Residual motion discrimination using colour information without primary visual cortex

Poststroke conscious visual deficit: clinical course and changes in cerebral activations

BACKGROUND AND PURPOSE

Little is known about the outcome and recovery mechanisms of visual perception after a focal lesion of the occipital lobe in humans, especially after stroke. In this study, the authors aimed to describe the clinical course and the neural substrates of conscious perceptive visual deficit after posterior cerebral artery infarct.

METHODS

The authors prospectively included 8 patients (7 men and 1 woman; mean age, 64.6 ± 18 years) with visual deficit induced by partial damage of the striate cortex related to acute posterior cerebral artery infarct. Conscious perception of color and motion was assessed from the acute phase to the third month. Functional magnetic resonance imaging was performed to investigate neural substrates of visual recovery.

RESULTS

In the acute phase of stroke, visual deficiency was global (3/8 patients), selective to color (4/8 patients), or selective to motion (1/8 patients). During the follow-up, visual performance increased with respect to color (from 29% to 70%; P < .005) and with respect to motion (from 47% to 74%; P < .005). Despite a lack of ipsilesional V1 area activation in the acute phase, activations in this area and in the contralesional extrastriate cortex were obtained during follow-up. Both ipsilesional and contralesional V4 activations were correlated with better outcome.

CONCLUSIONS

Extensive visual recovery occurs early after partial acute posterior cerebral artery infarct. Spared islands in ipsilesional V1 area and transcallosal pathways might be involved in poststroke visual recovery.

Deficits of visual motion perception and optokinetic nystagmus after posterior suprasylvian lesions in the ferret (Mustela putorius furo)

We recently described an area in the ferret posterior suprasylvian (PSS) cortex characterized by a high proportion of direction selective neurons. To answer the question whether area PSS subserves functions similar to cat posteromediolateral suprasylvian area (PMLS) and monkey medial temporal area (MT) we investigated the contribution of area PSS to visual motion perception and optokinetic nystagmus. Ferrets were tested on global motion detection before and after bilateral lesions involving area PSS and control lesions of other extrastriate visual areas. Following PSS lesions motion coherence thresholds were significantly increased both in pigmented and albino ferrets, whereas control lesions sparing PSS did not affect visual motion perception. Optokinetic nystagmus was strongly reduced to absent after PSS lesions. These results indicate that area PSS is crucial for global motion processing in the ferret and in that sense may be functionally equivalent to PMLS in the cat and area MT in the monkey.

Low-level phenomenal vision despite unilateral destruction of primary visual cortex

GY, an extensively studied human hemianope, is aware of salient visual events in his cortically blind field but does not call this "vision." To learn whether he has low-level conscious visual sensations or whether instead he has gained conscious knowledge about, or access to, visual information that does not produce a conscious phenomenal sensation, we attempted to image process a stimulus s presented to the impaired field so that when the transformed stimulus T(s) was presented to the normal hemifield it would cause a sensation similar to that caused by s in the impaired field. While degradation of contrast, spatio-temporal filtering, contrast reversal, and addition of smear and random blobs all failed to match the response to a flashed bar s(f), moving textures of low contrast were accepted to match the response to a moving contrast-defined bar, s(m). Orientation and motion direction discrimination of the perceptually matched stimuli [s(m) and T(s(m))] was closely similar. We suggest that the existence of a satisfactory match indicates that GY has phenomenal vision.

Sustained extrastriate cortical activation without visual awareness revealed by fMRI studies of hemianopic patients

Patients with lesions in the primary visual cortex (V1) may show processing of visual stimuli presented in their field of cortical blindness even when they report being unaware of the stimuli. To elucidate the neuroanatomical basis of their residual visual functions, we used functional magnetic resonance imaging in two hemianopic patients, FS and GY. In the first experiment, a rotating spiral stimulus was used to assess the responsiveness of dorsal stream areas. Although no response was detectable within denervated or destroyed early visual cortex, motion-sensitive areas (hMT+/V5) ipsilateral to the lesion showed a strong sustained hemodynamic response. In GY, this activation was at least as strong as that of his contralesional hMT+/V5 to the stimulus in the normal hemifield. In the second experiment, coloured images of natural objects were used to assess the responsiveness of ventral stream areas. Again, no activity was detectable in ipsilesional early visual areas, but extrastriate areas in the lateral occipital cortex (hMT+/V5 and LO) and within the posterior fusiform gyrus (V4/V8) showed a robust sustained hemodynamic response. In both experiments, we observed that ipsilesional areas responded to stimuli presented in either hemifield, whereas the normal hemisphere responded preferentially to stimuli in the sighted hemifield. As only one subject occasionally noticed the onset of stimulation in the impaired field, the unexpectedly strong sustained activity in ipsilesional dorsal and ventral cortical areas appears to be insufficient to generate conscious vision.

Is V1 necessary for conscious vision in areas of relative cortical blindness?

Visual field defects result from postgeniculate lesions. It is generally assumed that absolute defects are caused by total destruction or denervation of primary visual cortex (V1) and that the degraded but conscious vision that remains or returns in relative or partial defects is mediated by compromised V1 cortex that retains a sufficiently large population of functional neurons. We here report the results of three patients with long-standing postgeniculate lesions who underwent functional magnetic resonance imaging while their partial defect was stimulated with high-contrast reversing checkerboard stimuli. Although the stimulation evoked conscious visual impressions in all three, in only one patient did it activate perilesional V1. In the other two we found no evidence for perilesional activation, indicating that some conscious vision may return in the absence of functional ipsilesional V1.

Cortical evoked potentials due to motion contrast in the blind hemifield

Subcortical visual inputs to motion-selective cortex in primates survive after damage to the primary visual cortex (area 17/V1). Activation of human motion cortex was examined using scalp electrodes in a V1-damaged hemianope. Blind field motion-onset visual evoked potentials (VEPs) shared many of the characteristics associated with sighted vision but were smaller in amplitude and had longer latencies. The representative negative wave (C(II) peak) showed typical dependency on stimulus contrast, its peak latency increased and amplitude decreased as contrast decreased, reflecting the difficulty with which directional information could be detected. VEPs were present at contrasts below 25% when blind field motion was imperceptible even though direction guessing was paradoxically accurate. Subcortical inputs to motion cortex contribute to visual experience but not to conscious perception.

Direction discrimination of moving gratings and plaids and coherence in dot displays without primary visual cortex (V1)

We present new experimental observations of G.Y., a well-tested patient with unilateral loss of primary visual cortex. We stimulated G.Y.'s blind hemifield using first- and second-order motion stimuli at velocities around psychophysical threshold. Using a dual response paradigm (awareness level of visual motion, motion direction discrimination) psychophysical performance improved with increasing velocity and dot coherence. We were also able to influence directly G.Y.'s performance for the better and at will, by placing the emphasis solely on direction discrimination. In the absence of V1, graduated detection and discrimination of stimuli known to activate both V1 and extrastriate motion areas MT/V5 and MST is still possible. These results are in line with residual visual processing but did not show evidence of unconscious processing of motion stimuli characteristic of 'blindsight'.