Multisensory spatial perception in visually impaired infants

Lack of visual experience leads to severe distortions in the hand representation of the body model

This study investigates the impact of vision on the maintenance of hand representation in the implicit body model, particularly focusing on congenitally blind individuals. To address this, we performed a hand landmark localization task on blind individuals who lacked visual experience of their bodies and compared their performance to normally sighted and normally sighted but blindfolded participants. Through measurements of finger lengths, hand width, and shape index, we demonstrate that blind participants exhibit significantly greater distortions in their hand representation compared to sighted and blindfolded controls. Notably, blind individuals displayed a marked overestimation of hand width and an underestimation of finger lengths, particularly in digits D2, D3, and D4. Surprisingly, blind subjects with partial vision displayed more severe distortions than those with no residual vision. Furthermore, our findings reveal that late-blind participants exhibit similar levels of distortion as congenitally blind individuals, suggesting an extended period of susceptibility to the lack of visual input in shaping body representations. The Reverse Distortion (RD) hypothesis provides a plausible explanation for these distortions, suggesting that compensatory mechanisms occur within the body model to counteract the anisotropic cortical representations. Our results support this hypothesis: blind individuals have expanded cortical representations processing tactile information, so this could lead to more pronounced distortions in their hand representation of the body model. This underscores the importance of visual input in modulating body representations. Overall, our study highlights the malleability of body representations and the intricate interplay between sensory inputs and cortical processing in shaping the implicit body model.

Highly compromised auditory spatial perception in aided congenitally hearing-impaired and rapid improvement with tactile technology

Spatial understanding is a multisensory construct while hearing is the only natural sense enabling the simultaneous perception of the entire 3D space. To test whether such spatial understanding is dependent on auditory experience, we study congenitally hearing-impaired users of assistive devices. We apply an in-house technology, which, inspired by the auditory system, performs intensity-weighting to represent external spatial positions and motion on the fingertips. We see highly impaired auditory spatial capabilities for tracking moving sources, which based on the "critical periods" theory emphasizes the role of nature in sensory development. Meanwhile, for tactile and audio-tactile spatial motion perception, the hearing-impaired show performance similar to typically hearing individuals. The immediate availability of 360° external space representation through touch, despite the lack of such experience during the lifetime, points to the significant role of nurture in spatial perception development, and to its amodal character. The findings show promise toward advancing multisensory solutions for rehabilitation.

Multisensory training improves the development of spatial cognition after sight restoration from congenital cataracts

Spatial cognition and mobility are typically impaired in congenitally blind individuals, as vision usually calibrates space perception by providing the most accurate distal spatial cues. We have previously shown that sight restoration from congenital bilateral cataracts guides the development of more accurate space perception, even when cataract removal occurs years after birth. However, late cataract-treated individuals do not usually reach the performance levels of the typically sighted population. Here, we developed a brief multisensory training that associated audiovisual feedback with body movements. Late cataract-treated participants quickly improved their space representation and mobility, performing as well as typically sighted controls in most tasks. Their improvement was comparable with that of a group of blind participants, who underwent training coupling their movements with auditory feedback alone. These findings suggest that spatial cognition can be enhanced by a training program that strengthens the association between bodily movements and their sensory feedback (either auditory or audiovisual).

Are blind individuals immune to bodily illusions? Somatic rubber hand illusion in the blind revisited

Multisensory awareness of one's own body relies on the integration of signals from various sensory modalities such as vision, touch, and proprioception. But how do blind individuals perceive their bodies without visual cues, and does the brain of a blind person integrate bodily senses differently from a sighted person? To address this question, we aimed to replicate the only two previous studies on this topic, which claimed that blind individuals do not experience the somatic rubber hand illusion, a bodily illusion triggered by the integration of correlated tactile and proprioceptive signals from the two hands. We used a larger sample size than the previous studies and added Bayesian analyses to examine statistical evidence in favor of the lack of an illusion effect. Moreover, we employed tests to investigate whether enhanced tactile acuity and cardiac interoceptive accuracy in blind individuals could also explain the weaker illusion. We tested 36 blind individuals and 36 age- and sex-matched sighted volunteers. The results show that blind individuals do not experience the somatic rubber hand illusion based on questionnaire ratings and behavioral measures that assessed changes in hand position sense toward the location of the rubber hand. This conclusion is supported by Bayesian evidence in favor of the null hypothesis. The findings confirm that blind individuals do not experience the somatic rubber hand illusion, indicating that lack of visual experience leads to permanent changes in multisensory bodily perception. In summary, our study suggests that changes in multisensory integration of tactile and proprioceptive signals may explain why blind individuals are "immune" to the nonvisual version of the rubber hand illusion.

Blindness affects the developmental trajectory of the sleeping brain

Sleep plays a crucial role in brain development, sensory information processing, and consolidation. Sleep spindles are markers of these mechanisms as they mirror the activity of the thalamocortical circuits. Spindles can be subdivided into two groups, slow (10-13 Hz) and fast (13-16 Hz), which are each associated with different functions. Specifically, fast spindles oscillate in the high-sigma band and are associated with sensorimotor processing, which is affected by visual deprivation. However, how blindness influences spindle development has not yet been investigated. We recorded nap video-EEG of 50 blind/severely visually impaired (BSI) and 64 sighted children aged 5 months to 6 years old. We considered aspects of both macro- and micro-structural spindles. The BSI children lacked the evolution of developmental spindles within the central area. Specifically, young BSI children presented low central high-sigma and high-beta (25-30 Hz) event-related spectral perturbation and showed no signs of maturational decrease. High-sigma and high-beta activity in the BSI group correlated with clinical indices predicting perceptual and motor disorders. Our findings suggest that fast spindles are pivotal biomarkers for identifying an early developmental deviation in BSI children. These findings are critical for initial therapeutic intervention.

Task-dependent spatial processing in the visual cortex

To solve spatial tasks, the human brain asks for support from the visual cortices. Nonetheless, representing spatial information is not fixed but depends on the reference frames in which the spatial inputs are involved. The present study investigates how the kind of spatial representations influences the recruitment of visual areas during multisensory spatial tasks. Our study tested participants in an electroencephalography experiment involving two audio-visual (AV) spatial tasks: a spatial bisection, in which participants estimated the relative position in space of an AV stimulus in relation to the position of two other stimuli, and a spatial localization, in which participants localized one AV stimulus in relation to themselves. Results revealed that spatial tasks specifically modulated the occipital event-related potentials (ERPs) after the onset of the stimuli. We observed a greater contralateral early occipital component (50-90 ms) when participants solved the spatial bisection, and a more robust later occipital response (110-160 ms) when they processed the spatial localization. This observation suggests that different spatial representations elicited by multisensory stimuli are sustained by separate neurophysiological mechanisms.

Cortical signatures of visual body representation develop in human infancy

Human infants cannot report their experiences, limiting what we can learn about their bodily awareness. However, visual cortical responses to the body, linked to visual awareness and selective attention in adults, can be easily measured in infants and provide a promising marker of bodily awareness in early life. We presented 4- and 8-month-old infants with a flickering (7.5 Hz) video of a hand being stroked and recorded steady-state visual evoked potentials (SSVEPs). In half of the trials, the infants also received tactile stroking synchronously with visual stroking. The 8-month-old, but not the 4-month-old infants, showed a significant enhancement of SSVEP responses when they received tactile stimulation concurrent with the visually observed stroking. Follow-up experiments showed that this enhancement did not occur when the visual hand was presented in an incompatible posture with the infant's own body or when the visual stimulus was a body-irrelevant video. Our findings provide a novel insight into the development of bodily self-awareness in the first year of life.

Similarities and differences in the neural correlates of letter and speech sound integration in blind and sighted readers

Learning letter and speech sound (LS) associations is a major step in reading acquisition common for all alphabetic scripts, including Braille used by blind readers. The left superior temporal cortex (STC) plays an important role in audiovisual LS integration in sighted people, but it is still unknown what neural mechanisms are responsible for audiotactile LS integration in blind individuals. Here, we investigated the similarities and differences between LS integration in blind Braille (N = 42, age range: 9-60 y.o.) and sighted print (N = 47, age range: 9-60 y.o.) readers who acquired reading using different sensory modalities. In both groups, the STC responded to both isolated letters and isolated speech sounds, showed enhanced activation when they were presented together, and distinguished between congruent and incongruent letter and speech sound pairs. However, the direction of the congruency effect was different between the groups. Sighted subjects showed higher activity for incongruent LS pairs in the bilateral STC, similarly to previously studied typical readers of transparent orthographies. In the blind, congruent pairs resulted in an increased response in the right STC. These differences may be related to more sequential processing of Braille as compared to print reading. At the same time, behavioral efficiency in LS discrimination decisions and the congruency effect were found to be related to age and reading skill only in sighted participants, suggesting potential differences in the developmental trajectories of LS integration between blind and sighted readers.

How do human newborns come to understand the multimodal environment?

For a long time, newborns were considered as human beings devoid of perceptual abilities who had to learn with effort everything about their physical and social environment. Extensive empirical evidence gathered in the last decades has systematically invalidated this notion. Despite the relatively immature state of their sensory modalities, newborns have perceptions that are acquired, and are triggered by, their contact with the environment. More recently, the study of the fetal origins of the sensory modes has revealed that in utero all the senses prepare to operate, except for the vision mode, which is only functional starting from the first minutes after birth. This discrepancy between the maturation of the different senses leads to the question of how human newborns come to understand our multimodal and complex environment. More precisely, how the visual mode interacts with the tactile and auditory modes from birth. After having defined the tools that newborns use to interact with other sensory modalities, we review studies across different fields of research such as the intermodal transfer between touch and vision, auditory-visual speech perception, and the existence of links between the dimensions of space, time, and number. Overall, evidence from these studies supports the idea that human newborns are spontaneously driven, and cognitively equipped, to link information collected by the different sensory modes in order to create a representation of a stable world.

Multisensory representations of space and time in sensory cortices

Clear evidence demonstrated a supramodal organization of sensory cortices with multisensory processing occurring even at early stages of information encoding. Within this context, early recruitment of sensory areas is necessary for the development of fine domain-specific (i.e., spatial or temporal) skills regardless of the sensory modality involved, with auditory areas playing a crucial role in temporal processing and visual areas in spatial processing. Given the domain-specificity and the multisensory nature of sensory areas, in this study, we hypothesized that preferential domains of representation (i.e., space and time) of visual and auditory cortices are also evident in the early processing of multisensory information. Thus, we measured the event-related potential (ERP) responses of 16 participants while performing multisensory spatial and temporal bisection tasks. Audiovisual stimuli occurred at three different spatial positions and time lags and participants had to evaluate whether the second stimulus was spatially (spatial bisection task) or temporally (temporal bisection task) farther from the first or third audiovisual stimulus. As predicted, the second audiovisual stimulus of both spatial and temporal bisection tasks elicited an early ERP response (time window 50-90 ms) in visual and auditory regions. However, this early ERP component was more substantial in the occipital areas during the spatial bisection task, and in the temporal regions during the temporal bisection task. Overall, these results confirmed the domain specificity of visual and auditory cortices and revealed that this aspect selectively modulates also the cortical activity in response to multisensory stimuli.

Survey on Psychological Well-Being and Quality of Life in Visually Impaired Individuals: Dancesport vs. Other Sound Input-Based Sports

Sport practice has the widely demonstrated potential of promoting well-being and physical/mental health, especially in disabled individuals. Nowadays, visually impaired people can participate in several sports commonly adapted and played substituting visual input with auditory or tactile ones. By integrating movement and music, dance can simultaneously promote physical and emotional involvement and enhances vicarious sense recruitment. On these premises, we performed a survey to assess the psychological well-being (PWB) and quality of life (QoL) in visually impaired athletes, comparing dancesport vs other sound input-based sports. Twenty-one visually impaired dancers and twenty-seven visually impaired athletes practicing adapted baseball, showdown, blind futsal, or blind tennis completed a structured self-report survey including the Italian version of PWB-18 scale and the Short Form-12 (SF-12) questionnaire. Dancers reported significantly higher scores in PWB-18 autonomy, environmental mastery, and self-acceptance along with a higher PWB total score than the other athlete group. Similarly, the SF-12 questionnaire results demonstrated significantly higher scores in both physical and mental QoL of visually impaired dancers compared with other athletes. In conclusion, our findings suggest that, given its peculiarities, the practice of dancesport may have a stronger positive impact on PWB and QoL of visually impaired individuals than other sound input-based sports.