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Kvanta A, Rangaswamy N, Holopigian K, Watters C, Jennings N, Liew MSH, Bigelow C, Grosskreutz C, Burstedt M, Venkataraman A, Westman S, Geirsdottir A, Stasi K, André H. Interim safety and efficacy of gene therapy for RLBP1-associated retinal dystrophy: a phase 1/2 trial. Nat Commun 2024; 15:7438. [PMID: 39256350 PMCID: PMC11387776 DOI: 10.1038/s41467-024-51575-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 08/13/2024] [Indexed: 09/12/2024] Open
Abstract
Gene therapy holds promise for treatment of inherited retinal dystrophies, a group of rare genetic disorders characterized by severe loss of vision. Here, we report up to 3-year pre-specified interim safety and efficacy results of an open-label first-in-human dose-escalation phase 1/2 gene therapy clinical trial in 12 patients with retinal dystrophy caused by biallelic mutations in the retinaldehyde-binding protein 1 (RLBP1) gene of the visual cycle. The primary endpoints were systemic and ocular safety and recovery of dark adaptation. Secondary endpoints included microperimetry, visual field sensitivity, dominant eye test and patient-reported outcomes. Subretinal delivery of an adeno-associated viral vector (AAV8-RLBP1) was well tolerated with dose-dependent intraocular inflammation which responded to corticosteroid treatment, and focal atrophy of the retinal pigment epithelium as the dose limiting toxicity. Dark adaptation kinetics, the primary efficacy endpoint, improved significantly in all dose-cohorts. Treatment with AAV8-RLBP1 resulted in the resolution of disease-related retinal deposits, suggestive of successful restoration of the visual cycle. In conclusion, to date, AAV8-RLBP1 has shown preliminary safety and efficacy in patients with RLBP1-associated retinal dystrophy. Trial number: NCT03374657.
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Affiliation(s)
- Anders Kvanta
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
| | | | - Karen Holopigian
- Novartis Institutes for Biomedical Research, East Hanover, NJ, USA
| | | | - Nicki Jennings
- Novartis Institutes for Biomedical Research, Cambridge, MA, USA
| | | | - Chad Bigelow
- Novartis Institutes for Biomedical Research, Cambridge, MA, USA
| | | | - Marie Burstedt
- Department of Clinical Sciences/Ophthalmology, University of Umeå, Umeå, Sweden
| | - Abinaya Venkataraman
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Sofie Westman
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Asbjörg Geirsdottir
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Kalliopi Stasi
- Novartis Institutes for Biomedical Research, Cambridge, MA, USA
| | - Helder André
- Department of Clinical Neuroscience, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
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2
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Huang W, Huang B, Sun J, Sun Q, Liang Y, Chen H, Wang X, Xiong G. fNIRS Changes in the Middle Temporal and Occipital Cortices After a Cochlear Implant. Laryngoscope 2024. [PMID: 39140234 DOI: 10.1002/lary.31687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/12/2024] [Accepted: 07/24/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES The relationship between the middle temporal (MTG) and occipital cortices in post-lingually deaf (PLD) individuals is unclear. This study aimed to investigate changes in the MTG and occipital cortices excitability and their effects on the occipital cortex in individuals with PLD after receiving a cochlear implant (CI). METHODS Twenty-six individuals with severe-to-profound binaural sensorineural PLD were assessed clinically. Nine individuals had received a unilateral cochlear implant over 6 months, while 17 had not. Brodmann area 19 (BA19, extra-striate occipital cortex) and MTG (auditory-related area of cortex) were selected as regions of interest. The excitability of the ROI was observed and compared in the surgery and no-surgery groups by functional near-infrared spectroscopy (fNIRS) in the resting state, and correlations between connectivity of the MTG and occipital cortex, and as well as the duration of time that had elapsed following CI surgery, were investigated. RESULTS fNIRS revealed enhanced global cortical connectivity in the BA19 and MTG on the operative side (p < 0.05) and the connectivity between BA19 and the MTG also increased (p < 0.05). The connectivity between the MTG and BA19 was positively correlated with the duration of cochlear implantation, as was the case for BA18. CONCLUSION There was evidence for remodeling of the cerebral cortex: increased excitability was observed in the MTG and BA19, and their connectivity was enhanced, indicating a synergistic effect. Moreover, the MTG may further stimulate the visual cortex by strengthening their connectivity after CI. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Wanyi Huang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Bixue Huang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Jincangjian Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Qiyang Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Yue Liang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Huiting Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Xianren Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Guanxia Xiong
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
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3
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Stiles NRB, Choupan J, Ameri H, Patel VR, Shi Y. Visual Cortical Thickness Increases with Prolonged Artificial Vision Restoration. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.26.24309493. [PMID: 38978654 PMCID: PMC11230327 DOI: 10.1101/2024.06.26.24309493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The Argus II retinal prosthesis restores visual perception to late blind patients. It has been shown that structural changes occur in the brain due to late-onset blindness, including cortical thinning in visual regions of the brain. Following vision restoration, it is not yet known whether these visual regions are reinvigorated and regain a normal cortical thickness or retain the diminished thickness from blindness. We evaluated the cortical thicknesses of ten Argus II Retinal Prostheses patients, ten blind patients, and thirteen sighted participants. The Argus II patients on average had a thicker left Cuneus Cortex and Lateral Occipital Cortex relative to the blind patients. The duration of the Argus II use (time since implant in active users) significantly partially correlated with thicker visual cortical regions in the left hemisphere. Furthermore, in the two case studies (scanned before and after implantation), the patient with longer device use (44.5 months) had an increase in the cortical thickness of visual regions, whereas the shorter-using patient did not (6.5 months). Finally, a third case, scanned at three time points post-implantation, showed an increase in cortical thickness in the Lateral Occipital Cortex between 43.5 and 57 months, which was maintained even after 3 years of disuse (106 months). Overall, the Argus II patients' cortical thickness was on average significantly rejuvenated in two higher visual regions and, patients using the implant for a longer duration had thicker visual regions. This research raises the possibility of structural plasticity reversing visual cortical atrophy in late-blind patients with prolonged vision restoration.
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Alemi R, Wolfe J, Neumann S, Manning J, Hanna L, Towler W, Wilson C, Bien A, Miller S, Schafer E, Gemignani J, Koirala N, Gracco VL, Deroche M. Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy. Percept Mot Skills 2024; 131:74-105. [PMID: 37977135 PMCID: PMC10863375 DOI: 10.1177/00315125231213167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Auditory-motor and visual-motor networks are often coupled in daily activities, such as when listening to music and dancing; but these networks are known to be highly malleable as a function of sensory input. Thus, congenital deafness may modify neural activities within the connections between the motor, auditory, and visual cortices. Here, we investigated whether the cortical responses of children with cochlear implants (CI) to a simple and repetitive motor task would differ from that of children with typical hearing (TH) and we sought to understand whether this response related to their language development. Participants were 75 school-aged children, including 50 with CI (with varying language abilities) and 25 controls with TH. We used functional near-infrared spectroscopy (fNIRS) to record cortical responses over the whole brain, as children squeezed the back triggers of a joystick that vibrated or not with the squeeze. Motor cortex activity was reflected by an increase in oxygenated hemoglobin concentration (HbO) and a decrease in deoxygenated hemoglobin concentration (HbR) in all children, irrespective of their hearing status. Unexpectedly, the visual cortex (supposedly an irrelevant region) was deactivated in this task, particularly for children with CI who had good language skills when compared to those with CI who had language delays. Presence or absence of vibrotactile feedback made no difference in cortical activation. These findings support the potential of fNIRS to examine cognitive functions related to language in children with CI.
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Affiliation(s)
- Razieh Alemi
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Jace Wolfe
- Oberkotter Foundation, Oklahoma City, OK, USA
| | - Sara Neumann
- Hearts for Hearing Foundation, Oklahoma City, OK, USA
| | - Jacy Manning
- Hearts for Hearing Foundation, Oklahoma City, OK, USA
| | - Lindsay Hanna
- Hearts for Hearing Foundation, Oklahoma City, OK, USA
| | - Will Towler
- Hearts for Hearing Foundation, Oklahoma City, OK, USA
| | - Caleb Wilson
- Department of Otolaryngology-Head & Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Alexander Bien
- Department of Otolaryngology-Head & Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sharon Miller
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, TX, USA
| | - Erin Schafer
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, TX, USA
| | - Jessica Gemignani
- Department of Developmental and Social Psychology, University of Padua, Padova, Italy
| | | | | | - Mickael Deroche
- Department of Psychology, Concordia University, Montreal, QC, Canada
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5
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Kral A, Sharma A. Crossmodal plasticity in hearing loss. Trends Neurosci 2023; 46:377-393. [PMID: 36990952 PMCID: PMC10121905 DOI: 10.1016/j.tins.2023.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/27/2023] [Accepted: 02/21/2023] [Indexed: 03/29/2023]
Abstract
Crossmodal plasticity is a textbook example of the ability of the brain to reorganize based on use. We review evidence from the auditory system showing that such reorganization has significant limits, is dependent on pre-existing circuitry and top-down interactions, and that extensive reorganization is often absent. We argue that the evidence does not support the hypothesis that crossmodal reorganization is responsible for closing critical periods in deafness, and crossmodal plasticity instead represents a neuronal process that is dynamically adaptable. We evaluate the evidence for crossmodal changes in both developmental and adult-onset deafness, which start as early as mild-moderate hearing loss and show reversibility when hearing is restored. Finally, crossmodal plasticity does not appear to affect the neuronal preconditions for successful hearing restoration. Given its dynamic and versatile nature, we describe how this plasticity can be exploited for improving clinical outcomes after neurosensory restoration.
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Affiliation(s)
- Andrej Kral
- Institute of AudioNeuroTechnology and Department of Experimental Otology, Otolaryngology Clinics, Hannover Medical School, Hannover, Germany; Australian Hearing Hub, School of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Anu Sharma
- Department of Speech Language and Hearing Science, Center for Neuroscience, Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA.
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6
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Caravaca-Rodriguez D, Gaytan SP, Suaning GJ, Barriga-Rivera A. Implications of Neural Plasticity in Retinal Prosthesis. Invest Ophthalmol Vis Sci 2022; 63:11. [PMID: 36251317 DOI: 10.1167/iovs.63.11.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Retinal degenerative diseases such as retinitis pigmentosa cause a progressive loss of photoreceptors that eventually prevents the affected person from perceiving visual sensations. The absence of a visual input produces a neural rewiring cascade that propagates along the visual system. This remodeling occurs first within the retina. Then, subsequent neuroplastic changes take place at higher visual centers in the brain, produced by either the abnormal neural encoding of the visual inputs delivered by the diseased retina or as the result of an adaptation to visual deprivation. While retinal implants can activate the surviving retinal neurons by delivering electric current, the unselective activation patterns of the different neural populations that exist in the retinal layers differ substantially from those in physiologic vision. Therefore, artificially induced neural patterns are being delivered to a brain that has already undergone important neural reconnections. Whether or not the modulation of this neural rewiring can improve the performance for retinal prostheses remains a critical question whose answer may be the enabler of improved functional artificial vision and more personalized neurorehabilitation strategies.
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Affiliation(s)
- Daniel Caravaca-Rodriguez
- Department of Applied Physics III, Technical School of Engineering, Universidad de Sevilla, Sevilla, Spain
| | - Susana P Gaytan
- Department of Physiology, Universidad de Sevilla, Sevilla, Spain
| | - Gregg J Suaning
- School of Biomedical Engineering, University of Sydney, Sydney, Australia
| | - Alejandro Barriga-Rivera
- Department of Applied Physics III, Technical School of Engineering, Universidad de Sevilla, Sevilla, Spain.,School of Biomedical Engineering, University of Sydney, Sydney, Australia
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7
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Nadvar N, Stiles N, Choupan J, Patel V, Ameri H, Shi Y, Liu Z, Jonides J, Weiland J. Sight restoration reverses blindness-induced cross-modal functional connectivity changes between the visual and somatosensory cortex at rest. Front Neurosci 2022; 16:902866. [PMID: 36213743 PMCID: PMC9539921 DOI: 10.3389/fnins.2022.902866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022] Open
Abstract
Resting-state functional connectivity (rsFC) has been used to assess the effect of vision loss on brain plasticity. With the emergence of vision restoration therapies, rsFC analysis provides a means to assess the functional changes following sight restoration. Our study demonstrates a partial reversal of blindness-induced rsFC changes in Argus II retinal prosthesis patients compared to those with severe retinitis pigmentosa (RP). For 10 healthy control (HC), 10 RP, and 7 Argus II subjects, four runs of resting-state functional magnetic resonance imaging (fMRI) per subject were included in our study. rsFC maps were created with the primary visual cortex (V1) as the seed. The rsFC group contrast maps for RP > HC, Argus II > RP, and Argus II > HC revealed regions in the post-central gyrus (PostCG) with significant reduction, significant enhancement, and no significant changes in rsFC to V1 for the three contrasts, respectively. These findings were also confirmed by the respective V1-PostCG ROI-ROI analyses between test groups. Finally, the extent of significant rsFC to V1 in the PostCG region was 5,961 in HC, 0 in RP, and 842 mm3 in Argus II groups. Our results showed a reduction of visual-somatosensory rsFC following blindness, consistent with previous findings. This connectivity was enhanced following sight recovery with Argus II, representing a reversal of changes in cross-modal functional plasticity as manifested during rest, despite the rudimentary vision obtained by Argus II patients. Future investigation with a larger number of test subjects into this rare condition can further unveil the profound ability of our brain to reorganize in response to vision restoration.
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Affiliation(s)
- Negin Nadvar
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Noelle Stiles
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Jeiran Choupan
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Vivek Patel
- Irvine School of Medicine, The University of California, Irvine, Irvine, CA, United States
| | - Hossein Ameri
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Yonggang Shi
- Laboratory of Neuro Imaging, USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Zhongming Liu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, United States
| | - John Jonides
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - James Weiland
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, United States
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8
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Piwecki M, Woźniacka R. Analysing the Influence of Selected Eye Dysfunctions on Palpation Abilities of Massage Therapists. REHABILITACJA MEDYCZNA 2022. [DOI: 10.5604/01.3001.0015.8753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Palpation arises controversy in the field of physiotherapy. On the one hand, this method provides a lot of valuable information. On the other, issues related to its reliability still exist. Additionally, questions about factors affecting palpation and users’ dispositions should be taken into consideration.
Research objectives: The main aim of the study was to determine the impact of visual impairment on the palpatory skills of massage therapists.
Material and methods: The research involved 58 participants divided into 3 groups. The first group consisted of 23, visually-impaired massage therapists, the second one was made up of 22 massage therapists and the control group consisted of 13 people unrelated to massage. The subjects took the hair test, the weight test and the measurement of Static Two-Point Discrimination within the fingertips I-III, thenar and hypothenar.
Results: The analysis does not show any significant differences between the first and second group. Statistics reveal differences between the group of massage practitioners (group 1 and 2) and the control group. Visual impairment was not the most influential factor in the study.
Conclusions: The level of palpation skills may be modified in both visually-impaired and healthy people. However, mechanisms that allow these modifications remain unclear. On the basis of the research, visual impairment is not considered as the only factor affecting palpation skills. Experience in palpation may well be an equally important factor.
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Affiliation(s)
- Marcin Piwecki
- Euro-Asian Foundation for Business Education in Kraków, Poland
| | - Renata Woźniacka
- Institute of Applied Sciences, Faculty of Motor Rehabilitation, University of Physical Education in Kraków, Poland
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9
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Colzato LS, Beste C, Hommel B. Focusing on cognitive potential as the bright side of mental atypicality. Commun Biol 2022; 5:188. [PMID: 35233060 PMCID: PMC8888587 DOI: 10.1038/s42003-022-03126-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/04/2022] [Indexed: 12/18/2022] Open
Abstract
Standard accounts of mental health are based on a "deficit view" solely focusing on cognitive impairments associated with psychiatric conditions. Based on the principle of neural competition, we suggest an alternative. Rather than focusing on deficits, we should focus on the cognitive potential that selective dysfunctions might bring with them. Our approach is based on two steps: the identification of the potential (i.e., of neural systems that might have benefited from reduced competition) and the development of corresponding training methods, using the testing-the-limits approach. Counterintuitively, we suggest to train not only the impaired function but on the function that might have benefitted or that may benefit from the lesser neural competition of the dysfunctional system.
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Affiliation(s)
- Lorenza S Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany. .,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China. .,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany.
| | - Bernhard Hommel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
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10
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Stiles NRB, Weiland JD, Patel VR. Visual-tactile shape perception in the visually restored with artificial vision. J Vis 2022; 22:14. [PMID: 35195673 PMCID: PMC8883179 DOI: 10.1167/jov.22.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
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.
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Affiliation(s)
- Noelle R B Stiles
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA.,
| | - James D Weiland
- Departments of Biomedical Engineering and Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.,
| | - Vivek R Patel
- Department of Ophthalmology, University of California, Irvine, Irvine, CA, USA.,
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11
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Lowndes R, Molz B, Warriner L, Herbik A, de Best PB, Raz N, Gouws A, Ahmadi K, McLean RJ, Gottlob I, Kohl S, Choritz L, Maguire J, Kanowski M, Käsmann-Kellner B, Wieland I, Banin E, Levin N, Hoffmann MB, Morland AB, Baseler HA. Structural Differences Across Multiple Visual Cortical Regions in the Absence of Cone Function in Congenital Achromatopsia. Front Neurosci 2021; 15:718958. [PMID: 34720857 PMCID: PMC8551799 DOI: 10.3389/fnins.2021.718958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
Most individuals with congenital achromatopsia (ACHM) carry mutations that affect the retinal phototransduction pathway of cone photoreceptors, fundamental to both high acuity vision and colour perception. As the central fovea is occupied solely by cones, achromats have an absence of retinal input to the visual cortex and a small central area of blindness. Additionally, those with complete ACHM have no colour perception, and colour processing regions of the ventral cortex also lack typical chromatic signals from the cones. This study examined the cortical morphology (grey matter volume, cortical thickness, and cortical surface area) of multiple visual cortical regions in ACHM (n = 15) compared to normally sighted controls (n = 42) to determine the cortical changes that are associated with the retinal characteristics of ACHM. Surface-based morphometry was applied to T1-weighted MRI in atlas-defined early, ventral and dorsal visual regions of interest. Reduced grey matter volume in V1, V2, V3, and V4 was found in ACHM compared to controls, driven by a reduction in cortical surface area as there was no significant reduction in cortical thickness. Cortical surface area (but not thickness) was reduced in a wide range of areas (V1, V2, V3, TO1, V4, and LO1). Reduction in early visual areas with large foveal representations (V1, V2, and V3) suggests that the lack of foveal input to the visual cortex was a major driving factor in morphological changes in ACHM. However, the significant reduction in ventral area V4 coupled with the lack of difference in dorsal areas V3a and V3b suggest that deprivation of chromatic signals to visual cortex in ACHM may also contribute to changes in cortical morphology. This research shows that the congenital lack of cone input to the visual cortex can lead to widespread structural changes across multiple visual areas.
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Affiliation(s)
- Rebecca Lowndes
- Department of Psychology, University of York, York, United Kingdom
- York Neuroimaging Centre, Department of Psychology, University of York, York, United Kingdom
| | - Barbara Molz
- Department of Psychology, University of York, York, United Kingdom
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, Netherlands
| | - Lucy Warriner
- Department of Psychology, University of York, York, United Kingdom
| | - Anne Herbik
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Pieter B. de Best
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Noa Raz
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Andre Gouws
- York Neuroimaging Centre, Department of Psychology, University of York, York, United Kingdom
| | - Khazar Ahmadi
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Rebecca J. McLean
- University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Irene Gottlob
- University of Leicester Ulverscroft Eye Unit, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Susanne Kohl
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, University Clinics Tübingen, Tübingen, Germany
| | - Lars Choritz
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - John Maguire
- School of Optometry and Vision Sciences, University of Bradford, Bradford, United Kingdom
| | - Martin Kanowski
- Department of Neurology, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Barbara Käsmann-Kellner
- Department of Ophthalmology, Saarland University Hospital and Medical Faculty of the Saarland University Hospital, Homburg, Germany
| | - Ilse Wieland
- Department of Molecular Genetics, Institute for Human Genetics, University Hospital, Otto von Guericke University, Magdeburg, Germany
| | - Eyal Banin
- Degenerative Diseases of the Retina Unit, Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Netta Levin
- MRI Unit, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel
| | - Michael B. Hoffmann
- Department of Ophthalmology, University Hospital, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Antony B. Morland
- Department of Psychology, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
| | - Heidi A. Baseler
- Department of Psychology, University of York, York, United Kingdom
- York Biomedical Research Institute, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
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Stiles NRB, Patel VR, Weiland JD. Multisensory perception in Argus II retinal prosthesis patients: Leveraging auditory-visual mappings to enhance prosthesis outcomes. Vision Res 2021; 182:58-68. [PMID: 33607599 DOI: 10.1016/j.visres.2021.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/18/2022]
Abstract
Crossmodal mappings associate features (such as spatial location) between audition and vision, thereby aiding sensory binding and perceptual accuracy. Previously, it has been unclear whether patients with artificial vision will develop crossmodal mappings despite the low spatial and temporal resolution of their visual perception (particularly in light of the remodeling of the retina and visual cortex that takes place during decades of vision loss). To address this question, we studied crossmodal mappings psychophysically in Retinitis Pigmentosa patients with partial visual restoration by means of Argus II retinal prostheses, which incorporate an electrode array implanted on the retinal surface that stimulates still-viable ganglion cells with a video stream from a head-mounted camera. We found that Argus II patients (N = 10) exhibit significant crossmodal mappings between auditory location and visual location, and between auditory pitch and visual elevation, equivalent to those of age-matched sighted controls (N = 10). Furthermore, Argus II patients (N = 6) were able to use crossmodal mappings to locate a visual target more quickly with auditory cueing than without. Overall, restored artificial vision was shown to interact with audition via crossmodal mappings, which implies that the reorganization during blindness and the limitations of artificial vision did not prevent the relearning of crossmodal mappings. In particular, cueing based on crossmodal mappings was shown to improve visual search with a retinal prosthesis. This result represents a key first step toward leveraging crossmodal interactions for improved patient visual functionality.
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Affiliation(s)
- Noelle R B Stiles
- Department of Ophthalmology, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA; Department of Biomedical Engineering, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.
| | - Vivek R Patel
- Department of Ophthalmology, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA
| | - James D Weiland
- Department of Biomedical Engineering, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA; Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48109, USA
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