The Sensitive Period for Tactile Remapping Does Not Include Early Infancy

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.

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.

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.

Multisensory spatial perception in visually impaired infants

Congenitally blind infants are not only deprived of visual input but also of visual influences on the intact senses. The important role that vision plays in the early development of multisensory spatial perception1, 2, 3, 4, 5, 6, 7 (e.g., in crossmodal calibration8, 9, 10 and in the formation of multisensory spatial representations of the body and the world^1,2) raises the possibility that impairments in spatial perception are at the heart of the wide range of difficulties that visually impaired infants show across spatial,8, 9, 10, 11, 12 motor,13, 14, 15, 16, 17 and social domains.^8,18,19 But investigations of early development are needed to clarify how visually impaired infants’ spatial hearing and touch support their emerging ability to make sense of their body and the outside world. We compared sighted (S) and severely visually impaired (SVI) infants’ responses to auditory and tactile stimuli presented on their hands. No statistically reliable differences in the direction or latency of responses to auditory stimuli emerged, but significant group differences emerged in responses to tactile and audiotactile stimuli. The visually impaired infants showed attenuated audiotactile spatial integration and interference, weighted more tactile than auditory cues when the two were presented in conflict, and showed a more limited influence of representations of the external layout of the body on tactile spatial perception.²⁰ These findings uncover a distinct phenotype of multisensory spatial perception in early postnatal visual deprivation. Importantly, evidence of audiotactile spatial integration in visually impaired infants, albeit to a lesser degree than in sighted infants, signals the potential of multisensory rehabilitation methods in early development.

Video abstract

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Visually impaired infants have a distinct phenotype of audiotactile perception

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Infants with severe visual impairment (SVI) place more weight on tactile locations

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SVI infants show attenuated audiotactile spatial integration and interference

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SVI infants do not show an influence of body representations on tactile space

Imagine Your Crossed Hands as Uncrossed: Visual Imagery Impacts the Crossed-Hands Deficit

Successful interaction with our environment requires accurate tactile localization. Although we seem to localize tactile stimuli effortlessly, the processes underlying this ability are complex. This is evidenced by the crossed-hands deficit, in which tactile localization performance suffers when the hands are crossed. The deficit results from the conflict between an internal reference frame, based in somatotopic coordinates, and an external reference frame, based in external spatial coordinates. Previous evidence in favour of the integration model employed manipulations to the external reference frame (e.g., blindfolding participants), which reduced the deficit by reducing conflict between the two reference frames. The present study extends this finding by asking blindfolded participants to visually imagine their crossed arms as uncrossed. This imagery manipulation further decreased the magnitude of the crossed-hands deficit by bringing information in the two reference frames into alignment. This imagery manipulation differentially affected males and females, which was consistent with the previously observed sex difference in this effect: females tend to show a larger crossed-hands deficit than males and females were more impacted by the imagery manipulation. Results are discussed in terms of the integration model of the crossed-hands deficit.

The development of body representations: an associative learning account

Representing one's own body is of fundamental importance to interact with our environment, yet little is known about how body representations develop. One account suggests that the ability to represent one's own body is present from birth and supports infants' ability to detect similarities between their own and others' bodies. However, in recent years evidence has been accumulating for alternative accounts that emphasize the role of multisensory experience obtained through acting and interacting with our own body in the development of body representations. Here, we review this evidence, and propose an integrative account that suggests that through experience, infants form multisensory associations that facilitate the development of body representations. This associative account provides a coherent explanation for previous developmental findings, and generates novel hypotheses for future research.

The size-weight illusion is unimpaired in individuals with a history of congenital visual deprivation

Visual deprivation in childhood can lead to lifelong impairments in multisensory processing. Here, the Size-Weight Illusion (SWI) was used to test whether visuo-haptic integration recovers after early visual deprivation. Normally sighted individuals perceive larger objects to be lighter than smaller objects of the same weight. In Experiment 1, individuals treated for dense bilateral congenital cataracts (who had no patterned visual experience at birth), individuals treated for developmental cataracts (who had patterned visual experience at birth, but were visually impaired), congenitally blind individuals and normally sighted individuals had to rate the weight of manually explored cubes that differed in size (Small, Medium, Large) across two possible weights (350 g, 700 g). In Experiment 2, individuals treated for dense bilateral congenital cataracts were compared to sighted individuals in a similar task using a string set-up, which removed haptic size cues. In both experiments, indistinguishable SWI effects were observed across all groups. These results provide evidence that early aberrant vision does not interfere with the development of the SWI, and suggest a recovery of the integration of size and weight cues provided by the visual and haptic modality.

Sensitivity to Visual-Tactile Colocation on the Body Prior to Skilled Reaching in Early Infancy

Two experiments examined perceptual colocation of visual and tactile stimuli in young infants. Experiment 1 compared 4- (n = 15) and 6-month-old (n = 12) infants' visual preferences for visual-tactile stimulus pairs presented across the same or different feet. The 4- and 6-month-olds showed, respectively, preferences for colocated and noncolocated conditions, demonstrating sensitivity to visual-tactile colocation on their feet. This extends previous findings of visual-tactile perceptual colocation on the hands in older infants. Control conditions excluded the possibility that both 6- (Experiment 1), and 4-month-olds (Experiment 2, n = 12) perceived colocation on the basis of an undifferentiated supramodal coding of spatial distance between stimuli. Bimodal perception of visual-tactile colocation is available by 4 months of age, that is, prior to the development of skilled reaching.

The Human Face Becomes Mapped as a Sensorimotor Reaching Space During the First Year

Although recent behavioral and neural research indicates that infants represent the body's structure, how they engage self-representations for action is little understood. This study addressed how the human face becomes a reaching space. Infants (N = 24; 2-11 months) were tested longitudinally approximately every 3 weeks on their ability to reach to a vibrating target placed at different locations on the face. Successful reaches required coordinating skin- and body-based codes for location, a problem known as tactile remapping. Findings suggest that a functional representation of the face is initially fragmented. Infants localized targets in the perioral region before other areas (ears/temples). Additionally, infants predominantly reached ipsilaterally to targets. Collectively, the findings illuminate how the face becomes an integrated sensorimotor space for self-reaching.

Reaching to the Self: The Development of Infants' Ability to Localize Targets on the Body

This study focused on the development of infants' sensorimotor knowledge about the layout of their bodies. Little is known about the development of the body as a reaching space, despite the importance of this skill for many self-directed adaptive behaviors, such as removing foreign stimuli from the skin or scratching an itch. A new method was developed in which vibrating targets were placed on the heads and arms of 7- to 21-month-old infants (N = 78) to test reaching localization of targets. Manual localization improved with age, and visual localization was associated with successful reaching. Use of the ipsilateral or contralateral hand varied with body region: Infants primarily used the ipsilateral hand for head targets but the contralateral hand for arm targets, for which ipsilateral reaches were not biomechanically possible. The results of this research highlight a previously understudied form of self-knowledge involving a functional capacity to reach to tactile targets on the body surface.

Reaching with one arm to the other: Coordinating touch, proprioception, and action during infancy

Reaching to target locations on the body has been studied little despite its importance for adaptive behaviors such as feeding, grooming, and indicating a source of discomfort. This behavior requires multisensory integration given that it involves coordination of touch, proprioception, and sometimes vision as well as action. Here we examined the origins of this skill by investigating how infants begin to localize targets on the body and the motor strategies by which they do so. Infants (7-21 months of age) were prompted to reach to a vibrating target placed at five arm/hand locations (elbow, crook of elbow, forearm, palm, and top of hand) one by one. To manually localize the target, infants needed to reach with one arm to the other. Results suggest that coordination increases with age in the strategies that infants used to localize body targets. Most infants showed bimanual coordination and usually moved the target arm toward the reaching arm to assist reaching. Furthermore, intersensory coordination increased with age. Simultaneous movements of the two arms increased with age, as did coordination between vision and reaching. The results provide new information about the development of multisensory integration during tactile localization and how such integration is linked to action.

A Conceptual Model of Tactile Processing across Body Features of Size, Shape, Side, and Spatial Location

The processing of touch depends of multiple factors, such as the properties of the skin and type of receptors stimulated, as well as features related to the actual configuration and shape of the body itself. A large body of research has focused on the effect that the nature of the stimuli has on tactile processing. Less research, however, has focused on features beyond the nature of the touch. In this review, we focus on some features related to the body that have been investigated for less time and in a more fragmented way. These include the symmetrical quality of the two sides of the body, the postural configuration of the body, as well as the size and shape of different body parts. We will describe what we consider three key aspects: (1) how and at which stages tactile information is integrated between different parts and sides of the body; (2) how tactile signals are integrated with online and stored postural configurations of the body, regarded as priors; (3) and how tactile signals are integrated with representations of body size and shape. Here, we describe how these different body dimensions affect integration of tactile information as well as guide motor behavior by integrating them in a single model of tactile processing. We review a wide range of neuropsychological, neuroimaging, and neurophysiological data and suggest a revised model of tactile integration on the basis of the one proposed previously by Longo et al.

Cortical signatures of vicarious tactile experience in four-month-old infants

The human brain recruits similar brain regions when a state is experienced (e.g., touch, pain, actions) and when that state is passively observed in other individuals. In adults, seeing other people being touched activates similar brain areas as when we experience touch ourselves. Here we show that already by four months of age, cortical responses to tactile stimulation are modulated by visual information specifying another person being touched. We recorded somatosensory evoked potentials (SEPs) in 4-month-old infants while they were presented with brief vibrotactile stimuli to the hands. At the same time that the tactile stimuli were presented the infants observed another person's hand being touched by a soft paintbrush or approached by the paintbrush which then touched the surface next to their hand. A prominent positive peak in SEPs contralateral to the site of tactile stimulation around 130 ms after the tactile stimulus onset was of a significantly larger amplitude for the "Surface" trials than for the "Hand" trials. These findings indicate that, even at four months of age, somatosensory cortex is not only involved in the personal experience of touch but can also be vicariously recruited by seeing other people being touched.

Tactile localization biases are modulated by gaze direction

Identifying the spatial location of touch on the skin surface is a fundamental function of our somatosensory system. Despite the fact that stimulation of even single mechanoreceptive afferent fibres is sufficient to produce clearly localised percepts, tactile localisation can be modulated also by higher level processes such as body posture. This suggests that tactile events are coded using multiple representations using different coordinate systems. Recent reports provide evidence for systematic biases on tactile localisation task, which are thought to result from a supramodal representation of the skin surface. While the influence of non-informative vision of the body and gaze direction on tactile discrimination tasks has been extensively studied, their effects on tactile localisation tasks remain largely unexplored. To address this question, participants performed a tactile localization task on their left hand under different visual conditions by means of a mirror box; in the mirror condition, a single stimulus was delivered on participants' hand, while the reflexion of the right hand was seen through the mirror; in the object condition, participants looked at a box through the mirror, and in the right hand condition, participants looked directly at their right hand. Participants reported the location of the tactile stimuli using a silhouette of a hand. Results showed a shift in the localization of the touches towards the tip of the fingers (distal bias) and the thumb (radial biases) across conditions. Critically, distal biases were reduced when participants looked towards the mirror compared to when they looked at their right hand suggesting that gaze direction reduces the typical proximo-distal biases in tactile localization. Moreover, vision of the hand modulates the internal configuration of points' locations, by elongating it, in the radio-ulnar axis.

Visual Experience Shapes the Neural Networks Remapping Touch into External Space

Localizing touch relies on the activation of skin-based and externally defined spatial frames of reference. Psychophysical studies have demonstrated that early visual deprivation prevents the automatic remapping of touch into external space. We used fMRI to characterize how visual experience impacts the brain circuits dedicated to the spatial processing of touch. Sighted and congenitally blind humans performed a tactile temporal order judgment (TOJ) task, either with the hands uncrossed or crossed over the body midline. Behavioral data confirmed that crossing the hands has a detrimental effect on TOJ judgments in sighted but not in early blind people. Crucially, the crossed hand posture elicited enhanced activity, when compared with the uncrossed posture, in a frontoparietal network in the sighted group only. Psychophysiological interaction analysis revealed, however, that the congenitally blind showed enhanced functional connectivity between parietal and frontal regions in the crossed versus uncrossed hand postures. Our results demonstrate that visual experience scaffolds the neural implementation of the location of touch in space.SIGNIFICANCE STATEMENT In daily life, we seamlessly localize touch in external space for action planning toward a stimulus making contact with the body. For efficient sensorimotor integration, the brain has therefore to compute the current position of our limbs in the external world. In the present study, we demonstrate that early visual deprivation alters the brain activity in a dorsal parietofrontal network typically supporting touch localization in the sighted. Our results therefore conclusively demonstrate the intrinsic role that developmental vision plays in scaffolding the neural implementation of touch perception.