Indirect tactual discrimination of heights by blind and blindfolded sighted subjects

Spatial Memory and Blindness: The Role of Visual Loss on the Exploration and Memorization of Spatialized Sounds

Spatial memory relies on encoding, storing, and retrieval of knowledge about objects’ positions in their surrounding environment. Blind people have to rely on sensory modalities other than vision to memorize items that are spatially displaced, however, to date, very little is known about the influence of early visual deprivation on a person’s ability to remember and process sound locations. To fill this gap, we tested sighted and congenitally blind adults and adolescents in an audio-spatial memory task inspired by the classical card game “Memory.” In this research, subjects (blind, n = 12; sighted, n = 12) had to find pairs among sounds (i.e., animal calls) displaced on an audio-tactile device composed of loudspeakers covered by tactile sensors. To accomplish this task, participants had to remember the spatialized sounds’ position and develop a proper mental spatial representation of their locations. The test was divided into two experimental conditions of increasing difficulty dependent on the number of sounds to be remembered (8 vs. 24). Results showed that sighted participants outperformed blind participants in both conditions. Findings were discussed considering the crucial role of visual experience in properly manipulating auditory spatial representations, particularly in relation to the ability to explore complex acoustic configurations.

Mental Imagery Follows Similar Cortical Reorganization as Perception: Intra-Modal and Cross-Modal Plasticity in Congenitally Blind

Cortical plasticity in congenitally blind individuals leads to cross-modal activation of the visual cortex and may lead to superior perceptual processing in the intact sensory domains. Although mental imagery is often defined as a quasi-perceptual experience, it is unknown whether it follows similar cortical reorganization as perception in blind individuals. In this study, we show that auditory versus tactile perception evokes similar intra-modal discriminative patterns in congenitally blind compared with sighted participants. These results indicate that cortical plasticity following visual deprivation does not influence broad intra-modal organization of auditory and tactile perception as measured by our task. Furthermore, not only the blind, but also the sighted participants showed cross-modal discriminative patterns for perception modality in the visual cortex. During mental imagery, both groups showed similar decoding accuracies for imagery modality in the intra-modal primary sensory cortices. However, no cross-modal discriminative information for imagery modality was found in early visual cortex of blind participants, in contrast to the sighted participants. We did find evidence of cross-modal activation of higher visual areas in blind participants, including the representation of specific-imagined auditory features in visual area V4.

Auditory and proprioceptive spatial impairments in blind children and adults

It is not clear what role visual information plays in the development of space perception. It has previously been shown that in absence of vision, both the ability to judge orientation in the haptic modality and bisect intervals in the auditory modality are severely compromised (Gori, Sandini, Martinoli & Burr, 2010; Gori, Sandini, Martinoli & Burr, 2014). Here we report for the first time also a strong deficit in proprioceptive reproduction and audio distance evaluation in early blind children and adults. Interestingly, the deficit is not present in a small group of adults with acquired visual disability. Our results support the idea that in absence of vision the audio and proprioceptive spatial representations may be delayed or drastically weakened due to the lack of visual calibration over the auditory and haptic modalities during the critical period of development.

Haptic Object Recognition is View-Independent in Early Blind but not Sighted People

Object recognition, whether visual or haptic, is impaired in sighted people when objects are rotated between learning and test, relative to an unrotated condition, that is, recognition is view-dependent. Loss of vision early in life results in greater reliance on haptic perception for object identification compared with the sighted. Therefore, we hypothesized that early blind people may be more adept at recognizing objects despite spatial transformations. To test this hypothesis, we compared early blind and sighted control participants on a haptic object recognition task. Participants studied pairs of unfamiliar three-dimensional objects and performed a two-alternative forced-choice identification task, with the learned objects presented both unrotated and rotated 180° about they-axis. Rotation impaired the recognition accuracy of sighted, but not blind, participants. We propose that, consistent with our hypothesis, haptic view-independence in the early blind reflects their greater experience with haptic object perception.

The haptic recognition of geometrical shapes in congenitally blind and blindfolded adolescents: is there a haptic prototype effect?

BACKGROUND

It has been shown that visual geometrical shape categories (rectangle and triangle) are graded structures organized around a prototype as demonstrated by perception and production tasks in adults as well as in children. The visual prototypical shapes are better recognized than other exemplars of the categories. Their existence could emerge from early exposure to these prototypical shapes that are present in our visual environment. The present study examined the role of visual experience in the existence of prototypical shapes by comparing the haptic recognition of geometrical shapes in congenitally blind and blindfolded adolescents.

METHODOLOGY/PRINCIPAL FINDINGS

To determine whether the existence of a prototype effect (higher recognition of prototypical shapes than non prototypical shapes) depended on visual experience, congenitally blind and blindfolded sighted adolescents were asked to recognize in the haptic modality three categories of correct shapes (square, rectangle, triangle) varying in orientation (prototypical/canonical orientation vs. non prototypical/canonical orientation rotated by 45°) among a set of other shapes. A haptic prototype effect was found in the blindfolded sighted whereas no difference between prototypical and non prototypical correct shapes was observed in the congenitally blind. A control experiment using a similar visual recognition task confirmed the existence of a visual prototype effect in a group of sighted adolescents.

CONCLUSION/SIGNIFICANCE

These findings show that the prototype effect is not intrinsic to the haptic modality but depends on visual experience. This suggests that the occurrence of visual and haptic prototypical shapes in the recognition of geometrical shape seems to depend on visual exposure to these prototypical shapes existing in our environment.

Impaired visual size-discrimination in children with movement disorders

Multisensory integration of spatial information occurs late in childhood, at around eight years (Gori, Del Viva, Sandini, & Burr, 2008). For younger children, the haptic system dominates size discrimination and vision dominates orientation discrimination: the dominance may reflect sensory calibration, and could have direct consequences on children born with specific sensory disabilities. Here we measure thresholds for visual discrimination of orientation and size in children with movement disorders of upper limbs. Visual orientation discrimination was very similar to the age-matched typical children, but visual size discrimination thresholds were far worse, in all eight individuals with early-onset movement disorder. This surprising and counterintuitive result is readily explained by the cross-sensory calibration hypothesis: when the haptic sense is unavailable for manipulation, it cannot be readily used to estimate size, and hence to calibrate the visual experience of size: visual discrimination is subsequently impaired. This complements a previous study showing that non-sighted children have reduced acuity for haptic orientation, but not haptic size, discriminations (Gori, Sandini, Martinoli, & Burr, 2010). Together these studies show that when either vision or haptic manipulation is impaired, the impairment also impacts on complementary sensory systems that are calibrated by that one.

The role of visual experience for the neural basis of spatial cognition

Blindness often results in the adaptive neural reorganization of the remaining modalities, producing sharper auditory and haptic behavioral performance. Yet, non-visual modalities might not be able to fully compensate for the lack of visual experience as in the case of congenital blindness. For example, developmental visual experience seems to be necessary for the maturation of multisensory neurons for spatial tasks. Additionally, the ability of vision to convey information in parallel might be taken into account as the main attribute that cannot be fully compensated by the spared modalities. Therefore, the lack of visual experience might impair all spatial tasks that require the integration of inputs from different modalities, such as having to represent a set of objects on the basis of the spatial relationships among the objects, rather than the spatial relationship that each object has with oneself. Here we integrate behavioral and neural evidence to conclude that visual experience is necessary for the neural development of normal spatial cognition.

Effects of Cane Length and Diameter and Judgment Type on the Constant Error Ratio for Estimated Height in Blindfolded, Visually Impaired, and Sighted Participants

The purpose of this study was to assess the ability of blindfolded, visually impaired, and sighted individuals to estimate object height as a function of cane length, cane diameter, and judgment type. 48 undergraduate students (ages 20 to 23 years) were recruited to participate in the study. Participants were divided into low-vision, severely myopic, and normal-vision groups. Five stimulus heights were explored with three cane lengths, varying cane diameters, and judgment types. The participants were asked to estimate the stimulus height with or without reference to a standard block. Results showed that the constant error ratio for estimated height improved with decreasing cane length and comparative judgment. The findings were unclear regarding the effect of cane length on haptic perception of height. Implications were discussed for designing environments, such as stair heights, chairs, the magnitude of apertures, etc., for visually impaired individuals.

Sensory Organization Determinants of Postural Stability in Trained Ballet Dancers

Trained ballet dancers and nondancer controls completed six balance tests using computerized dynamic posturography. The tests facilitated assessment of the type of sensory organization used to maintain postural control under conditions ranging from quiet standing to a situation in which visual and/or somatosensory information was systematically removed or made unreliable. Results indicated that ballet dancers and controls have comparable balance ability during eyes open and eyes closed conditions. However, when somatosensory information alone or in combination with visual information was made unreliable, dancers were significantly less stable than controls and utilized a hip strategy to maintain postural control.

Tool-Use: Capturing Multisensory Spatial Attention or Extending Multisensory Peripersonal Space?

The active and skilful use of tools has been claimed to lead to the "extension" of the visual receptive fields of single neurons representing peripersonal space--the visual space immediately surrounding one's body parts. While this hypothesis provides an attractive and potentially powerful explanation for one neural basis of tool-use behaviours in human and nonhuman primates, a number of competing hypotheses for the reported behavioural effects of tool-use have not yet been subjected to empirical test. Here, we report five behavioural experiments in healthy human participants (n=120) involving the effects of tool-use on visual-tactile interactions in peripersonal space. Specifically, we address the possibility that the use of only a single tool, which is typical of many neuropsychological studies of tool-use, induces a spatial allocation of attention towards the side where the tool is held. Participants' tactile discrimination responses were more strongly affected by visual stimuli presented on the right side when they held a single tool on the right, compared to visual stimuli presented on the left. When [corrected] two tools were held, one in each hand, this spatial effect disappeared. Our results are incompatible with the hypothesis that tool-use extends peripersonal space, and suggest instead that the use and/or manipulation of [corrected] tools results in an automatic multisensory shift of spatial attention to the side of space where the tip of the tool is actively held. These results have implications for many of the cognitive neuroscientific studies of tool-use published to date.

Obstacle avoidance during locomotion using haptic information in normally sighted humans

The goal of the study was to examine the accuracy and precision of control of adaptive locomotion using haptic information in normally sighted humans before and after practice. Obstacle avoidance paradigm was used to study adaptive locomotion; individuals were required to approach and step over different sizes of obstacles placed in the travel path under three sensory conditions: full vision (FV); restricted lower visual field (RLVF) using blinders on custom glass frames; and no vision (NV) using haptic information only. In the NV condition, individuals were a given an appropriate-sized cane to guide their locomotion. Footfall patterns were recorded using the GAITRite system, and lead and trail limb trajectories were monitored using the OPTOTRAK system, which tracked infrared diodes placed on the toes and the cane. Approach step lengths were reduced for the haptic condition: this slowed the forward progression and allowed greater time for haptic exploration, which ranged from 2.5 to 4 s and consisted of horizontal cane movements (to detect the width and relative location of the obstacle) and vertical cane movements (to detect the height of the obstacle). Based on feed-forward and on-line sensory (under both vision and haptic conditions) information about location of the obstacle relative to the individual, variability of foot placement reduced as the individual came closer to the obstacle, as has been shown in the literature. The only difference was that the reduction in variability of foot placement under haptic condition occurred in the last step compared with earlier under vision. Considering that the obstacle is detected only when the cane comes in contact, as opposed to vision condition when it is visible earlier, this difference is understandable. Variability and magnitude of lead and trail limb elevation for the haptic condition was higher than the RLVF and FV conditions. In contrast, only the magnitude of lead and trail limb elevation was higher in the RLVF condition when compared with the FV condition. This suggests that it is the inability of the haptic sense to provide accurate information about obstacle characteristics compared with the visual system, and not simple caution that lead to higher limb elevation. In the haptic and RLVF condition when vision was unavailable for on-line monitoring of lead limb elevation, kinesthetic information from lead limb elevation was used to fine-tune trail limb elevation. Both the control of approach phase and limb elevation findings held up even after sufficient practice to learn haptic guidance of adaptive locomotion in the second experiment. These results provide a clear picture of the efficacy of the haptic sensory system to guide locomotion in a cluttered environment.

The effect of cane length on the haptic perception of height

PURPOSE

The purpose of this investigation was to determine whether the ability to haptically perceive object height is a function of the length of cane being wielded by blindfolded individuals.

METHOD

Fifteen sighted females between the ages of 18 and 25 years volunteered to participate in the study. Five different heights of wooden blocks were haptically explored with four different cane lengths (0.92, 1.22, 1.37 and 1.67 m), cane length order being randomized across 2 days of testing. Subjects were asked to report whether the explored block's height was taller, shorter, or equal to that of a previously presented standard block. The percentages of correct judgments for each cane and block height combination were subjected to statistical analysis.

RESULTS

The analysis revealed significant main effects for cane length, F (3, 42) = 9.47, p < 0.0001, and block height, F (4, 56) = 17.69, p < 0.0001. The interaction of cane length and block height was not significant, F < 1. The accuracy of haptic perception improved with decreased cane length and increased difference in height from the standard block.

CONCLUSIONS

Contrary to previous research on haptic perception in which probe length was found not to affect judgment accuracy, the present study found a marked influence of cane length on perceptual accuracy. This finding indicates that length is an important property that should be taken into account when prescribing canes for the visually impaired.

Structural and functional analyses of the occipital cortex in visual impaired patients with visual loss before 14 years old

Single photon emission tomography (SPECT) perfusion images of the brain of individuals with complete visual loss before the age of 14 were carried out and compared to those of visually normal subjects, in order to assess hypothetical differences in brain structural and metabolism between the two groups. Study group was comprised by 2 females and 3 males, aged 30 +/- 10 years. Controls were composed by 6 females and 5 males aged 41.5 +/- 3.8 years. All individuals were submitted to physical and neurological examinations, and to MRI and to SPECT. Blind subjects presented larger perfusion measurements bilaterally in their medial temporal lobes (p=0.030, right side; p=0.01, left side), but smaller perfusion measurements in their left frontotemporal area than controls (p=0.026). Intragroup analysis of the study group disclosed asymmetric perfusion, lesser in the left temporal and parietal areas (p=0.026 and p<0.0001, respectively) compared to the right side. In the healthy controls, reduced perfusion was also noted at the left parietal areas when compared to the right side (p=0.035). The study revealed that completely blind patients that became visually impaired before the age of 14 in spite of not having MRI detectable changes in their brain's anatomy do present increases in perfusion of their left and right medial temporal lobes, and a reduction in the perfusion of the left frontotemporal area, as compared to normal controls. While the increases in blood flow may reflect compensatory mechanisms for visual deprivation, the significance of the diminished perfusion in the left frontotemporal area remains elusive.

Evaluation of headache intensity in migrainous patients with visual handicap through the tactile analogical scale (TAS)

The tactile analogue scale (TAS) was elaborated to be used in blind subjects or those who can not use the vision during their crises. The objective of this study was to characterize, from TAS, the architecture of migraine attacks in subjects with visual disability. For that, 11 migrainous with visual disturb (MVD) subjects were studied and 22 migrainous subjects with no visual disability as a control group. All patients fulfilled the criteria for migraine and the patients of the group studied showed visual acuteness less than 20/200. To evaluate the results, the patients of the group MVD were subdivide within two groups, according to their visual acuteness: subgroup A subjects with subnormal vision and subgroup B amaurotic ones. In subgroup A measurement 46 attacks with average of the migraine attacks of the 56.50 mm, in the subgroup B 45 attacks with average of the 59.58 mm and in the control group 92 attacks with average of the 49.88 mm. When subgroup B and control group were compared there was a significant statistic difference (p=0.022). Through these outcomes we can observe that the migrainous subjects with no visual afference show a higher pain intensity during the migraine crises comparing to those subjects with no visual handicap. The study suggests that, as in other forms of sensibility, the total visual loss can also interfere in the nociceptive control of the pain during the migraine attacks.

Does mobility performance of visually impaired adults improve immediately after orientation and mobility training?

BACKGROUND

Previous studies that have attempted to determine the effect of orientation and mobility training on mobility performance of visually impaired adults have had a number of limitations. With the inclusion of a control group of subjects, this study investigated the effect of orientation and mobility training on mobility performance of a group of visually impaired adults.

METHODS

Vision was measured binocularly as high- and low-contrast visual acuity, letter and edge contrast sensitivity, and Humphrey kinetic visual fields. The subjects' mobility performance was assessed as percentage preferred walking speed (PPWS) and error score before and after mobility training.

RESULTS

Orientation and mobility training did not enhance mobility performance compared with the control group, who did not receive training, when performance was measured immediately after training. PPWS improved for both groups with short-term practice only, but there was no improvement in error score due to either practice or training.

CONCLUSIONS

There was no immediate improvement in mobility performance of visually impaired adults after orientation and mobility training. Familiarity with the route may play an important role in measured improvement of mobility performance after orientation and mobility training.

Automatic postural response systems in individuals with congenital total blindness

This study examined the effects of the absence of vision from birth on automatic postural responses to platform displacements during stance. Postural responses were induced by producing randomly four types of perturbations which consisted of forward and backward translations, and toe up and down rotations. Nine congenitally totally blind and nine sighted adults served as subjects. EMG signals were recorded from four muscles in the right leg, and reaction time to somatosensory stimuli generated by platform displacements was measured by pushing a hand-held button. To assess the ability to control postural balance, the root mean square (RMS) values for lateral and antero-posterior sway before, during, and after perturbations were calculated. The EMG amplitude in the gastrocnemius muscle of a blind subject was smaller than that of a sighted subject with eyes closed. No significant differences were found between blind and sighted subjects in EMG latencies of the lower extremity muscles in response to perturbations. The blind subjects had significantly faster reaction times to somatosensory stimuli triggered by platform displacements, but in toe down rotations no significant difference was found between blind and sighted subjects. The difference in the EMG latencies and reaction times between the two groups suggests that blindness from birth may not affect the spinal stretch reflex, but may affect a volitional act mediated through the motor cortex. There were also no significant differences in the RMS values for postural sway between blind and sighted subjects with eyes open or closed, although blind subjects swayed more after backward translations than did sighted subjects with eyes open. Results suggest that the ability to control postural balance during perturbations was not affected by vision loss from birth. Our findings suggest that the automatic postural response systems of humans are unaffected by the absence of vision from birth and are rather hard wired.