Increased BOLD variability in the parietal cortex and enhanced parieto-occipital connectivity during tactile perception in congenitally blind individuals

Electroencephalography Spectral-power Volatility Predicts Problem-solving Outcomes

Temporal variability is a fundamental property of brain processes and is functionally important to human cognition. This study examined how fluctuations in neural oscillatory activity are related to problem-solving performance as one example of how temporal variability affects high-level cognition. We used volatility to assess step-by-step fluctuations of EEG spectral power while individuals attempted to solve word-association puzzles. Inspired by recent results with hidden-state modeling, we tested the hypothesis that spectral-power volatility is directly associated with problem-solving outcomes. As predicted, volatility was lower during trials solved with insight compared with those solved analytically. Moreover, volatility during prestimulus preparation for problem-solving predicted solving outcomes, including solving success and solving time. These novel findings were replicated in a separate data set from an anagram-solving task, suggesting that less-rapid transitions between neural oscillatory synchronization and desynchronization predict better solving performance and are conducive to solving with insight for these types of problems. Thus, volatility can be a valuable index of cognition-related brain dynamics.

Orthopaedic problems in the blind

Background

Blindness is a common problem in every society and country. The problem ranges from complete blindness to partially sighted in the affected population. India has close to 12 million visually impaired people. Orthopaedic problems are not uncommon in blind. Orthopaedic Surgeons though had been aware of the postural and gait abnormalities in blind but very few published studies have systematically focused on the effect of blindness on the development of posture and gait.

Methods

Case Control study done for the orthopaedic evaluation of the blind and partially sighted individuals. The study population included 242 students of Ahmadi School for the Blind, Aligarh Muslim University, Aligarh (India), as the cases and another matched set of 250 non-blind children. All the children were assessed for the orthopaedic problems like degree of ligamentous laxity, spinal alignment, foot morphology and alignment of hips, knees and ankles. Standing posture and gait were also examined and recorded. Ligamentous laxity was assessed according to the method adopted by Beighton et al.10 Chi-square test was applied using IBM SPSS 23.0.

Results

139 children (57.4 %) were found to have laxity of the ligaments. 72 children (29.7 %) had spine deformities, out of which kyphosis was present in 34 (47.2 %), scoliosis in 23 (31.9 %), lordosis in 13 (18.0 %), and meningomyelocele in 2 (2.9 %) children. 119 children (49.1 %) had foot deformities. 37 children (15.2 %) had knee deformity. 22 children (9.0 %) showed evidence of cerebral palsy. 216 children (89.2 %) had varying degrees of postural abnormalities. The data was statistically significant when compared with the control group (P < 0.05).

Conclusion

Blindness causes a wide range of complicated sensory and motor problems that frequently forces people into isolation. Blind rehabilitation requires an interdisciplinary approach. Orthopaedic problems are quite common in blind individuals and should be dealt separately.

Reading Braille by Touch Recruits Posterior Parietal Cortex

Blind readers use a tactile reading system consisting of raised dot arrays: braille/⠃⠗⠇. How do human brains implement reading by touch? The current study looked for signatures of reading-specific orthographic processes in braille, separate from low-level somatosensory responses and semantic processes. Of specific interest were responses in posterior parietal cortices (PPCs), because of their role in high-level tactile perception. Congenitally blind, proficient braille readers read real words and pseudowords by touch while undergoing fMRI. We leveraged the system of contractions in English braille, where one braille cell can represent multiple English print letters (e.g., "ing" ⠬, "one" ⠐⠕), making it possible to separate physical and orthographic word length. All words in the study consisted of four braille cells, but their corresponding Roman letter spellings varied from four to seven letters (e.g., "con-c-er-t" ⠒⠉⠻⠞. contracted: four cells; uncontracted: seven letters). We found that the bilateral supramarginal gyrus in the PPC increased its activity as the uncontracted word length increased. By contrast, in the hand region of primary somatosensory cortex (S1), activity increased as a function of a low-level somatosensory feature: dot-number per word. The PPC also showed greater response to pseudowords than real words and distinguished between real and pseudowords in multivariate-pattern analysis. Parieto-occipital, early visual and ventral occipito-temporal, as well as prefrontal cortices also showed sensitivity to the real-versus-pseudoword distinction. We conclude that PPC is involved in orthographic processing for braille, that is, braille character and word recognition, possibly because of braille's tactile modality.

Chemogenetic manipulation of astrocyte activity at the synapse- a gateway to manage brain disease

Astrocytes are the major glial cell type in the central nervous system (CNS). Initially regarded as supportive cells, it is now recognized that this highly heterogeneous cell population is an indispensable modulator of brain development and function. Astrocytes secrete neuroactive molecules that regulate synapse formation and maturation. They also express hundreds of G protein-coupled receptors (GPCRs) that, once activated by neurotransmitters, trigger intracellular signalling pathways that can trigger the release of gliotransmitters which, in turn, modulate synaptic transmission and neuroplasticity. Considering this, it is not surprising that astrocytic dysfunction, leading to synaptic impairment, is consistently described as a factor in brain diseases, whether they emerge early or late in life due to genetic or environmental factors. Here, we provide an overview of the literature showing that activation of genetically engineered GPCRs, known as Designer Receptors Exclusively Activated by Designer Drugs (DREADDs), to specifically modulate astrocyte activity partially mimics endogenous signalling pathways in astrocytes and improves neuronal function and behavior in normal animals and disease models. Therefore, we propose that expressing these genetically engineered GPCRs in astrocytes could be a promising strategy to explore (new) signalling pathways which can be used to manage brain disorders. The precise molecular, functional and behavioral effects of this type of manipulation, however, differ depending on the DREADD receptor used, targeted brain region and timing of the intervention, between healthy and disease conditions. This is likely a reflection of regional and disease/disease progression-associated astrocyte heterogeneity. Therefore, a thorough investigation of the effects of such astrocyte manipulation(s) must be conducted considering the specific cellular and molecular environment characteristic of each disease and disease stage before this has therapeutic applicability.

The Parietal Lobe in Alzheimer’s Disease and Blindness

The progressive aging of the population will notably increase the burden of those diseases which leads to a disabling situation, such as Alzheimer’s disease (AD) and ophthalmological diseases that cause a visual impairment (VI). Eye diseases that cause a VI raise neuroplastic processes in the parietal lobe. Meanwhile, the aforementioned lobe suffers a severe decline throughout AD. From this perspective, diving deeper into the particularities of the parietal lobe is of paramount importance. In this article, we discuss the functions of the parietal lobe, review the parietal anatomical and pathophysiological peculiarities in AD, and also describe some of the changes in the parietal region that occur after VI. Although the alterations in the hippocampus and the temporal lobe have been well documented in AD, the alterations of the parietal lobe have been less thoroughly explored. Recent neuroimaging studies have revealed that some metabolic and perfusion impairments along with a reduction of the white and grey matter could take place in the parietal lobe during AD. Conversely, it has been speculated that blinding ocular diseases induce a remodeling of the parietal region which is observable through the improvement of the integration of multimodal stimuli and in the increase of the volume of this cortical region. Based on current findings concerning the parietal lobe in both pathologies, we hypothesize that the increased activity of the parietal lobe in people with VI may diminish the neurodegeneration of this brain region in those who are visually impaired by oculardiseases.

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.

Disrupted signal variability of spontaneous neural activity in children with attention-deficit/hyperactivity disorder

Brain signal variability (BSV) has shown to be powerful in characterizing human brain development and neuropsychiatric disorders. Multiscale entropy (MSE) is a novel method for quantifying the variability of brain signal, and helps elucidate complex dynamic pathological mechanisms in children with attention-deficit/hyperactivity disorder (ADHD). Here, multiple-channel resting-state functional near-infrared spectroscopy (fNIRS) imaging data were acquired from 42 children with ADHD and 41 healthy controls (HCs) and then BSV was calculated for each participant based on the MSE analysis. Compared with HCs, ADHD group exhibited reduced BSV in both high-order and primary brain functional networks, e.g., the default mode, frontoparietal, attention and visual networks. Intriguingly, the BSV aberrations negatively correlated with ADHD symptoms in the frontoparietal network and negatively correlated with reaction time variability in the frontoparietal, default mode, somatomotor and attention networks. This study demonstrates a wide alternation in the moment-to-moment variability of spontaneous brain signal in children with ADHD, and highlights the potential for using MSE metric as a disease biomarker.

Visual Cortex Alterations in Early and Late Blind Subjects During Tactile Perception

Involvement of visual cortex varies during tactile perception tasks in early blind (EB) and late blind (LB) human subjects. This study explored differences in sensory motor networks associated with tactile task in EB and LB subjects and between children and adolescents. A total of 40 EB subjects, 40 LB subjects, and 30 sighted controls were recruited in two subgroups: children (6-12 years) and adolescents (13-19 years). Data were acquired using a 3T MR scanner. Analyses of blood oxygen level dependent (BOLD), functional connectivity (FC), correlation, and post hoc test for multiple comparisons were carried out. Difference in BOLD activity was observed in EB and LB groups in visual cortex during tactile perception, with increased FC of visual with dorsal attention and sensory motor networks in EB. EB adolescents exhibited increased connectivity with default mode and salience networks when compared with LB. Functional results correlated with duration of training, suggestive of better performance in EB. Alteration in sensory and visual networks in EB and LB correlated with duration of tactile training. Age of onset of blindness has an effect in cross-modal reorganization of visual cortex in EB and multimodal in LB in children and adolescents.

The Effect of Blindness on Spatial Asymmetries

The human cerebral cortex is asymmetrically organized with hemispheric lateralization pervading nearly all neural systems of the brain. Whether the lack of normal visual development affects hemispheric specialization subserving the deployment of visuospatial attention asymmetries is controversial. In principle, indeed, the lack of early visual experience may affect the lateralization of spatial functions, and the blind may rely on a different sensory input compared to the sighted. In this review article, we thus present a current state-of-the-art synthesis of empirical evidence concerning the effects of visual deprivation on the lateralization of various spatial processes (i.e., including line bisection, mirror symmetry, and localization tasks). Overall, the evidence reviewed indicates that spatial processes are supported by a right hemispheric network in the blind, hence, analogously to the sighted. Such a right-hemisphere dominance, however, seems more accentuated in the blind as compared to the sighted as indexed by the greater leftward bias shown in different spatial tasks. This is possibly the result of the more pronounced involvement of the right parietal cortex during spatial tasks in blind individuals compared to the sighted, as well as of the additional recruitment of the right occipital cortex, which would reflect the cross-modal plastic phenomena that largely characterize the blind brain.

Available Sensory Input Determines Motor Performance and Strategy in Early Blind and Sighted Short-Tailed Opossums

The early loss of vision results in a reorganized neocortex, affecting areas of the brain that process both the spared and lost senses, and leads to heightened abilities on discrimination tasks involving the spared senses. Here, we used performance measures and machine learning algorithms that quantify behavioral strategy to determine if and how early vision loss alters adaptive sensorimotor behavior. We tested opossums on a motor task involving somatosensation and found that early blind animals had increased limb placement accuracy compared with sighted controls, while showing similarities in crossing strategy. However, increased reliance on tactile inputs in early blind animals resulted in greater deficits in limb placement and behavioral flexibility when the whiskers were trimmed. These data show that compensatory cross-modal plasticity extends beyond sensory discrimination tasks to motor tasks involving the spared senses and highlights the importance of whiskers in guiding forelimb control.

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Early blind opossums outperform sighted controls during ladder rung walking

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Whisker trimming causes forelimb accuracy deficits in blind and sighted opossums

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Whisker trimming, but not the loss of vision, impacts stereotypical movements

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Both groups adopt conservative approaches to ladder crossing after whisker trimming

Compensatory Cross-Modal Plasticity Persists After Sight Restoration

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

Early Loss of Vision Results in Extensive Reorganization of Plasticity-Related Receptors and Alterations in Hippocampal Function That Extend Through Adulthood

Although by adulthood cortical structures and their capacity for processing sensory information have become established and stabilized, under conditions of cortical injury, or sensory deprivation, rapid reorganization occurs. Little is known as to the impact of this kind of adaptation on cellular processes related to memory encoding. However, imaging studies in humans suggest that following loss or impairment of a sensory modality, not only cortical but also subcortical structures begin to reorganize. It is likely that these processes are supported by neurotransmitter receptors that enable synaptic and cortical plasticity. Here, we explored to what extent the expression of plasticity-related proteins (GABA-A, GABA-B, GluN1, GluN2A, GluN2B) is altered following early vision loss, and whether this impacts on hippocampal function. We observed that in the period of 2-4 months postnatally in CBA/J-mice that experience hereditary postnatal retinal degeneration, systematic changes of GABA-receptor and NMDA-receptor subunit expression occurred that emerged first in the hippocampus and developed later in the cortex, compared to control mice that had normal vision. Changes were accompanied by significant impairments in hippocampal long-term potentiation and hippocampus-dependent learning. These data indicate that during cortical adaptation to early loss of vision, hippocampal information processing is compromised, and this status impacts on the acquisition of spatial representations.

A thalamocortical pathway for fast rerouting of tactile information to occipital cortex in congenital blindness

In congenitally blind individuals, the occipital cortex responds to various nonvisual inputs. Some animal studies raise the possibility that a subcortical pathway allows fast re-routing of tactile information to the occipital cortex, but this has not been shown in humans. Here we show using magnetoencephalography (MEG) that tactile stimulation produces occipital cortex activations, starting as early as 35 ms in congenitally blind individuals, but not in blindfolded sighted controls. Given our measured thalamic response latencies of 20 ms and a mean estimated lateral geniculate nucleus to primary visual cortex transfer time of 15 ms, we claim that this early occipital response is mediated by a direct thalamo-cortical pathway. We also observed stronger directed connectivity in the alpha band range from posterior thalamus to occipital cortex in congenitally blind participants. Our results strongly suggest the contribution of a fast thalamo-cortical pathway in the cross-modal activation of the occipital cortex in congenitally blind humans.

In congenitally blind people, tactile stimuli can activate the occipital (visual) cortex. Here, the authors show using magnetoencephalography (MEG) that occipital activation can occur within 35 ms following tactile stimulation, suggesting the existence of a fast thalamocortical pathway for touch in congenitally blind humans.

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

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

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

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

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

Experimental design modulates variance in BOLD activation: The variance design general linear model

Typical fMRI studies have focused on either the mean trend in the blood-oxygen-level-dependent (BOLD) time course or functional connectivity (FC). However, other statistics of the neuroimaging data may contain important information. Despite studies showing links between the variance in the BOLD time series (BV) and age and cognitive performance, a formal framework for testing these effects has not yet been developed. We introduce the variance design general linear model (VDGLM), a novel framework that facilitates the detection of variance effects. We designed the framework for general use in any fMRI study by modeling both mean and variance in BOLD activation as a function of experimental design. The flexibility of this approach allows the VDGLM to (a) simultaneously make inferences about a mean or variance effect while controlling for the other and (b) test for variance effects that could be associated with multiple conditions and/or noise regressors. We demonstrate the use of the VDGLM in a working memory application and show that engagement in a working memory task is associated with whole-brain decreases in BOLD variance.

Altered Brain Signal Variability in Patients With Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by a chronic, continuous symptom of worry and exaggerated startle response. Although functional abnormality in GAD has been widely studied using functional magnetic resonance imaging (fMRI), the dynamic signatures of GAD are not fully understood. As a vital index of brain function, brain signal variability (BSV) reflects the capacity of state transition of neural activities. In this study, we recruited 47 patients with GAD and 38 healthy controls (HCs) to investigate whether or not BSV is altered in patients with GAD by measuring the standard deviation of fMRI signal of each voxel. We found that patients with GAD exhibited decreased BSV in widespread regions including the visual network, sensorimotor network, frontoparietal network, limbic system, and thalamus, indicating an inflexible brain state transfer pattern in these systems. Furthermore, the correlation between BSV and trait anxiety score was prone to be positive in patients with GAD but negative in HCs. The opposite relationships between BSV and anxiety level in the two groups indicate that the brain with moderate anxiety level may stay in the most stable rather than in the flexible state. As the first study of BSV in GAD, we revealed extensively decreased BSV in patients with GAD similar to that in other mental disorders but with a non-linear relationship between BSV and anxiety level indicating a novel neurodynamic mechanism of the anxious brain.

Visual and Motor Recovery After "Cognitive Therapeutic Exercises" in Cortical Blindness: A Case Study

BACKGROUND AND PURPOSE

Spontaneous visual recovery is rare after cortical blindness. While visual rehabilitation may improve performance, no visual therapy has been widely adopted, as clinical outcomes are variable and rarely translate into improvements in activities of daily living (ADLs). We explored the potential value of a novel rehabilitation approach "cognitive therapeutic exercises" for cortical blindness.

CASE DESCRIPTION

The subject of this case study was 48-year-old woman with cortical blindness and tetraplegia after cardiac arrest. Prior to the intervention, she was dependent in ADLs and poorly distinguished shapes and colors after 19 months of standard visual and motor rehabilitation. Computed tomographic images soon after symptom onset demonstrated acute infarcts in both occipital cortices.

INTERVENTION

The subject underwent 8 months of intensive rehabilitation with "cognitive therapeutic exercises" consisting of discrimination exercises correlating sensory and visual information.

OUTCOMES

Visual fields increased; object recognition improved; it became possible to watch television; voluntary arm movements improved in accuracy and smoothness; walking improved; and ADL independence and self-reliance increased. Subtraction of neuroimaging acquired before and after rehabilitation showed that focal glucose metabolism increases bilaterally in the occipital poles.

DISCUSSION

This study demonstrates feasibility of "cognitive therapeutic exercises" in an individual with cortical blindness, who experienced impressive visual and sensorimotor recovery, with marked ADL improvement, more than 2 years after ischemic cortical damage.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A173).

Postural control in blind individuals: A systematic review

Postural control (PC) requires the interaction of the three sensory systems for a good maintenance of the balance, and in blind people, lack of visual input can harm your PC. Thus the objective is to perform a literature review concerning role of sight in the maintenance of PC and the adaptation of brain structures when vision is absent. Studies were searched from Pubmed, and EMBASE that included individuals with congenital blindness. Articles studying person with acquired blindness or low vision was excluded from this review. 26 out of 322 articles were selected for review, and we found that 1) blind individuals exhibit PC deficits and that is compensated by the intensification of the remaining systems; 2) Neuroplastic adaptation occurs throughout the entire cerebral cortex; and 3) Sensorimotor stimulation and transcranial direct current stimulation seem to be a rehabilitation strategy. According to this review, the findings suggest that improved remaining sensations in the presence of adaptations and neuroplasticity, does not translate into better postural control performance. Regarding rehabilitation strategies, more studies are needed to show which therapeutic modality best contributes to postural control.

Interplay between Heightened Temporal Variability of Spontaneous Brain Activity and Task-Evoked Hyperactivation in the Blind

The brain's functional organization can be altered by visual deprivation. This is observed by comparing blind and sighted people's activation response to tactile discrimination tasks, like braille reading. Where, the blind have higher activation than the sighted upon tactile discrimination tasks, especially high activation difference is seen in ventral occipitotemporal (vOT) cortex. However, it remains unknown, whether this vOT hyperactivation is related to alteration of spontaneous activity. To address this question, we examined 16 blind subjects, 19 low-vision individuals, and 21 normally sighted controls using functional magnetic resonance imaging (fMRI). Subjects were scanned in resting-state and discrimination tactile task. In spontaneous activity, when compared to sighted subjects, we found both blind and low vision subjects had increased local signal synchronization and increased temporal variability. During tactile tasks, compared to sighted subjects, blind and low-vision subject's vOT had stronger tactile task-induced activation. Furthermore, through inter-subject partial correlation analysis, we found temporal variability is more related to tactile-task activation, than local signal synchronization's relation to tactile-induced activation. Our results further support that vision impairment induces vOT cortical reorganization. The hyperactivation in the vOT during tactile stimulus processing in the blind may be related to their greater dynamic range of spontaneous activity.

Tactile Object Familiarity in the Blind Brain Reveals the Supramodal Perceptual-Mnemonic Nature of the Perirhinal Cortex

This study is the first to investigate the neural underpinnings of tactile object familiarity in the blind during both perception and memory. In the sighted, the perirhinal cortex (PRC) has been implicated in the assessment of visual object familiarity-a crucial everyday task-as evidenced by reduced activation when an object becomes familiar. Here, to examine the PRC's role in tactile object familiarity in the absence of vision, we trained blind participants on a unique memory-guided drawing technique and measured brain activity while they perceptually explored raised-line drawings, drew them from tactile memory, and scribbled (control). Functional magnetic resonance imaging (fMRI) before and after a week of training revealed a significant decrease in PRC activation from pre- to post-training (i.e., from unfamiliar to familiar) during perceptual exploration as well as memory-guided drawing, but not scribbling. This familiarity-based reduction is the first evidence that the PRC represents tactile object familiarity in the blind. Furthermore, the finding of this effect during both tactile perception and tactile memory provides the critical link in establishing the PRC as a structure whose representations are supramodal for both perception and memory.

Identifying Dysfunctional Cortex: Dissociable Effects of Stroke and Aging on Resting State Dynamics in MEG and fMRI

Spontaneous signals in neuroimaging data may provide information on cortical health in disease and aging, but the relative sensitivity of different approaches is unknown. In the present study, we compared different but complementary indicators of neural dynamics in resting-state MEG and BOLD fMRI, and their relationship with blood flow. Participants included patients with post-stroke aphasia, age-matched controls, and young adults. The complexity of brain activity at rest was quantified in MEG using spectral analysis and multiscale entropy (MSE) measures, whereas BOLD variability was quantified as the standard deviation (SDBOLD), mean squared successive difference (MSSD), and sample entropy of the BOLD time series. We sought to assess the utility of signal variability and complexity measures as markers of age-related changes in healthy adults and perilesional dysfunction in chronic stroke. The results indicate that reduced BOLD variability is a robust finding in aging, whereas MEG measures are more sensitive to the cortical abnormalities associated with stroke. Furthermore, reduced complexity of MEG signals in perilesional tissue were correlated with hypoperfusion as assessed with arterial spin labeling (ASL), while no such relationship was apparent with BOLD variability. These findings suggest that MEG signal complexity offers a sensitive index of neural dysfunction in perilesional tissue in chronic stroke, and that these effects are clearly distinguishable from those associated with healthy aging.

One dataset, many conclusions: BOLD variability's complicated relationships with age and motion artifacts

In recent years, the variability of the blood-oxygen level dependent (BOLD) signal has received attention as an informative measure in its own right. At the same time, there has been growing concern regarding the impact of motion in fMRI, particularly in the domain of resting state studies. Here, we demonstrate that, not only does motion (among other confounds) exert an influence on the results of a BOLD variability analysis of task-related fMRI data-but, that the exact method used to deal with this influence has at least as large an effect as the motion itself. This sensitivity to relatively minor methodological changes is particularly concerning as studies begin to take on a more applied bent, and the risk of mischaracterizing the relationship between BOLD variability and various individual difference variables (for instance, disease progression) acquires real-world relevance.

Steady-state BOLD Response to Higher-order Cognition Modulates Low-Frequency Neural Oscillations

Steady-state responses (SSRs) reflect the synchronous neural oscillations evoked by noninvasive and consistently repeated stimuli at the fundamental or harmonic frequencies. The steady-state evoked potentials (SSEPs; the representative form of the SSRs) have been widely used in the cognitive and clinical neurosciences and brain–computer interface research. However, the steady-state evoked potentials have limitations in examining high-frequency neural oscillations and basic cognition. In addition, synchronous neural oscillations in the low frequency range (&lt;1 Hz) and in higher-order cognition have received a little attention. Therefore, we examined the SSRs in the low frequency range using a new index, the steady-state BOLD responses (SSBRs) evoked by semantic stimuli. Our results revealed that the significant SSBRs were induced at the fundamental frequency of stimuli and the first harmonic in task-related regions, suggesting the enhanced variability of neural oscillations entrained by exogenous stimuli. The SSBRs were independent of neurovascular coupling and characterized by sensorimotor bias, an indication of regional-dependent neuroplasticity. Furthermore, the amplitude of SSBRs may predict behavioral performance and show the psychophysiological relevance. Our findings provide valuable insights into the understanding of the SSRs evoked by higher-order cognition and how the SSRs modulate low-frequency neural oscillations.

Neural and behavioral correlates of extended training during sleep deprivation in humans: evidence for local, task-specific effects

Recent work has demonstrated that behavioral manipulations targeting specific cortical areas during prolonged wakefulness lead to a region-specific homeostatic increase in theta activity (5-9 Hz), suggesting that theta waves could represent transient neuronal OFF periods (local sleep). In awake rats, the occurrence of an OFF period in a brain area relevant for behavior results in performance errors. Here we investigated the potential relationship between local sleep events and negative behavioral outcomes in humans. Volunteers participated in two prolonged wakefulness experiments (24 h), each including 12 h of practice with either a driving simulation (DS) game or a battery of tasks based on executive functions (EFs). Multiple high-density EEG recordings were obtained during each experiment, both in quiet rest conditions and during execution of two behavioral tests, a response inhibition test and a motor test, aimed at assessing changes in impulse control and visuomotor performance, respectively. In addition, fMRI examinations obtained at 12 h intervals were used to investigate changes in inter-regional connectivity. The EF experiment was associated with a reduced efficiency in impulse control, whereas DS led to a relative impairment in visuomotor control. A specific spatial and temporal correlation was observed between EEG theta waves occurring in task-related areas and deterioration of behavioral performance. The fMRI connectivity analysis indicated that performance impairment might partially depend on a breakdown in connectivity determined by a "network overload." Present results demonstrate the existence of an association between theta waves during wakefulness and performance errors and may contribute explaining behavioral impairments under conditions of sleep deprivation/restriction.

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.

Using structural and functional brain imaging to uncover how the brain adapts to blindness

Advances in neuroimaging technology have been instrumental in uncovering the dramatic neurological changes that result from blindness, as well as revealing the inner workings of the human brain. Specifically, modern imaging techniques enable us to examine how the brain adapts and "re-wires" itself as a result of changes in behavior, the environment, injury, or disease; a process referred to as neuroplasticity. Following an overview of commonly employed neuroimaging techniques, we discuss structural and functional neuroplastic brain changes associated with profound visual deprivation. In particular, we highlight how associated structural changes often occur within areas that process intact senses (such as hearing, touch, and smell) while functional changes tend to implicate areas of the brain normally ascribed to the processing of visual information. Evidence will primarily focus on profound blindness due to ocular cause, but related work in cerebral/cortical visual impairment (CVI) will also be discussed. The potential importance of these findings within the context of education and rehabilitation is proposed.

Anatomical and functional plasticity in early blind individuals and the mixture of experts architecture

As described elsewhere in this special issue, recent advances in neuroimaging over the last decade have led to a rapid expansion in our knowledge of anatomical and functional correlations within the normal and abnormal human brain. Here, we review how early blindness has been used as a model system for examining the role of visual experience in the development of anatomical connections and functional responses. We discuss how lack of power in group comparisons may provide a potential explanation for why extensive anatomical changes in cortico-cortical connectivity are not observed. Finally we suggest a framework-cortical specialization via hierarchical mixtures of experts-which offers some promise in reconciling a wide range of functional and anatomical data.

It's not all in your car: functional and structural correlates of exceptional driving skills in professional racers

Driving is a complex behavior that requires the integration of multiple cognitive functions. While many studies have investigated brain activity related to driving simulation under distinct conditions, little is known about the brain morphological and functional architecture in professional competitive driving, which requires exceptional motor and navigational skills. Here, 11 professional racing-car drivers and 11 “naïve” volunteers underwent both structural and functional brain magnetic resonance imaging (MRI) scans. Subjects were presented with short movies depicting a Formula One car racing in four different official circuits. Brain activity was assessed in terms of regional response, using an Inter-Subject Correlation (ISC) approach, and regional interactions by mean of functional connectivity. In addition, voxel-based morphometry (VBM) was used to identify specific structural differences between the two groups and potential interactions with functional differences detected by the ISC analysis. Relative to non-experienced drivers, professional drivers showed a more consistent recruitment of motor control and spatial navigation devoted areas, including premotor/motor cortex, striatum, anterior, and posterior cingulate cortex and retrosplenial cortex, precuneus, middle temporal cortex, and parahippocampus. Moreover, some of these brain regions, including the retrosplenial cortex, also had an increased gray matter density in professional car drivers. Furthermore, the retrosplenial cortex, which has been previously associated with the storage of observer-independent spatial maps, revealed a specific correlation with the individual driver's success in official competitions. These findings indicate that the brain functional and structural organization in highly trained racing-car drivers differs from that of subjects with an ordinary driving experience, suggesting that specific anatomo-functional changes may subtend the attainment of exceptional driving performance.

Correlation of vision loss with tactile-evoked V1 responses in retinitis pigmentosa

Neuroimaging studies have shown that the visual cortex of visually impaired humans is active during tactile tasks. We sought to determine if this cross-modal activation in the primary visual cortex is correlated with vision loss in individuals with retinitis pigmentosa (RP), an inherited degenerative photoreceptor disease that progressively diminishes vision later in life. RP and sighted subjects completed three tactile tasks: a symmetry discrimination task, a Braille-dot counting task, and a sandpaper roughness discrimination task. We measured tactile-evoked blood oxygenation level dependent (BOLD) responses using functional magnetic resonance imaging (fMRI). For each subject, we quantified the cortical extent of the tactile-evoked response by the proportion of modulated voxels within the primary visual cortex (V1) and its strength by the mean absolute modulation amplitude of the modulated voxels. We characterized vision loss in terms of visual acuity and the areal proportion of V1 that corresponds to the preserved visual field. Visual acuity and proportion of the preserved visual field both had a highly significant effect on the cortical extent of the V1 BOLD response to tactile stimulation, while visual acuity also had a significant effect on the strength of the V1 response. These effects of vision loss on cross-modal responses were reliable despite high inter-subject variability. Controlling for task-evoked responses in the primary somatosensory cortex (S1) across subjects further strengthened the effects of vision loss on cross-model responses in V1. We propose that such cross-modal responses in V1 and other visual areas may be used as a cortically localized biomarker to account for individual differences in visual performance following sight recovery treatments.

Alpha rhythm oscillations and MMSE scores are differently modified by transdermal or oral rivastigmine in patients with Alzheimer's disease

BACKGROUND

Alzheimer's disease (AD) is the most common cause of dementia in older patients. Rivastigmine, a reversible cholinesterase inhibitor, has been shown to improve the clinical manifestations of AD by delaying the breakdown of acetylcholine (ACh) released into synaptic clefts. Moreover, there is evidence that ACh modulates EEG alpha frequency.

OBJECTIVES

the objectives of this pilot study in patients with AD were to determine the effects of two formulations of RV (transdermal and oral) on Mini-Mental State Examination (MMSE) scores and on alpha frequency in particular the posterior dominant rhythm.

METHODS

twenty subjects with AD were randomly assigned to receive either RV transdermal patch (RV-TDP, n=10) or RV capsules (RV-CP, n=10) according to the standard recommended dosage regimen. All patients were driven to the maximum drug dosage. Diagnosis of AD was made according to NINCDS-ADRDA criteria and the Diagnostic and Statistical Manual of Mental Disorders IV. All patients underwent EEG recordings at the beginning and at the end of the 18-month study period using P3, P4, O1 and O2 electrodes each at high (10.5-13.0 Hz) and low (8.0-10.5 Hz) frequency. MMSE scores were determined at the start of the study and at three successive 6-month intervals (T0, T1, T2, and T3).

RESULTS

administration of RV-DP increases the spectral power of alpha waves in the posterior region and is associated with improved cognitive function as evidenced by significant changes in MMSE scores.

CONCLUSION

RV-DP provides an effective and long-term management option in patients with AD.

Neural correlates associated with superior tactile symmetry perception in the early blind

Symmetry is an organizational principle that is ubiquitous throughout the visual world. However, this property can also be detected through non-visual modalities such as touch. The role of prior visual experience on detecting tactile patterns containing symmetry remains unclear. We compared the behavioral performance of early blind and sighted (blindfolded) controls on a tactile symmetry detection task. The tactile patterns used were similar in design and complexity as in previous visual perceptual studies. The neural correlates associated with this behavioral task were identified with functional magnetic resonance imaging (fMRI). In line with growing evidence demonstrating enhanced tactile processing abilities in the blind, we found that early blind individuals showed significantly superior performance in detecting tactile symmetric patterns compared to sighted controls. Furthermore, comparing patterns of activation between these two groups identified common areas of activation (e.g. superior parietal cortex) but key differences also emerged. In particular, tactile symmetry detection in the early blind was also associated with activation that included peri-calcarine cortex, lateral occipital (LO), and middle temporal (MT) cortex, as well as inferior temporal and fusiform cortex. These results contribute to the growing evidence supporting superior behavioral abilities in the blind, and the neural correlates associated with crossmodal neuroplasticity following visual deprivation.

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.

How skill expertise shapes the brain functional architecture: an fMRI study of visuo-spatial and motor processing in professional racing-car and naïve drivers

The present study was designed to investigate the brain functional architecture that subserves visuo-spatial and motor processing in highly skilled individuals. By using functional magnetic resonance imaging (fMRI), we measured brain activity while eleven Formula racing-car drivers and eleven ‘naïve’ volunteers performed a motor reaction and a visuo-spatial task. Tasks were set at a relatively low level of difficulty such to ensure a similar performance in the two groups and thus avoid any potential confounding effects on brain activity due to discrepancies in task execution. The brain functional organization was analyzed in terms of regional brain response, inter-regional interactions and blood oxygen level dependent (BOLD) signal variability. While performance levels were equal in the two groups, as compared to naïve drivers, professional drivers showed a smaller volume recruitment of task-related regions, stronger connections among task-related areas, and an increased information integration as reflected by a higher signal temporal variability. In conclusion, our results demonstrate that, as compared to naïve subjects, the brain functional architecture sustaining visuo-motor processing in professional racing-car drivers, trained to perform at the highest levels under extremely demanding conditions, undergoes both ‘quantitative’ and ‘qualitative’ modifications that are evident even when the brain is engaged in relatively simple, non-demanding tasks. These results provide novel evidence in favor of an increased ‘neural efficiency’ in the brain of highly skilled individuals.

Compensatory plasticity and cross-modal reorganization following early visual deprivation

For human and non-human primates, vision is one of the most privileged sensory channels used to interact with the environment. The importance of vision is strongly embedded in the organization of the primate brain as about one third of its cortical surface is involved in visual functions. It is therefore not surprising that the absence of vision from birth, or the loss of vision later in life, has huge consequences, both anatomically and functionally. Studies in animals and humans, conducted over the past few decades, have demonstrated that the absence of vision causes massive structural changes that take place not only in the visually deprived cortex but also in other brain areas. These studies have further shown that the visually deprived cortex becomes responsive to a wide variety of non-visual sensory inputs. Recent studies even showed a role of the visually deprived cortex in cognitive processes. At the behavioral level, increases in acuity for auditory and tactile processes have been reported. The study of the congenitally blind brain also offers a unique model to gain better insights into the functioning of the normal sighted brain and to understand to what extent visual experience is necessary for the brain to develop its functional architecture. Finally, the study of the blind brain allows us to investigate how consciousness develops in the absence of vision. How does the brain of someone who has never had any visual perception form an image of the external world? In this paper, we discuss recent findings from animal studies as well as from behavioural and functional brain imaging studies in sighted and blind individuals that address these questions.

Moment-to-moment brain signal variability: a next frontier in human brain mapping?

Neuroscientists have long observed that brain activity is naturally variable from moment-to-moment, but neuroimaging research has largely ignored the potential importance of this phenomenon. An emerging research focus on within-person brain signal variability is providing novel insights, and offering highly predictive, complementary, and even orthogonal views of brain function in relation to human lifespan development, cognitive performance, and various clinical conditions. As a result, brain signal variability is evolving as a bona fide signal of interest, and should no longer be dismissed as meaningless noise when mapping the human brain.

Cholinergic enhancement reduces functional connectivity and BOLD variability in visual extrastriate cortex during selective attention

Enhancing cholinergic function improves performance on various cognitive tasks and alters neural responses in task specific brain regions. We have hypothesized that the changes in neural activity observed during increased cholinergic function reflect an increase in neural efficiency that leads to improved task performance. The current study tested this hypothesis by assessing neural efficiency based on cholinergically-mediated effects on regional brain connectivity and BOLD signal variability. Nine subjects participated in a double-blind, placebo-controlled crossover fMRI study. Following an infusion of physostigmine (1 mg/h) or placebo, echo-planar imaging (EPI) was conducted as participants performed a selective attention task. During the task, two images comprised of superimposed pictures of faces and houses were presented. Subjects were instructed periodically to shift their attention from one stimulus component to the other and to perform a matching task using hand held response buttons. A control condition included phase-scrambled images of superimposed faces and houses that were presented in the same temporal and spatial manner as the attention task; participants were instructed to perform a matching task. Cholinergic enhancement improved performance during the selective attention task, with no change during the control task. Functional connectivity analyses showed that the strength of connectivity between ventral visual processing areas and task-related occipital, parietal and prefrontal regions reduced significantly during cholinergic enhancement, exclusively during the selective attention task. Physostigmine administration also reduced BOLD signal temporal variability relative to placebo throughout temporal and occipital visual processing areas, again during the selective attention task only. Together with the observed behavioral improvement, the decreases in connectivity strength throughout task-relevant regions and BOLD variability within stimulus processing regions support the hypothesis that cholinergic augmentation results in enhanced neural efficiency. This article is part of a Special Issue entitled 'Cognitive Enhancers'.