Visual Motion Area MT+/V5 Responds to Auditory Motion in Human Sight-Recovery Subjects

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.

Visual training after central retinal loss limits structural white matter degradation: an MRI study

BACKGROUND

Macular degeneration of the eye is a common cause of blindness and affects 8% of the worldwide human population. In adult cats with bilateral lesions of the central retina, we explored the possibility that motion perception training can limit the associated degradation of the visual system. We evaluated how visual training affects behavioral performance and white matter structure. Recently, we proposed (Kozak et al. in Transl Vis Sci Technol 10:9, 2021) a new motion-acuity test for low vision patients, enabling full visual field functional assessment through simultaneous perception of shape and motion. Here, we integrated this test as the last step of a 10-week motion-perception training.

RESULTS

Cats were divided into three groups: retinal-lesioned only and two trained groups, retinal-lesioned trained and control trained. The behavioral data revealed that trained cats with retinal lesions were superior in motion tasks, even when the difficulty relied only on acuity. 7 T-MRI scanning was done before and after lesioning at 5 different timepoints, followed by Fixel-Based and Fractional Anisotropy Analysis. In cats with retinal lesions, training resulted in a more localized and reduced percentage decrease in Fixel-Based Analysis metrics in the dLGN, caudate nucleus and hippocampus compared to untrained cats. In motion-sensitive area V5/PMLS, the significant decreases in fiber density were equally strong in retinal-lesioned untrained and trained cats, up to 40% in both groups. The only cortical area with Fractional Anisotropy values not affected by central retinal loss was area V5/PMLS. In other visual ROIs, the Fractional Anisotropy values increased over time in the untrained retinal lesioned group, whereas they decreased in the retinal lesioned trained group and remained at a similar level as in trained controls.

CONCLUSIONS

Overall, our MRI results showed a stabilizing effect of motion training applied soon after central retinal loss induction on white matter structure. We propose that introducing early motion-acuity training for low vision patients, aimed at the intact and active retinal peripheries, may facilitate brain plasticity processes toward better vision.

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.

Stimulus-responsive and task-dependent activations in occipital regions during pitch perception by early blind listeners

Although it has been established that cross-modal activations occur in the occipital cortex during auditory processing among congenitally and early blind listeners, it remains uncertain whether these activations in various occipital regions reflect sensory analysis of specific sound properties, non-perceptual cognitive operations associated with active tasks, or the interplay between sensory analysis and cognitive operations. This fMRI study aimed to investigate cross-modal responses in occipital regions, specifically V5/MT and V1, during passive and active pitch perception by early blind individuals compared to sighted individuals. The data showed that V5/MT was responsive to pitch during passive perception, and its activations increased with task complexity. By contrast, widespread occipital regions, including V1, were only recruited during two active perception tasks, and their activations were also modulated by task complexity. These fMRI results from blind individuals suggest that while V5/MT activations are both stimulus-responsive and task-modulated, activations in other occipital regions, including V1, are dependent on the task, indicating similarities and differences between various visual areas during auditory processing.

Audiovisual interactions outside of visual awareness during motion adaptation

Motion aftereffects (MAEs), illusory motion experienced in a direction opposed to real motion experienced during prior adaptation, have been used to assess audiovisual interactions. In a previous study from our laboratory, we demonstrated that a congruent direction of auditory motion presented concurrently with visual motion during adaptation strengthened the consequent visual MAE, compared to when auditory motion was incongruent in direction. Those judgments of MAE strength, however, could have been influenced by expectations or response bias from mere knowledge of the state of audiovisual congruity during adaptation. To prevent such knowledge, we now employed continuous flash suppression to render visual motion perceptually invisible during adaptation, ensuring that observers were completely unaware of visual adapting motion and only aware of the motion direction of the sound they were hearing. We found a small but statistically significant congruence effect of sound on adaptation strength produced by invisible adaptation motion. After considering alternative explanations for this finding, we conclude that auditory motion can impact the strength of visual processing produced by translational visual motion even when that motion transpires outside of awareness.

Do you hear what I see? How do early blind individuals experience object motion?

One of the most important tasks for 3D vision is tracking the movement of objects in space. The ability of early blind individuals to understand motion in the environment from noisy and unreliable auditory information is an impressive example of cortical adaptation that is only just beginning to be understood. Here, we compare visual and auditory motion processing, and discuss the effect of early blindness on the perception of auditory motion. Blindness leads to cross-modal recruitment of the visual motion area hMT+ for auditory motion processing. Meanwhile, the planum temporale, associated with auditory motion in sighted individuals, shows reduced selectivity for auditory motion. We discuss how this dramatic shift in the cortical basis of motion processing might influence the perceptual experience of motion in early blind individuals. This article is part of a discussion meeting issue 'New approaches to 3D vision'.

Top-down modulation of visual cortical processing after transient congenital blindness

Early visual experience has been shown to be critical for the development of visual and multisensory functions; however, its impact on functional brain organization remains largely unexplored. Here, we therefore investigated the effect of early visual deprivation on top-down attentional modulation of visual cortical processing within the occipito-temporal cortex. Furthermore, we explored whether early visual deprivation may affect the extent to which typically visual, motion-selective area hMT responds to moving visual stimuli. Using functional magnetic resonance imaging, we compared cortical responses in area hMT and in the fusiform face area (FFA) to moving face stimuli - which were either task relevant or task irrelevant - relative to stationary face stimuli between cataract-reversal participants and normally sighted controls. Although both groups exhibited significantly stronger visual cortical responses in area hMT to moving stimuli than during the stationary baseline, the magnitude of this effect was significantly lower in the cataract-reversal group. In contrast, both groups exhibited significantly enhanced visual cortical responses in area hMT and in the FFA when moving face stimuli were task relevant compared to when they were task irrelevant, with no significant differences between groups in the magnitude of these effects. These results indicate that top-down attentional modulation of visual cortical processing in area hMT and FFA does not depend on early visual experience. Furthermore, the present results suggest that the functional specialization of area hMT for visual motion processing may be partially disrupted by early visual deprivation.

Structural and Functional Network-Level Reorganization in the Coding of Auditory Motion Directions and Sound Source Locations in the Absence of Vision

hMT+/V5 is a region in the middle occipitotemporal cortex that responds preferentially to visual motion in sighted people. In cases of early visual deprivation, hMT+/V5 enhances its response to moving sounds. Whether hMT+/V5 contains information about motion directions and whether the functional enhancement observed in the blind is motion specific, or also involves sound source location, remains unsolved. Moreover, the impact of this cross-modal reorganization of hMT+/V5 on the regions typically supporting auditory motion processing, like the human planum temporale (hPT), remains equivocal. We used a combined functional and diffusion-weighted MRI approach and individual in-ear recordings to study the impact of early blindness on the brain networks supporting spatial hearing in male and female humans. Whole-brain univariate analysis revealed that the anterior portion of hMT+/V5 responded to moving sounds in sighted and blind people, while the posterior portion was selective to moving sounds only in blind participants. Multivariate decoding analysis revealed that the presence of motion direction and sound position information was higher in hMT+/V5 and lower in hPT in the blind group. While both groups showed axis-of-motion organization in hMT+/V5 and hPT, this organization was reduced in the hPT of blind people. Diffusion-weighted MRI revealed that the strength of hMT+/V5-hPT connectivity did not differ between groups, whereas the microstructure of the connections was altered by blindness. Our results suggest that the axis-of-motion organization of hMT+/V5 does not depend on visual experience, but that congenital blindness alters the response properties of occipitotemporal networks supporting spatial hearing in the sighted.SIGNIFICANCE STATEMENT Spatial hearing helps living organisms navigate their environment. This is certainly even more true in people born blind. How does blindness affect the brain network supporting auditory motion and sound source location? Our results show that the presence of motion direction and sound position information was higher in hMT+/V5 and lower in human planum temporale in blind relative to sighted people; and that this functional reorganization is accompanied by microstructural (but not macrostructural) alterations in their connections. These findings suggest that blindness alters cross-modal responses between connected areas that share the same computational goals.

Typical resting state activity of the brain requires visual input during an early sensitive period

Sensory deprivation, following a total loss of one sensory modality e.g. vision, has been demonstrated to result in compensatory plasticity. It is yet not known to which extent neural changes, e.g. higher resting-state activity in visual areas (cross-modal plasticity) as a consequence of blindness, reverse, when sight is restored. Here, we used functional MRI to acquire blood oxygen level-dependent resting-state activity during an eyes open and an eyes closed state in congenital cataract-reversal individuals, developmental cataract-reversal individuals, congenitally permanently blind individuals and sighted controls. The amplitude of low frequency fluctuation of the blood oxygen level-dependent signal—a neural marker of spontaneous brain activity during rest—was analyzed. In accordance with previous reports, in normally sighted controls we observed an increase in amplitude of low-frequency fluctuation during rest with the eyes open compared with rest with eyes closed in visual association areas and in parietal cortex but a decrease in auditory and sensorimotor regions. In congenital cataract-reversal individuals, we found an increase of the amplitude of slow blood oxygen level-dependent fluctuations in visual cortex during rest with eyes open compared with rest with eyes closed too but this increase was larger in amplitude than in normally sighted controls. In contrast, congenital cataract-reversal individuals lagged a similar increase in parietal regions and did not show the typical decrease of amplitude of low-frequency fluctuation in auditory cortex. Congenitally blind individuals displayed an overall higher amplitude in slow blood oxygen level-dependent fluctuations in visual cortex compared with sighted individuals and compared with congenital cataract-reversal individuals in the eyes closed condition. Higher amplitude of low-frequency fluctuation in visual cortex of congenital cataract-reversal individuals than in normally sighted controls during eyes open might indicate an altered excitatory–inhibitory balance of visual neural circuits. By contrast, the lower parietal increase and the missing downregulation in auditory regions suggest a reduced influence of the visual system on multisensory and the other sensory systems after restoring sight in congenitally blind individuals. These results demonstrate a crucial dependence of visual and multisensory neural system functioning on visual experience during a sensitive phase in human brain development.

Study of extravisual resting-state networks in pituitary adenoma patients with vision restoration

Background

Pituitary adenoma (PA) may compress the optic apparatus, resulting in impaired vision. Some patients can experience improved vision rapidly after surgery. During the early period after surgery, however, the change in neurofunction in the extravisual cortex and higher cognitive cortex has yet to be explored.

Objective

Our study focused on the changes in the extravisual resting-state networks in patients with PA after vision restoration.

Methods

We recruited 14 patients with PA who experienced visual improvement after surgery. The functional connectivity (FC) of 6 seeds [auditory cortex (A1), Broca’s area, posterior cingulate cortex (PCC) for the default mode network (DMN), right caudal anterior cingulate cortex for the salience network (SN) and left dorsolateral prefrontal cortex for the executive control network (ECN)] were evaluated. A paired t test was conducted to identify the differences between two groups of patients.

Results

Compared with their preoperative counterparts, patients with PA with improved vision exhibited decreased FC with the right A1 in the left insula lobule, right middle temporal gyrus and left postcentral gyrus and increased FC in the right paracentral lobule; decreased FC with the Broca in the left middle temporal gyrus and increased FC in the left insula lobule and right thalamus; decreased FC with the DMN in the right declive and right precuneus; increased FC in right Brodmann area 17, the left cuneus and the right posterior cingulate; decreased FC with the ECN in the right posterior cingulate, right angular and right precuneus; decreased FC with the SN in the right middle temporal gyrus, right hippocampus, and right precuneus; and increased FC in the right fusiform gyrus, the left lingual gyrus and right Brodmann area 19.

Conclusions

Vision restoration may cause a response of cross-modal plasticity and multisensory systems related to A1 and the Broca. The DMN and SN may be involved in top-down control of the subareas within the visual cortex. The precuneus may be involved in the DMN, ECN and SN simultaneously.

Visual-tactile shape perception in the visually restored with artificial vision

Retinal prostheses partially restore vision to late blind patients with retinitis pigmentosa through electrical stimulation of still-viable retinal ganglion cells. We investigated whether the late blind can perform visual–tactile shape matching following the partial restoration of vision via retinal prostheses after decades of blindness.

We tested for visual–visual, tactile–tactile, and visual–tactile two-dimensional shape matching with six Argus II retinal prosthesis patients, ten sighted controls, and eight sighted controls with simulated ultra-low vision. In the Argus II patients, the visual–visual shape matching performance was significantly greater than chance. Although the visual–tactile shape matching performance of the Argus II patients was not significantly greater than chance, it was significantly higher with longer duration of prosthesis use. The sighted controls using natural vision and the sighted controls with simulated ultra-low vision both performed the visual–visual and visual–tactile shape matching tasks significantly more accurately than the Argus II patients. The tactile–tactile matching was not significantly different between the Argus II patients and sighted controls with or without simulated ultra-low vision.

These results show that experienced retinal prosthesis patients can match shapes across the senses and integrate artificial vision with somatosensation. The correlation of retinal prosthesis patients’ crossmodal shape matching performance with the duration of device use supports the value of experience to crossmodal shape learning. These crossmodal shape matching results in Argus II patients are the first step toward understanding crossmodal perception after artificial visual restoration.

Delayed Auditory Brainstem Responses (ABR) in children after sight-recovery

Studies in non-human animal models have revealed that in early development, the onset of visual input gates the critical period closure of some auditory functions. The study of rare individuals whose sight was restored after a period of congenital blindness offers the rare opportunity to assess whether early visual input is a prerequisite for the full development of auditory functions in humans as well. Here, we investigated whether a few months of delayed visual onset would affect the development of Auditory Brainstem Responses (ABRs). ABRs are widely used in the clinical practice to assess both functionality and development of the subcortical auditory pathway and, provide reliable data at the individual level. We collected Auditory Brainstem Responses from two case studies, young children (both having less than 5 years of age) who experienced a transient visual deprivation since birth due to congenital bilateral dense cataracts (BC), and who acquired sight at about two months of age. As controls, we tested 41 children (sighted controls, SC) with typical development, as well as two children who were treated (at about two months of age) for congenital monocular cataracts (MC). The SC group data served to predict, at the individual level, wave latencies of each BC and MC participant. Statistics were performed both at the single subject as well as at the group levels on latencies of main ABR waves (I, III, V and SN10). Results revealed delayed response latencies for both BC children compared with the SC group starting from the wave III. Conversely, no difference emerged between MC children and the SC group. These findings suggest that in case the onset of patterned visual input is delayed, the functional development of the subcortical auditory pathway lags behind typical developmental trajectories. Ultimately results are in favor of the presence of a crossmodal sensitive period in the human subcortical auditory system.

Direct Structural Connections between Auditory and Visual Motion-Selective Regions in Humans

In humans, the occipital middle-temporal region (hMT⁺/V5) specializes in the processing of visual motion, while the planum temporale (hPT) specializes in auditory motion processing. It has been hypothesized that these regions might communicate directly to achieve fast and optimal exchange of multisensory motion information. Here we investigated, for the first time in humans (male and female), the presence of direct white matter connections between visual and auditory motion-selective regions using a combined fMRI and diffusion MRI approach. We found evidence supporting the potential existence of direct white matter connections between individually and functionally defined hMT⁺/V5 and hPT. We show that projections between hMT⁺/V5 and hPT do not overlap with large white matter bundles, such as the inferior longitudinal fasciculus and the inferior frontal occipital fasciculus. Moreover, we did not find evidence suggesting the presence of projections between the fusiform face area and hPT, supporting the functional specificity of hMT⁺/V5-hPT connections. Finally, the potential presence of hMT⁺/V5-hPT connections was corroborated in a large sample of participants (n = 114) from the human connectome project. Together, this study provides a first indication for potential direct occipitotemporal projections between hMT⁺/V5 and hPT, which may support the exchange of motion information between functionally specialized auditory and visual regions.SIGNIFICANCE STATEMENT Perceiving and integrating moving signal across the senses is arguably one of the most important perceptual skills for the survival of living organisms. In order to create a unified representation of movement, the brain must therefore integrate motion information from separate senses. Our study provides support for the potential existence of direct connections between motion-selective regions in the occipital/visual (hMT⁺/V5) and temporal/auditory (hPT) cortices in humans. This connection could represent the structural scaffolding for the rapid and optimal exchange and integration of multisensory motion information. These findings suggest the existence of computationally specific pathways that allow information flow between areas that share a similar computational goal.

Neural mechanisms of visual sensitive periods in humans

Sensitive periods in brain development are phases of enhanced susceptibility to experience. Here we discuss research from human and non-human neuroscience studies which have demonstrated a) differences in the way infants vs. adults learn; b) how the brain adapts to atypical conditions, in particular a congenital vs. a late onset blindness (sensitive periods for atypical brain development); and c) the extent to which neural systems are capable of acquiring a typical brain organization after sight restoration following a congenital vs. late phase of pattern vision deprivation (sensitive periods for typical brain development). By integrating these three lines of research, we propose neural mechanisms characteristic of sensitive periods vs. adult neuroplasticity and learning.

Electrocorticography Evidence of Tactile Responses in Visual Cortices

There is ongoing debate regarding the extent to which human cortices are specialized for processing a given sensory input versus a given type of information, independently of the sensory source. Many neuroimaging and electrophysiological studies have reported that primary and extrastriate visual cortices respond to tactile and auditory stimulation, in addition to visual inputs, suggesting these cortices are intrinsically multisensory. In particular for tactile responses, few studies have proven neuronal processes in visual cortex in humans. Here, we assessed tactile responses in both low-level and extrastriate visual cortices using electrocorticography recordings in a human participant. Specifically, we observed significant spectral power increases in the high frequency band (30-100 Hz) in response to tactile stimuli, reportedly associated with spiking neuronal activity, in both low-level visual cortex (i.e. V2) and in the anterior part of the lateral occipital-temporal cortex. These sites were both involved in processing tactile information and responsive to visual stimulation. More generally, the present results add to a mounting literature in support of task-sensitive and sensory-independent mechanisms underlying functions like spatial, motion, and self-processing in the brain and extending from higher-level as well as to low-level cortices.

Increased Right Posterior STS Recruitment Without Enhanced Directional-Tuning During Tactile Motion Processing in Early Deaf Individuals

Upon early sensory deprivation, the remaining modalities often exhibit cross-modal reorganization, such as primary auditory cortex (PAC) recruitment for visual motion processing in early deafness (ED). Previous studies of compensatory plasticity in ED individuals have given less attention to tactile motion processing. In the current study, we aimed to examine the effects of early auditory deprivation on tactile motion processing. We simulated four directions of tactile motion on each participant's right index finger and characterized their tactile motion responses and directional-tuning profiles using population receptive field analysis. Similar tactile motion responses were found within primary (SI) and secondary (SII) somatosensory cortices between ED and hearing control groups, whereas ED individuals showed a reduced proportion of voxels with directionally tuned responses in SI contralateral to stimulation. There were also significant but minimal responses to tactile motion within PAC for both groups. While early deaf individuals show significantly larger recruitment of right posterior superior temporal sulcus (pSTS) region upon tactile motion stimulation, there was no evidence of enhanced directional tuning. Greater recruitment of right pSTS region is consistent with prior studies reporting reorganization of multimodal areas due to sensory deprivation. The absence of increased directional tuning within the right pSTS region may suggest a more distributed population of neurons dedicated to processing tactile spatial information as a consequence of early auditory deprivation.

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.

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.

The Cross-Modal Effects of Sensory Deprivation on Spatial and Temporal Processes in Vision and Audition: A Systematic Review on Behavioral and Neuroimaging Research since 2000

One of the most significant effects of neural plasticity manifests in the case of sensory deprivation when cortical areas that were originally specialized for the functions of the deprived sense take over the processing of another modality. Vision and audition represent two important senses needed to navigate through space and time. Therefore, the current systematic review discusses the cross-modal behavioral and neural consequences of deafness and blindness by focusing on spatial and temporal processing abilities, respectively. In addition, movement processing is evaluated as compiling both spatial and temporal information. We examine whether the sense that is not primarily affected changes in its own properties or in the properties of the deprived modality (i.e., temporal processing as the main specialization of audition and spatial processing as the main specialization of vision). References to the metamodal organization, supramodal functioning, and the revised neural recycling theory are made to address global brain organization and plasticity principles. Generally, according to the reviewed studies, behavioral performance is enhanced in those aspects for which both the deprived and the overtaking senses provide adequate processing resources. Furthermore, the behavioral enhancements observed in the overtaking sense (i.e., vision in the case of deafness and audition in the case of blindness) are clearly limited by the processing resources of the overtaking modality. Thus, the brain regions that were previously recruited during the behavioral performance of the deprived sense now support a similar behavioral performance for the overtaking sense. This finding suggests a more input-unspecific and processing principle-based organization of the brain. Finally, we highlight the importance of controlling for and stating factors that might impact neural plasticity and the need for further research into visual temporal processing in deaf subjects.

Responses in area hMT+ reflect tuning for both auditory frequency and motion after blindness early in life

Previous studies report that human middle temporal complex (hMT+) is sensitive to auditory motion in early-blind individuals. Here, we show that hMT+ also develops selectivity for auditory frequency after early blindness, and that this selectivity is maintained after sight recovery in adulthood. Frequency selectivity was assessed using both moving band-pass and stationary pure-tone stimuli. As expected, within primary auditory cortex, both moving and stationary stimuli successfully elicited frequency-selective responses, organized in a tonotopic map, for all subjects. In early-blind and sight-recovery subjects, we saw evidence for frequency selectivity within hMT+ for the auditory stimulus that contained motion. We did not find frequency-tuned responses within hMT+ when using the stationary stimulus in either early-blind or sight-recovery subjects. We saw no evidence for auditory frequency selectivity in hMT+ in sighted subjects using either stimulus. Thus, after early blindness, hMT+ can exhibit selectivity for auditory frequency. Remarkably, this auditory frequency tuning persists in two adult sight-recovery subjects, showing that, in these subjects, auditory frequency-tuned responses can coexist with visually driven responses in hMT+.

Blindness and Human Brain Plasticity

Early blindness causes fundamental alterations of neural function across more than 25% of cortex-changes that span the gamut from metabolism to behavior and collectively represent one of the most dramatic examples of plasticity in the human brain. The goal of this review is to describe how the remarkable behavioral and neuroanatomical compensations demonstrated by blind individuals provide insights into the extent, mechanisms, and limits of human brain plasticity.

Development of the Visual Word Form Area Requires Visual Experience: Evidence from Blind Braille Readers

Learning to read causes the development of a letter- and word-selective region known as the visual word form area (VWFA) within the human ventral visual object stream. Why does a reading-selective region develop at this anatomical location? According to one hypothesis, the VWFA develops at the nexus of visual inputs from retinotopic cortices and linguistic input from the frontotemporal language network because reading involves extracting linguistic information from visual symbols. Surprisingly, the anatomical location of the VWFA is also active when blind individuals read Braille by touch, suggesting that vision is not required for the development of the VWFA. In this study, we tested the alternative prediction that VWFA development is in fact influenced by visual experience. We predicted that in the absence of vision, the "VWFA" is incorporated into the frontotemporal language network and participates in high-level language processing. Congenitally blind (n = 10, 9 female, 1 male) and sighted control (n = 15, 9 female, 6 male), male and female participants each took part in two functional magnetic resonance imaging experiments: (1) word reading (Braille for blind and print for sighted participants), and (2) listening to spoken sentences of different grammatical complexity (both groups). We find that in blind, but not sighted participants, the anatomical location of the VWFA responds both to written words and to the grammatical complexity of spoken sentences. This suggests that in blindness, this region takes on high-level linguistic functions, becoming less selective for reading. More generally, the current findings suggest that experience during development has a major effect on functional specialization in the human cortex.SIGNIFICANCE STATEMENT The visual word form area (VWFA) is a region in the human cortex that becomes specialized for the recognition of written letters and words. Why does this particular brain region become specialized for reading? We tested the hypothesis that the VWFA develops within the ventral visual stream because reading involves extracting linguistic information from visual symbols. Consistent with this hypothesis, we find that in congenitally blind Braille readers, but not sighted readers of print, the VWFA region is active during grammatical processing of spoken sentences. These results suggest that visual experience contributes to VWFA specialization, and that different neural implementations of reading are possible.

Following during physically-coupled joint action engages motion area MT+/V5

Interpersonal coordination during joint action depends on the perception of the partner's movements. In many such situations - for example, while moving furniture together or dancing a tango - there are kinesthetic interactions between the partners due to the forces shared between them that allow them to directly perceive one another's movements. Joint action of this type often involves a contrast between the roles of leader and follower, where the leader imparts forces onto the follower, and the follower has to be responsive to these force-cues during movement. We carried out a novel 2-person functional MRI study with trained couple dancers engaged in bimanual contact with an experimenter standing next to the bore of the magnet, where the two alternated between being the leader and follower of joint improvised movements, all with the eyes closed. One brain area that was unexpectedly more active during following than leading was the region of MT+/V5. While classically described as an area for processing visual motion, it has more recently been shown to be responsive to tactile motion as well. We suggest that MT+/V5 responds to motion based on force-cues during joint haptic interaction, most especially when a follower responds to force-cues coming from a leader's movements.

Plasticity Beyond V1: Reinforcement of Motion Perception upon Binocular Central Retinal Lesions in Adulthood

Induction of a central retinal lesion in both eyes of adult mammals is a model for macular degeneration and leads to retinotopic map reorganization in the primary visual cortex (V1). Here we characterized the spatiotemporal dynamics of molecular activity levels in the central and peripheral representation of five higher-order visual areas, V2/18, V3/19, V4/21a,V5/PMLS, area 7, and V1/17, in adult cats with central 10° retinal lesions (both sexes), by means of real-time PCR for the neuronal activity reporter gene zif268. The lesions elicited a similar, permanent reduction in activity in the center of the lesion projection zone of area V1/17, V2/18, V3/19, and V4/21a, but not in the motion-driven V5/PMLS, which instead displayed an increase in molecular activity at 3 months postlesion, independent of visual field coordinates. Also area 7 only displayed decreased activity in its LPZ in the first weeks postlesion and increased activities in its periphery from 1 month onward. Therefore we examined the impact of central vision loss on motion perception using random dot kinematograms to test the capacity for form from motion detection based on direction and velocity cues. We revealed that the central retinal lesions either do not impair motion detection or even result in better performance, specifically when motion discrimination was based on velocity discrimination. In conclusion, we propose that central retinal damage leads to enhanced peripheral vision by sensitizing the visual system for motion processing relying on feedback from V5/PMLS and area 7.SIGNIFICANCE STATEMENT Central retinal lesions, a model for macular degeneration, result in functional reorganization of the primary visual cortex. Examining the level of cortical reactivation with the molecular activity marker zif268 revealed reorganization in visual areas outside V1. Retinotopic lesion projection zones typically display an initial depression in zif268 expression, followed by partial recovery with postlesion time. Only the motion-sensitive area V5/PMLS shows no decrease, and even a significant activity increase at 3 months post-retinal lesion. Behavioral tests of motion perception found no impairment and even better sensitivity to higher random dot stimulus velocities. We demonstrate that the loss of central vision induces functional mobilization of motion-sensitive visual cortex, resulting in enhanced perception of moving stimuli.

Neural mechanisms underlying sound-induced visual motion perception: An fMRI study

Studies of crossmodal interactions in motion perception have reported activation in several brain areas, including those related to motion processing and/or sensory association, in response to multimodal (e.g., visual and auditory) stimuli that were both in motion. Recent studies have demonstrated that sounds can trigger illusory visual apparent motion to static visual stimuli (sound-induced visual motion: SIVM): A visual stimulus blinking at a fixed location is perceived to be moving laterally when an alternating left-right sound is also present. Here, we investigated brain activity related to the perception of SIVM using a 7T functional magnetic resonance imaging technique. Specifically, we focused on the patterns of neural activities in SIVM and visually induced visual apparent motion (VIVM). We observed shared activations in the middle occipital area (V5/hMT), which is thought to be involved in visual motion processing, for SIVM and VIVM. Moreover, as compared to VIVM, SIVM resulted in greater activation in the superior temporal area and dominant functional connectivity between the V5/hMT area and the areas related to auditory and crossmodal motion processing. These findings indicate that similar but partially different neural mechanisms could be involved in auditory-induced and visually-induced motion perception, and neural signals in auditory, visual, and, crossmodal motion processing areas closely and directly interact in the perception of SIVM.

Learning to see again: biological constraints on cortical plasticity and the implications for sight restoration technologies

The 'bionic eye'-so long a dream of the future-is finally becoming a reality with retinal prostheses available to patients in both the US and Europe. However, clinical experience with these implants has made it apparent that the visual information provided by these devices differs substantially from normal sight. Consequently, the ability of patients to learn to make use of this abnormal retinal input plays a critical role in whether or not some functional vision is successfully regained. The goal of the present review is to summarize the vast basic science literature on developmental and adult cortical plasticity with an emphasis on how this literature might relate to the field of prosthetic vision. We begin with describing the distortion and information loss likely to be experienced by visual prosthesis users. We then define cortical plasticity and perceptual learning, and describe what is known, and what is unknown, about visual plasticity across the hierarchy of brain regions involved in visual processing, and across different stages of life. We close by discussing what is known about brain plasticity in sight restoration patients and discuss biological mechanisms that might eventually be harnessed to improve visual learning in these patients.

Brain circuit-gene expression relationships and neuroplasticity of multisensory cortices in blind children

Sensory deprivation reorganizes neurocircuits in the human brain. The biological basis of such neuroplastic adaptations remains elusive. In this study, we applied two complementary graph theory-based functional connectivity analyses, one to evaluate whole-brain functional connectivity relationships and the second to specifically delineate distributed network connectivity profiles downstream of primary sensory cortices, to investigate neural reorganization in blind children compared with sighted controls. We also examined the relationship between connectivity changes and neuroplasticity-related gene expression profiles in the cerebral cortex. We observed that multisensory integration areas exhibited enhanced functional connectivity in blind children and that this reorganization was spatially associated with the transcription levels of specific members of the cAMP Response Element Binding protein gene family. Using systems-level analyses, this study advances our understanding of human neuroplasticity and its genetic underpinnings following sensory deprivation.

Enhanced Functional Coupling of Hippocampal Sub-regions in Congenitally and Late Blind Subjects

The hippocampus has exhibited navigation-related changes in volume and activity after visual deprivation; however, the resting-state functional connectivity (rsFC) changes of the hippocampus in the blind remains unknown. In this study, we focused on sub-region-specific rsFC changes of the hippocampus and their association with the onset age of blindness. The rsFC patterns of the hippocampal sub-regions (head, body and tail) were compared among 20 congenitally blind (CB), 42 late blind (LB), and 50 sighted controls (SC). Compared with the SC, both the CB and the LB showed increased hippocampal rsFCs with the posterior cingulate cortex, angular gyrus, parieto-occpital sulcus, middle occipito-temporal conjunction, inferior temporal gyrus, orbital frontal cortex, and middle frontal gyrus. In the blind subjects, the hippocampal tail had more extensive rsFC changes than the anterior hippocampus (body and head). The CB and the LB had similar changes in hippocampal rsFC. These altered rsFCs of the hippocampal sub-regions were neither correlated with onset age in the LB nor the duration of blindness in CB or LB subjects. The increased coupling of the hippocampal intrinsic functional network may reflect enhanced loading of the hippocampal-related networks for non-visual memory processing. Furthermore, the similar changes of hippocampal rsFCs between the CB and the LB suggests an experience-dependent rather than a developmental-dependent plasticity of the hippocampal intrinsic functional network.

Task-specific reorganization of the auditory cortex in deaf humans

The principles that guide large-scale cortical reorganization remain unclear. In the blind, several visual regions preserve their task specificity; ventral visual areas, for example, become engaged in auditory and tactile object-recognition tasks. It remains open whether task-specific reorganization is unique to the visual cortex or, alternatively, whether this kind of plasticity is a general principle applying to other cortical areas. Auditory areas can become recruited for visual and tactile input in the deaf. Although nonhuman data suggest that this reorganization might be task specific, human evidence has been lacking. Here we enrolled 15 deaf and 15 hearing adults into an functional MRI experiment during which they discriminated between temporally complex sequences of stimuli (rhythms). Both deaf and hearing subjects performed the task visually, in the central visual field. In addition, hearing subjects performed the same task in the auditory modality. We found that the visual task robustly activated the auditory cortex in deaf subjects, peaking in the posterior-lateral part of high-level auditory areas. This activation pattern was strikingly similar to the pattern found in hearing subjects performing the auditory version of the task. Although performing the visual task in deaf subjects induced an increase in functional connectivity between the auditory cortex and the dorsal visual cortex, no such effect was found in hearing subjects. We conclude that in deaf humans the high-level auditory cortex switches its input modality from sound to vision but preserves its task-specific activation pattern independent of input modality. Task-specific reorganization thus might be a general principle that guides cortical plasticity in the brain.

Sounds facilitate visual motion discrimination via the enhancement of late occipital visual representations

Sensory discriminations, such as judgements about visual motion, often benefit from multisensory evidence. Despite many reports of enhanced brain activity during multisensory conditions, it remains unclear which dynamic processes implement the multisensory benefit for an upcoming decision in the human brain. Specifically, it remains difficult to attribute perceptual benefits to specific processes, such as early sensory encoding, the transformation of sensory representations into a motor response, or to more unspecific processes such as attention. We combined an audio-visual motion discrimination task with the single-trial mapping of dynamic sensory representations in EEG activity to localize when and where multisensory congruency facilitates perceptual accuracy. Our results show that a congruent sound facilitates the encoding of motion direction in occipital sensory - as opposed to parieto-frontal - cortices, and facilitates later - as opposed to early (i.e. below 100 ms) - sensory activations. This multisensory enhancement was visible as an earlier rise of motion-sensitive activity in middle-occipital regions about 350 ms from stimulus onset, which reflected the better discriminability of motion direction from brain activity and correlated with the perceptual benefit provided by congruent multisensory information. This supports a hierarchical model of multisensory integration in which the enhancement of relevant sensory cortical representations is transformed into a more accurate choice.

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Feature specific multisensory integration occurs in sensory not amodal cortex.

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Feature specific integration occurs late, i.e. around 350 ms post stimulus onset.

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Acoustic and visual representations interact in occipital motion regions.

Auditory Motion Elicits a Visual Motion Aftereffect

The visual motion aftereffect is a visual illusion in which exposure to continuous motion in one direction leads to a subsequent illusion of visual motion in the opposite direction. Previous findings have been mixed with regard to whether this visual illusion can be induced cross-modally by auditory stimuli. Based on research on multisensory perception demonstrating the profound influence auditory perception can have on the interpretation and perceived motion of visual stimuli, we hypothesized that exposure to auditory stimuli with strong directional motion cues should induce a visual motion aftereffect. Here, we demonstrate that horizontally moving auditory stimuli induced a significant visual motion aftereffect—an effect that was driven primarily by a change in visual motion perception following exposure to leftward moving auditory stimuli. This finding is consistent with the notion that visual and auditory motion perception rely on at least partially overlapping neural substrates.

Visual BOLD Response in Late Blind Subjects with Argus II Retinal Prosthesis

Retinal prosthesis technologies require that the visual system downstream of the retinal circuitry be capable of transmitting and elaborating visual signals. We studied the capability of plastic remodeling in late blind subjects implanted with the Argus II Retinal Prosthesis with psychophysics and functional MRI (fMRI). After surgery, six out of seven retinitis pigmentosa (RP) blind subjects were able to detect high-contrast stimuli using the prosthetic implant. However, direction discrimination to contrast modulated stimuli remained at chance level in all of them. No subject showed any improvement of contrast sensitivity in either eye when not using the Argus II. Before the implant, the Blood Oxygenation Level Dependent (BOLD) activity in V1 and the lateral geniculate nucleus (LGN) was very weak or absent. Surprisingly, after prolonged use of Argus II, BOLD responses to visual input were enhanced. This is, to our knowledge, the first study tracking the neural changes of visual areas in patients after retinal implant, revealing a capacity to respond to restored visual input even after years of deprivation.

Multisensory integration substantiates distributed and overlapping neural networks

The hypothesis that highly overlapping networks underlie brain functions (neural reuse) is decisively supported by three decades of multisensory research. Multisensory areas process information from more than one sensory modality and therefore represent the best examples of neural reuse. Recent evidence of multisensory processing in primary visual cortices further indicates that neural reuse is a basic feature of the brain.

Early Blindness Results in Developmental Plasticity for Auditory Motion Processing within Auditory and Occipital Cortex

Early blind subjects exhibit superior abilities for processing auditory motion, which are accompanied by enhanced BOLD responses to auditory motion within hMT+ and reduced responses within right planum temporale (rPT). Here, by comparing BOLD responses to auditory motion in hMT+ and rPT within sighted controls, early blind, late blind, and sight-recovery individuals, we were able to separately examine the effects of developmental and adult visual deprivation on cortical plasticity within these two areas. We find that both the enhanced auditory motion responses in hMT+ and the reduced functionality in rPT are driven by the absence of visual experience early in life; neither loss nor recovery of vision later in life had a discernable influence on plasticity within these areas. Cortical plasticity as a result of blindness has generally be presumed to be mediated by competition across modalities within a given cortical region. The reduced functionality within rPT as a result of early visual loss implicates an additional mechanism for cross modal plasticity as a result of early blindness—competition across different cortical areas for functional role.

The Effect of Early Visual Deprivation on the Neural Bases of Auditory Processing

Transient congenital visual deprivation affects visual and multisensory processing. In contrast, the extent to which it affects auditory processing has not been investigated systematically. Research in permanently blind individuals has revealed brain reorganization during auditory processing, involving both intramodal and crossmodal plasticity. The present study investigated the effect of transient congenital visual deprivation on the neural bases of auditory processing in humans. Cataract-reversal individuals and normally sighted controls performed a speech-in-noise task while undergoing functional magnetic resonance imaging. Although there were no behavioral group differences, groups differed in auditory cortical responses: in the normally sighted group, auditory cortex activation increased with increasing noise level, whereas in the cataract-reversal group, no activation difference was observed across noise levels. An auditory activation of visual cortex was not observed at the group level in cataract-reversal individuals. The present data suggest prevailing auditory processing advantages after transient congenital visual deprivation, even many years after sight restoration.

SIGNIFICANCE STATEMENT

The present study demonstrates that people whose sight was restored after a transient period of congenital blindness show more efficient cortical processing of auditory stimuli (here speech), similarly to what has been observed in congenitally permanently blind individuals. These results underscore the importance of early sensory experience in permanently shaping brain function.

Retinotopic encoding of the Ternus-Pikler display reflected in the early visual areas

The visual representation of the world is often assumed to be retinotopic, and many visual brain areas are indeed organized retinotopically. Visual perception, however, is not based on a reference frame anchored in retinotopic coordinates. For example, when an object moves, motion of its constituent parts is perceived relative to the object rather than in retinotopic coordinates. The moving object thus serves as a nonretinotopic reference system for computing the properties of its parts. It is largely unknown how the brain accomplishes this feat. Here, we used the Ternus-Pikler display to pit retinotopic processing in a stationary reference system against nonretinotopic processing in a moving one. Using 7T fMRI, we found that the average blood-oxygen-level dependent activations in V1, V2, and V3 reflected the retinotopic properties, but not the nonretinotopic percepts, of the Ternus-Pikler display. In the human motion processing complex (hMT+), activations were compatible with both retinotopic and nonretinotopic encoding. Thus, hMT+ may be the first visual area encoding the nonretinotopic percepts of the Ternus-Pikler display.

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

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

"Visual" Cortex of Congenitally Blind Adults Responds to Syntactic Movement

Human cortex is comprised of specialized networks that support functions, such as visual motion perception and language processing. How do genes and experience contribute to this specialization? Studies of plasticity offer unique insights into this question. In congenitally blind individuals, "visual" cortex responds to auditory and tactile stimuli. Remarkably, recent evidence suggests that occipital areas participate in language processing. We asked whether in blindness, occipital cortices: (1) develop domain-specific responses to language and (2) respond to a highly specialized aspect of language-syntactic movement. Nineteen congenitally blind and 18 sighted participants took part in two fMRI experiments. We report that in congenitally blind individuals, but not in sighted controls, "visual" cortex is more active during sentence comprehension than during a sequence memory task with nonwords, or a symbolic math task. This suggests that areas of occipital cortex become selective for language, relative to other similar higher-cognitive tasks. Crucially, we find that these occipital areas respond more to sentences with syntactic movement but do not respond to the difficulty of math equations. We conclude that regions within the visual cortex of blind adults are involved in syntactic processing. Our findings suggest that the cognitive function of human cortical areas is largely determined by input during development.

SIGNIFICANCE STATEMENT

Human cortex is made up of specialized regions that perform different functions, such as visual motion perception and language processing. How do genes and experience contribute to this specialization? Studies of plasticity show that cortical areas can change function from one sensory modality to another. Here we demonstrate that input during development can alter cortical function even more dramatically. In blindness a subset of "visual" areas becomes specialized for language processing. Crucially, we find that the same "visual" areas respond to a highly specialized and uniquely human aspect of language-syntactic movement. These data suggest that human cortex has broad functional capacity during development, and input plays a major role in determining functional specialization.

Resting-State Retinotopic Organization in the Absence of Retinal Input and Visual Experience

Early visual areas have neuronal receptive fields that form a sampling mosaic of visual space, resulting in a series of retinotopic maps in which the same region of space is represented in multiple visual areas. It is not clear to what extent the development and maintenance of this retinotopic organization in humans depend on retinal waves and/or visual experience. We examined the corticocortical receptive field organization of resting-state BOLD data in normally sighted, early blind, and anophthalmic (in which both eyes fail to develop) individuals and found that resting-state correlations between V1 and V2/V3 were retinotopically organized for all subject groups. These results show that the gross retinotopic pattern of resting-state connectivity across V1-V3 requires neither retinal waves nor visual experience to develop and persist into adulthood. Significance statement: Evidence from resting-state BOLD data suggests that the connections between early visual areas develop and are maintained even in the absence of retinal waves and visual experience.

A selective impairment of perception of sound motion direction in peripheral space: A case study

It is still an open question if the auditory system, similar to the visual system, processes auditory motion independently from other aspects of spatial hearing, such as static location. Here, we report psychophysical data from a patient (female, 42 and 44 years old at the time of two testing sessions), who suffered a bilateral occipital infarction over 12 years earlier, and who has extensive damage in the occipital lobe bilaterally, extending into inferior posterior temporal cortex bilaterally and into right parietal cortex. We measured the patient's spatial hearing ability to discriminate static location, detect motion and perceive motion direction in both central (straight ahead), and right and left peripheral auditory space (50° to the left and right of straight ahead). Compared to control subjects, the patient was impaired in her perception of direction of auditory motion in peripheral auditory space, and the deficit was more pronounced on the right side. However, there was no impairment in her perception of the direction of auditory motion in central space. Furthermore, detection of motion and discrimination of static location were normal in both central and peripheral space. The patient also performed normally in a wide battery of non-spatial audiological tests. Our data are consistent with previous neuropsychological and neuroimaging results that link posterior temporal cortex and parietal cortex with the processing of auditory motion. Most importantly, however, our data break new ground by suggesting a division of auditory motion processing in terms of speed and direction and in terms of central and peripheral space.