control (HC) volunteers agreed to undergo resting state functional magnetic resonance imaging (fMRI) scans. After the fMRI data were preprocessed, regional homogeneity (ReHo) analysis was conducted to assess the differences in brain activity synchronicity between the two groups. Receiver operating characteristic (ROC) curve analysis was used to explore whether the brain areas with statistically significant ReHo differences have diagnostic and identification values for CB. All CB patients were also required to complete the Hospital Anxiety and Depression Scale (HADS) to evaluate their anxiety and depression levels. The results showed that in CB patients mean ReHo values were significantly lower than in HCs in the right orbital part of the middle frontal gyrus (MFGorb), bilateral middle occipital gyrus (MOG), and the right dorsolateral superior frontal gyrus (SFGdl), but significantly higher in the left paracentral lobule (PCL), right insula and bilateral thalamus. The ReHo value of MFGorb showed a negative linear correlation with both the anxiety score and the depression score of the HADS. ROC curve analysis revealed that the mean ReHo values which differed significantly between the groups have excellent diagnostic accuracy for CB (especially in the left PCL and right SFGdl regions). Patients with CB show abnormalities of ReHo values in several specific brain regions, suggesting potential regional structural changes, functional reorganization, or even psychological effects in these patients. FMRI ReHo analysis may find use as an objective method to confirm CB for medical or legal purposes.

Raising the stakes for cortical visual prostheses

In this issue of the JCI, the dream of restoring useful vision to blind individuals with neurotechnology moves one step closer to realization. Fernández et al. implanted an electrode array with 96 penetrating electrodes in the visual cortex of a blind patient who had been without light perception for 16 years due to optic neuropathy. Remarkably, the patient was able to perceive visual patterns created by passing current through array electrodes. The use of a penetrating electrode array meant that action potentials from single neurons could be recorded to study the neural response to stimulation. Compared with electrodes resting on the cortical surface, penetrating electrodes require one-tenth the current to create a visual percept. However, patterned electrical stimulation often fails to produce the expected percept for penetrating and surface electrode arrays, highlighting the need for further research to untangle the relationship between stimulus and perception.

Acquired olfactory loss alters functional connectivity and morphology

Removing function from a developed and functional sensory system is known to alter both cerebral morphology and functional connections. To date, a majority of studies assessing sensory-dependent plasticity have focused on effects from either early onset or long-term sensory loss and little is known how the recent sensory loss affects the human brain. With the aim of determining how recent sensory loss affects cerebral morphology and functional connectivity, we assessed differences between individuals with acquired olfactory loss (duration 7-36 months) and matched healthy controls in their grey matter volume, using multivariate pattern analyses, and functional connectivity, using dynamic connectivity analyses, within and from the olfactory cortex. Our results demonstrate that acquired olfactory loss is associated with altered grey matter volume in, among others, posterior piriform cortex, a core olfactory processing area, as well as the inferior frontal gyrus and angular gyrus. In addition, compared to controls, individuals with acquired anosmia displayed significantly stronger dynamic functional connectivity from the posterior piriform cortex to, among others, the angular gyrus, a known multisensory integration area. When assessing differences in dynamic functional connectivity from the angular gyrus, individuals with acquired anosmia had stronger connectivity from the angular gyrus to areas primary responsible for basic visual processing. These results demonstrate that recently acquired sensory loss is associated with both changed cerebral morphology within core olfactory areas and increase dynamic functional connectivity from olfactory cortex to cerebral areas processing multisensory integration.

Effect of vision loss on plasticity of the head and neck proprioception

AIM

To investigate whether head and neck proprioception and motor control could be compensatory enhanced by long-term vision loss or impairment.

METHODS

Individuals who were blind, low vision or sighted were included in the study, which would undergo the head repositioning test (HRT). The constant error (CE), absolute error (AE), variable error (VE) and root mean square error (RMSE) of each subject were statistically analyzed. Data were analyzed using the SAS 9.4. Tukey-Kramer for one-way ANOVA was used for comparison of blind, low vision, and sighted subjects, as well as to compare subjects with balanced vision, strong vision in the left eye and strong vision in the right eye. Independent sample t-test was used to compare subjects with congenital blindness and acquired blindness, as well as left and right hand dominance subjects.

RESULTS

A total of 90 individuals (25 blind subjects, 31 low vision subjects, and 34 sighted subjects) were included in the study. Among the blind subjects, 14 cases had congenital blindness and 11 cases had acquired blindness. Among the blind and low vision subjects, 21 cases had balanced binocular vision, 17 cases had strong vision in the left eye and 18 cases had strong vision in the right eye. Among all subjects, 11 cases were left hand dominance, and 79 cases were right hand dominance. There were significant differences in AE, VE, and RMSE in head rotation between blind, low vision, and sighted subjects (P<0.01), in AE, VE, and RMSE between blind and sighted (P<0.01), and in VE and RMSE between low vision and sighted (P<0.05). No significant difference between blind and low vision (P>0.05). Significant differences in CE and AE of head right rotation and CE of general head rotation between congenital and acquired (P<0.05). No significant differences between left and right hand dominance and in balance or not of binocular vision (P>0.05).

CONCLUSION

Long-term vision loss or impairment does not lead to compensatory enhancement of head and neck proprioception and motor control. Acquired experience contributes to HRT performance in the blind and has long-lasting effects on plasticity in the development of proprioception and sensorimotor control.

Neuroplasticity pathophysiological mechanisms underlying neuro-optometric rehabilitation in ischemic stroke – a brief review

Neuroplasticity is an essential phenomenon underlying on neurorehabilitation process, by which the brain can remodel the dysfunction consequent to a lesion. Ischemic brain lesions are the most frequent brain lesions often associated with visual function disability. Experimental and clinical studies established that visual function disability can impede the neurorehabilitation therapy efficiency. Neuro-optometric therapy has been proved to significantly improve the patient outcome after brain lesions. The pathophysiological mechanisms underlying this process are yet to be deciphered. Current knowledge regarding the pathophysiological mechanisms involved in ischemic lesions and neuroplasticity as a reparation process offers real support to a more efficient neurorehabilitation therapy that can contribute to the improvement of life quality in stroke patients. Keywords: neuroplasticity, neuro-optometric rehabilitation, ischemic stroke,

Microfluidic and Microscale Assays to Examine Regenerative Strategies in the Neuro Retina

Bioengineering systems have transformed scientific knowledge of cellular behaviors in the nervous system (NS) and pioneered innovative, regenerative therapies to treat adult neural disorders. Microscale systems with characteristic lengths of single to hundreds of microns have examined the development and specialized behaviors of numerous neuromuscular and neurosensory components of the NS. The visual system is comprised of the eye sensory organ and its connecting pathways to the visual cortex. Significant vision loss arises from dysfunction in the retina, the photosensitive tissue at the eye posterior that achieves phototransduction of light to form images in the brain. Retinal regenerative medicine has embraced microfluidic technologies to manipulate stem-like cells for transplantation therapies, where de/differentiated cells are introduced within adult tissue to replace dysfunctional or damaged neurons. Microfluidic systems coupled with stem cell biology and biomaterials have produced exciting advances to restore vision. The current article reviews contemporary microfluidic technologies and microfluidics-enhanced bioassays, developed to interrogate cellular responses to adult retinal cues. The focus is on applications of microfluidics and microscale assays within mammalian sensory retina, or neuro retina, comprised of five types of retinal neurons (photoreceptors, horizontal, bipolar, amacrine, retinal ganglion) and one neuroglia (Müller), but excludes the non-sensory, retinal pigmented epithelium.

The relationship between retinal cone density and cortical magnification in human albinism

The human fovea lies at the center of the retina and supports high-acuity vision. In normal visual system development, the highest acuity is correlated with both a high density of cone photoreceptors in the fovea and a magnified retinotopic representation of the fovea in the visual cortex. Both cone density and the cortical area dedicated to each degree of visual space—the latter describing cortical magnification (CM)—steadily decrease with increasing eccentricity from the fovea. In albinism, peak cone density at the fovea and visual acuity are decreased, but seem to be within normal limits in the periphery, thus providing a model to explore the correlation between retinal structure, cortical structure, and behavior. Here, we used adaptive optics scanning light ophthalmoscopy to assess retinal cone density and functional magnetic resonance imaging to measure CM in the primary visual cortex of normal controls and individuals with albinism. We find that retinotopic organization is more varied among individuals with albinism than previously appreciated. Additionally, CM outside the fovea is similar to that in controls, but also more variable. CM in albinism and controls exceeds that which might be predicted based on cone density alone, but is more accurately predicted by retinal ganglion cell density. This finding suggests that decreased foveal cone density in albinism may be partially counteracted by nonuniform connectivity between cones and their downstream signaling partners. Together, these results emphasize that central as well as retinal factors must be included to provide a complete picture of aberrant structure and function in albinism.

Plasticity in perception: insights from color vision deficiencies

Inherited color vision deficiencies typically result from a loss or alteration of the visual photopigments absorbing light and thus impact the very first step of seeing. There is growing interest in how subsequent steps in the visual pathway might be calibrated to compensate for the altered receptor signals, with the possibility that color coding and color percepts might be less severely impacted than the receptor differences predict. These compensatory adjustments provide important insights into general questions about sensory plasticity and the sensory and cognitive processes underlying how we experience color.

New insights into cortical development and plasticity: from molecules to behavior

The human brain contains 100 billion neurons, and each neuron can have up to 200,000 connections to other neurons. Recent advancements in neuroscience-ranging from molecular studies in animal models to behavioral studies in humans-have given us deeper insights into the development of this extraordinarily intricate system. Studies show a complex interaction between biological predispositions and environment; while the gross neuroanatomy and low-level functions develop early prior to receiving environmental inputs, functional selectivity is shaped through experience, governed by the maturation of local excitatory and inhibitory circuits and synaptic plasticity during sensitive periods early in development. Plasticity does not end with the closing of the early sensitive period - the environment continues to play an important role in learning throughout the lifespan. Recent work delineating the cascade of events that initiates, controls and ends sensitive periods, offers new hope of eventually being able to remediate various clinical conditions by selectively reopening plasticity.

Spatial Competence and Brain Plasticity in Congenital Blindness via Sensory Substitution Devices

In congenital blindness (CB), tactile, and auditory information can be reinterpreted by the brain to compensate for visual information through mechanisms of brain plasticity triggered by training. Visual deprivation does not cause a cognitive spatial deficit since blind people are able to acquire spatial knowledge about the environment. However, this spatial competence takes longer to achieve but is eventually reached through training-induced plasticity. Congenitally blind individuals can further improve their spatial skills with the extensive use of sensory substitution devices (SSDs), either visual-to-tactile or visual-to-auditory. Using a combination of functional and anatomical neuroimaging techniques, our recent work has demonstrated the impact of spatial training with both visual to tactile and visual to auditory SSDs on brain plasticity, cortical processing, and the achievement of certain forms of spatial competence. The comparison of performances between CB and sighted people using several different sensory substitution devices in perceptual and sensory-motor tasks uncovered the striking ability of the brain to rewire itself during perceptual learning and to interpret novel sensory information even during adulthood. We discuss here the implications of these findings for helping blind people in navigation tasks and to increase their accessibility to both real and virtual environments.

The role of spatial selective attention in the processing of affective prosodies in congenitally blind adults: An ERP study

The question whether spatial selective attention is necessary in order to process vocal affective prosody has been controversially discussed in sighted individuals: whereas some studies argue that attention is required in order to process emotions, other studies conclude that vocal prosody can be processed even outside the focus of spatial selective attention. Here, we asked whether spatial selective attention is necessary for the processing of affective prosodies after visual deprivation from birth. For this purpose, pseudowords spoken in happy, neutral, fearful or threatening prosodies were presented at the left or right loudspeaker. Congenitally blind individuals (N = 8) and sighted controls (N = 13) had to attend to one of the loudspeakers and detect rare pseudowords presented at the attended loudspeaker during EEG recording. Emotional prosody of the syllables was task-irrelevant. Blind individuals outperformed sighted controls by being more efficient in detecting deviant syllables at the attended loudspeaker. A higher auditory N1 amplitude was observed in blind individuals compared to sighted controls. Additionally, sighted controls showed enhanced attention-related ERP amplitudes in response to fearful and threatening voices during the time range of the N1. By contrast, blind individuals revealed enhanced ERP amplitudes in attended relative to unattended locations irrespective of the affective valence in all time windows (110-350 ms). These effects were mainly observed at posterior electrodes. The results provide evidence for "emotion-general" auditory spatial selective attention effects in congenitally blind individuals and suggest a potential reorganization of the voice processing brain system following visual deprivation from birth.

Multisensory Integration as a Window into Orderly and Disrupted Cognition and Communication

During our everyday lives, we are confronted with a vast amount of information from several sensory modalities. This multisensory information needs to be appropriately integrated for us to effectively engage with and learn from our world. Research carried out over the last half century has provided new insights into the way such multisensory processing improves human performance and perception; the neurophysiological foundations of multisensory function; the time course for its development; how multisensory abilities differ in clinical populations; and, most recently, the links between multisensory processing and cognitive abilities. This review summarizes the extant literature on multisensory function in typical and atypical circumstances, discusses the implications of the work carried out to date for theory and research, and points toward next steps for advancing the field.

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.