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Micheletti S, Galli J, Vezzoli M, Scaglioni V, Agostini S, Calza S, Merabet LB, Fazzi E. Academic skills in children with cerebral palsy and specific learning disorders. Dev Med Child Neurol 2024; 66:778-792. [PMID: 37990438 DOI: 10.1111/dmcn.15808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 09/02/2023] [Accepted: 10/17/2023] [Indexed: 11/23/2023]
Abstract
AIM To investigate the prevalence and clinical manifestations of reading, writing, and mathematics disorders in children with cerebral palsy (CP). We explored how the clinical profile of these children differed from those with specific learning disorders (SLDs), taking into account several factors, particularly IQ scores, neuropsychological aspects, and the presence of a visual impairment. METHOD A prospective cross-sectional study was conducted in 42 children with CP (mean age 9 years 8 months; SD = 2 years 2 months) and 60 children with SLDs (mean age 10 years; SD = 1 year 7 months). Clinical characteristics, neuromotor and cognitive profiles, neuropsychological aspects (speech performance, academic skills, visual attention, phonological awareness, working memory), and signs of visual impairment (visual acuity, contrast sensitivity, visual field, oculomotor functions) were assessed. A machine learning approach consisting of a random forest algorithm, where the outcome was the diagnosis and the covariates were the clinical variables collected in the sample, was used for the analyses. RESULTS About 59% of the children with CP had reading, writing, or mathematics disorders. Children with CP with learning disorders had a low performance IQ, normal phonological awareness, and working memory difficulties, whereas children with SLDs had normal performance IQ, impaired phonological awareness, and mild working memory difficulties. There were no differences in verbal IQ between the two groups. INTERPRETATION Learning disorders are frequently associated with CP, with different clinical characteristics, compared with SLDs. Assessment of academic skills is mandatory in these children, even if the IQ is normal. At school age, specific interventions to promote academic skills in children with CP could be a major rehabilitative goal. WHAT THIS PAPER ADDS Reading, writing, and mathematics disorders in cerebral palsy have specific clinical characteristics. Their underlying mechanisms differ from those described in specific learning disorders. Working memory impairment can be considered a hallmark of learning disorders in children with cerebral palsy.
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Affiliation(s)
- Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Jessica Galli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marika Vezzoli
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Vera Scaglioni
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Stefania Agostini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Elisa Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Arioli M, Ferrari C, Merabet LB, Cattaneo Z. Direct reciprocity and reputation shape trust decisions similarly in blind and sighted individuals. Conscious Cogn 2024; 120:103683. [PMID: 38552602 DOI: 10.1016/j.concog.2024.103683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/13/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
This study addresses the effects of blindness on trust. Using an auditory version of the multi-round Trust Game, we investigated the effect of reputation and reciprocity on trust decisions in early blind and sighted participants. During each round of the game, participants were endowed with a sum of money and had to decide how much they wanted to invest in their partners, who were manipulated as a function of their good or bad reputation and individualistic or cooperative behavior. The data showed that negative first impression about the partner (bad reputation and/or selfish behavior) impacted more blind participants than sighted ones. However, following repeated interactions with the partners, the overall mean investment aligned between the blind and sighted groups. We interpret these findings as suggesting that blindness may guide participants to a more cautionary behavior when dealing with partners with negative initial characteristics.
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Affiliation(s)
- Maria Arioli
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Chiara Ferrari
- Department of Humanities, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy.
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Zaira Cattaneo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
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Walter K, Manley CE, Bex PJ, Merabet LB. Visual search patterns during exploration of naturalistic scenes are driven by saliency cues in individuals with cerebral visual impairment. Sci Rep 2024; 14:3074. [PMID: 38321069 PMCID: PMC10847433 DOI: 10.1038/s41598-024-53642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/03/2024] [Indexed: 02/08/2024] Open
Abstract
We investigated the relative influence of image salience and image semantics during the visual search of naturalistic scenes, comparing performance in individuals with cerebral visual impairment (CVI) and controls with neurotypical development. Participants searched for a prompted target presented as either an image or text cue. Success rate and reaction time were collected, and gaze behavior was recorded with an eye tracker. A receiver operating characteristic (ROC) analysis compared the distribution of individual gaze landings based on predictions of image salience (using Graph-Based Visual Saliency) and image semantics (using Global Vectors for Word Representations combined with Linguistic Analysis of Semantic Salience) models. CVI participants were less likely and were slower in finding the target. Their visual search behavior was also associated with a larger visual search area and greater number of fixations. ROC scores were also lower in CVI compared to controls for both model predictions. Furthermore, search strategies in the CVI group were not affected by cue type, although search times and accuracy showed a significant correlation with verbal IQ scores for text-cued searches. These results suggest that visual search patterns in CVI are driven mainly by image salience and provide further characterization of higher-order processing deficits observed in this population.
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Affiliation(s)
- Kerri Walter
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
| | - Claire E Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA, 02114, USA
| | - Peter J Bex
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA, 02114, USA.
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Bauer CM, Merabet LB. Aberrant White Matter Development in Cerebral Visual Impairment: A Proposed Mechanism for Visual Dysfunction Following Early Brain Injury. J Integr Neurosci 2024; 23:1. [PMID: 38287851 DOI: 10.31083/j.jin2301001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Cerebral visual impairment (CVI) is a common sequala of early brain injury, damage, or malformation and is one of the leading individual causes of visual dysfunction in pediatric populations worldwide. Although patients with CVI are heterogeneous both in terms of underlying etiology and visual behavioural manifestations, there may be underlying similarities in terms of which white matter pathways are potentially altered. This exploratory study used diffusion tractography to examine potential differences in volume, quantitative anisotropy (QA), as well as mean, axial, and radial diffusivities (mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD), respectively) focusing on the dorsal and ventral visual stream pathways in a cohort of young adults with CVI compared to typically sighted and developing controls. METHODS High angular resolution diffusion imaging (HARDI) data were acquired in a sample of 10 individuals with a diagnosis of CVI (mean age = 17.3 years, 2.97 standard deviation (SD), range 14-22 years) and 17 controls (mean age = 19.82 years, 3.34 SD, range 15-25 years). The inferior longitudinal fasciculus (ILF), inferior fronto-occipital fasciculus (IFOF), vertical occipital fasciculus (VOF), and the three divisions of the superior longitudinal fasciculus (SLF I, II, and III) were virtually reconstructed and average tract volume (adjusted for intracranial volume), MD, AD, and RD were compared between CVI and control groups. As a secondary analysis, an analysis of variance (ANOVA) was carried out to investigate potential differences based on etiology (i.e., CVI due to periventricular leukomalacia (CVI-PVL) and CVI due to other causes (CVI-nonPVL)). RESULTS We observed a large degree of variation within the CVI group, which minimized the overall group differences in tractography outcomes when examining the CVI sample as a unitary group. In our secondary analysis, we observed significant reductions in tract volume in the CVI-PVL group compared to both controls and individuals with CVI due to other causes. We also observed widespread significant increases in QA, MD, and AD in CVI-PVL compared to the control group, with mixed effects in the CVI-nonPVL group. CONCLUSIONS These data provide preliminary evidence for aberrant development of key white matter fasciculi implicated in visual perceptual processing skills, which are often impaired to varying degrees in individuals with CVI. The results also indicate that the severity and extent of the white matter changes may be due in part to the underlying cause of the cerebral visual impairments. Additional analyses will need to be done in a larger sample alongside behavioural testing to fully appreciate the relationships between white matter integrity, visual dysfunction, and associated causes in individuals with CVI.
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Affiliation(s)
- Corinna M Bauer
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
- Lab of Neuroimaging and Vision Science, Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
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Merabet LB, Manley CE, Pamir Z, Bauer CM, Skerswetat J, Bex PJ. Motion and form coherence processing in individuals with cerebral visual impairment. Dev Med Child Neurol 2023; 65:1379-1386. [PMID: 37012700 PMCID: PMC10795851 DOI: 10.1111/dmcn.15591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
AIM Using a visual psychophysical paradigm, we sought to assess motion and form coherence thresholds as indices of dorsal and ventral visual stream processing respectively, in individuals with cerebral visual impairment (CVI). We also explored potential associations between psychophysical assessments and brain lesion severity in CVI. METHOD Twenty individuals previously diagnosed with CVI (mean age = 17 years 11 months [SD 5 years 10 months]; mean Verbal IQ = 86.42 [SD 35.85]) and 30 individuals with neurotypical development (mean age = 20 years 1 month [SD 3 years 8 months]; mean Verbal IQ = 110.05 [SD 19.34]) participated in the study. In this two-group comparison, cross-sectional study design, global motion, and form pattern coherence thresholds were assessed using a computerized, generalizable, self-administrable, and response-adaptive psychophysical paradigm called FInD (Foraging Interactive D-prime). RESULTS Consistent with dorsal stream dysfunction, mean global motion (but not form) coherence thresholds were significantly higher in individuals with CVI compared to controls. No statistically significant association was found between coherence thresholds and lesion severity. INTERPRETATION These results suggest that the objective assessment of motion and form coherence threshold sensitivities using this psychophysical paradigm may be useful in helping to characterize perceptual deficits and the complex clinical profile of CVI. WHAT THIS PAPER ADDS In participants with cerebral visual impairment (CVI), motion (but not form) coherence thresholds were significantly higher compared to controls. These psychophysical results support the notion of dorsal stream dysfunction in CVI.
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Affiliation(s)
- Lotfi B. Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Claire E. Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Zahide Pamir
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Bilkent University, Department of Psychology, Ankara, Turkey
| | - Corinna M. Bauer
- Lab for Neuroimaging and Vision Science, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jan Skerswetat
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
| | - Peter J. Bex
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
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Manley CE, Walter K, Micheletti S, Tietjen M, Cantillon E, Fazzi EM, Bex PJ, Merabet LB. Object identification in cerebral visual impairment characterized by gaze behavior and image saliency analysis. Brain Dev 2023; 45:432-444. [PMID: 37188548 PMCID: PMC10524860 DOI: 10.1016/j.braindev.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 05/17/2023]
Abstract
Individuals with cerebral visual impairment (CVI) have difficulties identifying common objects, especially when presented as cartoons or abstract images. In this study, participants were shown a series of images of ten common objects, each from five possible categories ranging from abstract black & white line drawings to color photographs. Fifty individuals with CVI and 50 neurotypical controls verbally identified each object and success rates and reaction times were collected. Visual gaze behavior was recorded using an eye tracker to quantify the extent of visual search area explored and number of fixations. A receiver operating characteristic (ROC) analysis was also carried out to compare the degree of alignment between the distribution of individual eye gaze patterns and image saliency features computed by the graph-based visual saliency (GBVS) model. Compared to controls, CVI participants showed significantly lower success rates and longer reaction times when identifying objects. In the CVI group, success rate improved moving from abstract black & white images to color photographs, suggesting that object form (as defined by outlines and contours) and color are important cues for correct identification. Eye tracking data revealed that the CVI group showed significantly greater visual search areas and number of fixations per image, and the distribution of eye gaze patterns in the CVI group was less aligned with the high saliency features of the image compared to controls. These results have important implications in helping to understand the complex profile of visual perceptual difficulties associated with CVI.
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Affiliation(s)
- Claire E Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Kerri Walter
- Translational Vision Lab. Department of Psychology, Northeastern University, Boston, MA, USA
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matthew Tietjen
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Emily Cantillon
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Elisa M Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Peter J Bex
- Translational Vision Lab. Department of Psychology, Northeastern University, Boston, MA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA.
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Federici A, Bennett CR, Bauer CM, Manley CE, Ricciardi E, Bottari D, Merabet LB. Altered neural oscillations underlying visuospatial processing in cerebral visual impairment. Brain Commun 2023; 5:fcad232. [PMID: 37693815 PMCID: PMC10489293 DOI: 10.1093/braincomms/fcad232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 06/16/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023] Open
Abstract
Visuospatial processing deficits are commonly observed in individuals with cerebral visual impairment, even in cases where visual acuity and visual field functions are intact. Cerebral visual impairment is a brain-based visual disorder associated with the maldevelopment of central visual pathways and structures. However, the neurophysiological basis underlying higher-order perceptual impairments in this condition has not been clearly identified, which in turn poses limits on developing rehabilitative interventions. Using combined eye tracking and EEG recordings, we assessed the profile and performance of visual search on a naturalistic virtual reality-based task. Participants with cerebral visual impairment and controls with neurotypical development were instructed to search, locate and fixate on a specific target placed among surrounding distractors at two levels of task difficulty. We analysed evoked (phase-locked) and induced (non-phase-locked) components of broadband (4-55 Hz) neural oscillations to uncover the neurophysiological basis of visuospatial processing. We found that visual search performance in cerebral visual impairment was impaired compared to controls (as indexed by outcomes of success rate, reaction time and gaze error). Analysis of neural oscillations revealed markedly reduced early-onset evoked theta [4-6 Hz] activity (within 0.5 s) regardless of task difficulty. Moreover, while induced alpha activity increased with task difficulty in controls, this modulation was absent in the cerebral visual impairment group identifying a potential neural correlate related to deficits with visual search and distractor suppression. Finally, cerebral visual impairment participants also showed a sustained induced gamma response [30-45 Hz]. We conclude that impaired visual search performance in cerebral visual impairment is associated with substantial alterations across a wide range of neural oscillation frequencies. This includes both evoked and induced components suggesting the involvement of feedforward and feedback processing as well as local and distributed levels of neural processing.
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Affiliation(s)
| | - Christopher R Bennett
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Corinna M Bauer
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Claire E Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | | | | | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
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Galli J, Loi E, Strobio C, Micheletti S, Martelli P, Merabet LB, Pasini N, Semeraro F, Fazzi E. Neurovisual profile in children affected by Angelman syndrome. Brain Dev 2023; 45:117-125. [PMID: 36344336 DOI: 10.1016/j.braindev.2022.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/09/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Angelman syndrome (AS) is a rare neurogenetic disorder caused by altered expression of the maternal copy of the UBE3A gene. Together with motor, cognitive, and speech impairment, ophthalmological findings including strabismus, and ocular fundus hypopigmentation characterize the clinical phenotype. The aim of this study was to detail the neurovisual profile of children affected by AS and to explore any possible genotype-phenotype correlations. METHODS Thirty-seven children (23 females, mean age 102.8 ± 54.4 months, age range 22 to 251 months) with molecular confirmed diagnosis of AS were enrolled in the study. All underwent a comprehensive video-recorded neurovisual evaluation including the assessment of ophthalmological aspects, oculomotor functions, and basic visual abilities. RESULTS All children had visual impairments mainly characterized by refractive errors, ocular fundus changes, strabismus, discontinuous/jerky smooth pursuit and altered saccadic movements, and/or reduced visual acuity. Comparing the neurovisual profiles between the deletion and non-deletion genetic subgroups, we found a significant statistical correlation between genotype and ocular fundus hypopigmentation (p = 0.03), discontinuous smooth pursuit (p < 0.05), and contrast sensitivity abnormalities (p < 0.01) being more frequent in the deletion subgroup. CONCLUSIONS Subjects affected by AS present a wide spectrum of neurovisual impairments that lead to a clinical profile consistent with cerebral visual impairment (CVI). Moreover, subjects with a chromosome deletion show a more severe visual phenotype with respect to ocular fundus changes, smooth pursuit movements, and contrast sensitivity. Early detection of these impaired visual functions may help promote the introduction of neurovisual habilitative programs which can improve children's visual, neuromotor, and cognitive outcomes.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Caterina Strobio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Paola Martelli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Italy; University of Brescia, Eye Clinic, Brescia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Pamir Z, Bauer CM, Manley CE, Dilks DD, Merabet LB. Neural correlates associated with a virtual reality based dynamic visual search in Cerebral Visual Impairment. J Vis 2022. [DOI: 10.1167/jov.22.14.4140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Zahide Pamir
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School. Boston, MA USA
| | - Corinna M. Bauer
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School. Boston, MA USA
| | - Claire E. Manley
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School. Boston, MA USA
| | - Daniel D. Dilks
- Department of Psychology, Emory University, Atlanta, GA 30322, USA
| | - Lotfi B. Merabet
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School. Boston, MA USA
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Manley CE, Cantillon E, Tietjen M, Walter K, Bex PJ, Merabet LB. Identification of 2D Images in Cerebral Visual Impairment (CVI) Based on Features and Gaze Behavior. J Vis 2022. [DOI: 10.1167/jov.22.14.4097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Claire E. Manley
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School
| | | | - Matthew Tietjen
- Bureau of Education and Services for the Blind, State of Connecticut
| | - Kerri Walter
- Department of Psychology, Northeastern University
| | - Peter J. Bex
- Department of Psychology, Northeastern University
| | - Lotfi B. Merabet
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School
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Zhang X, Manley CE, Micheletti S, Tesic I, Bennett CR, Fazzi EM, Merabet LB. Assessing visuospatial processing in cerebral visual impairment using a novel and naturalistic static visual search task. Res Dev Disabil 2022; 131:104364. [PMID: 36334401 DOI: 10.1016/j.ridd.2022.104364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 07/15/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Cerebral visual impairment (CVI) is a brain based visual disorder associated with the maldevelopment of central visual pathways. Individuals with CVI often report difficulties finding a target of interest in cluttered and crowded visual scenes. However, it remains unknown how manipulating task demands and other environmental factors influence visual search performance in this population. AIM We developed a novel and naturalistic virtual reality (VR) based static visual search task combined with eye tracking called the "virtual toy box" to objectively assess visual search performance in CVI. METHODS AND PROCEDURES A total of 38 individuals with CVI (mean age 13.18 years ± 3.58 SD) and 53 controls with neurotypical development (mean age 15.25 years ± 5.72 SD) participated in the study. In a first experiment, study subjects were instructed to search for a preselected toy presented among a varying number of surrounding distractor toys (set size ranging from 1 to 36 items). In a second experiment, we assessed the effects of manipulating item spacing and the size of the visual area explored (field of view; FOV). OUTCOMES AND RESULTS Behavioral outcomes collected were success rate, reaction time, gaze error, visual search area, and off-screen percent (an index of task compliance). Compared to age-matched controls, participants with CVI showed an overall impairment with respect to all the visual search outcomes of interest. Specifically, individuals with CVI were less likely and took longer to find the target, and search patterns were less accurate and precise compared to controls. Visual search response profiles were also comparatively less efficient and were associated with a slower initial pre-search (visual orienting) response as indexed by higher slope and intercept values derived from the analysis of reaction time × set size functions. Search performance was also more negatively affected in CVI at the smallest as well as largest spacing conditions tested, while increasing FOV was associated with greater decreased gaze accuracy and precision CONCLUSIONS AND IMPLICATIONS: These results are consistent with a general profile of impaired visual search abilities in CVI as well as worsening performance with increased visual task demands and an overall sensitivity to visual clutter and crowding. The observed profile of impaired visual search performance may be associated with dysfunctions related to how visual selective attention is deployed in individuals with CVI.
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Affiliation(s)
- Xin Zhang
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Claire E Manley
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Isidora Tesic
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Christopher R Bennett
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Elisa M Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA.
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12
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Houston KE, Keilty M, Collins C, Trehan R, Mouldovan T, Stuckart K, Engelhardt N, Nadeau M, Rovito CA, Merabet LB. Development and 5-year Evaluation of Diagnosis-Specific Protocols for Visual Neuro-Rehabilitation in a Multicenter Inpatient Rehabilitation Network. Arch Rehabil Res Clin Transl 2022; 5:100246. [PMID: 36968165 PMCID: PMC10036222 DOI: 10.1016/j.arrct.2022.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To provide a retrospective evaluation of a new eye and vision rehabilitation care pathway in a U.S. multi-site inpatient rehabilitation network involving the occupational therapy (OT) staff and a consulting doctor of optometry (OD) specializing in vision rehabilitation. Design Retrospective study. Setting Two Inpatient Rehabilitation Facilities (IRFs) and 1 Long Term Acute Care Hospital (LTACH). Participants There were 2083 records reviewed (44% women, avg. age 59 years). The most common diagnoses were hemispatial neglect (19.2%), homonymous field defects (18.5%), and oculomotor cranial nerve palsies (16.7%) (N=2083). Interventions Clinical care was reviewed where diagnosis-specific protocols were developed and training was provided to OTs in order to reinforce OD-prescribed interventions during daily treatment sessions, including (1) third, fourth, and sixth ocular cranial nerve palsies (OCNPs) with prisms fitted for full time, postural adaptation training, and oculomotor re-education using pursuits, saccades, head-rotations, and binocular vision exercises including alternate cover and vergence; (2) homonymous hemianopia with training awareness of field loss, eccentric viewing, and fitting of Peli lens for optical field expansion; and (3) prism adaptation therapy (PAT) for left hemispatial neglect. Main Outcome Measures Frequency of diagnoses. Hypothesis Diagnoses with developed protocols were most common. Secondarily, feasibility and efficacy by anonymous OT survey. Results 2083 vision consults were performed over 5 years. The most common diagnoses were hemispatial neglect (n=399, 19.2%), homonymous field defects (n=386, 18.5%), and OCNPs (n=347, 16.7%). None of the OTs reported the protocols were infeasible and 63% (IQR 38%-69%) reported their patients benefited from the interventions. The survey suggested prism for OCNPs helped in 42%, and Peli lens and PAT both helped in 38%. Conclusions Data support the feasibility of this inpatient eye and vision rehabilitation care pathway which may be used as a foundation for creating or refining similar programs elsewhere. Uniform administration of IRF-based visual neuro-rehabilitation care could provide a substrate for future clinical trials to evaluate efficacy.
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Affiliation(s)
- Kevin E. Houston
- Spaulding Rehabilitation Hospital Cape Cod, Sandwich, MA
- Spaulding Hospital for Continuing Medical Care Cambridge, Cambridge, MA
- Spaulding Rehabilitation Hospital, Boston, MA
- Massachusetts Eye and Ear, Optometry and Vision Rehabilitation Service, Boston, MA
- Harvard Medical School, Department of Ophthalmology, Boston, MA
- Schepens Eye Research Institute, Boston, MA
- Corresponding author Kevin E. Houston, OD, MSc, Massachusetts Eye and Ear, 243 Charles St. Boston, MA 02114.
| | - Matthew Keilty
- Spaulding Rehabilitation Hospital Cape Cod, Sandwich, MA
| | | | - Ritika Trehan
- Spaulding Hospital for Continuing Medical Care Cambridge, Cambridge, MA
| | | | | | | | - Melanie Nadeau
- Massachusetts Eye and Ear, Optometry and Vision Rehabilitation Service, Boston, MA
- Harvard Medical School, Department of Ophthalmology, Boston, MA
- Schepens Eye Research Institute, Boston, MA
| | - Craig A. Rovito
- Spaulding Rehabilitation Hospital, Boston, MA
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA
| | - Lotfi B. Merabet
- Spaulding Rehabilitation Hospital, Boston, MA
- Massachusetts Eye and Ear, Optometry and Vision Rehabilitation Service, Boston, MA
- Harvard Medical School, Department of Ophthalmology, Boston, MA
- Schepens Eye Research Institute, Boston, MA
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13
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Micheletti S, Merabet LB, Galli J, Fazzi E. VISUAL INTERVENTION IN EARLY ONSET VISUAL IMPAIRMENT: A REVIEW. Eur J Neurosci 2022. [PMID: 36217264 DOI: 10.1111/ejn.15841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/28/2022]
Abstract
Vision is a primary and motivating sense. Early visual experience derived from the external world is known to have an important impact on the development of central visual pathways and, not surprisingly, visual impairment constitutes a risk factor for overall development. In light of the role of vision in early brain development, infants and young children with visual impairment should be thus entitled to early and effective visual intervention programs. In this review, we discuss early visual interventions in infants and young children with visual impairment, focusing on their contents and outcomes. We defined a PICO format to critically review different models with a particular focus on parent-mediated and therapist-mediated approaches. We consider protocols that involved direct manipulation or improvement of the infants' visual inputs or were based on behavioral strategies and communication towards infants with visual impairment. We also provide an overview of the effectiveness of these protocols. A total of nine intervention protocols were selected for the purposes of this review. Substantial agreement regarding the importance of promoting the enrichment of infant environments, and more specifically in the context of active play that engages the whole family, has been reported in most of the studies. However, there is no clear agreement on methodological aspects, including clinical population characteristics, outcome measures, length of treatment, and follow-up programs. Further high-quality, carefully designed and adequately reported studies are needed in order to improve the clinical efficacy of these approaches to treating infants with visual impairment.
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Affiliation(s)
- Serena Micheletti
- ASST Spedali Civili of Brescia, Unit of Child Neurology and Psychiatry, Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Jessica Galli
- ASST Spedali Civili of Brescia, Unit of Child Neurology and Psychiatry, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elisa Fazzi
- ASST Spedali Civili of Brescia, Unit of Child Neurology and Psychiatry, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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14
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Bennett CR, Bauer CM, Bex PJ, Bottari D, Merabet LB. Visual search performance in cerebral visual impairment is associated with altered alpha band oscillations. Neuropsychologia 2021; 161:108011. [PMID: 34474066 PMCID: PMC8488018 DOI: 10.1016/j.neuropsychologia.2021.108011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/30/2021] [Accepted: 08/26/2021] [Indexed: 11/15/2022]
Abstract
Individuals with cerebral visual impairment (CVI) often present with deficits related to visuospatial processing. However, the neurophysiological basis underlying these higher order perceptual dysfunctions have not been clearly identified. We assessed visual search performance using a novel virtual reality based task paired with eye tracking to simulate the exploration of a naturalistic scene (a virtual toy box). This was combined with electroencephalography (EEG) recordings and an analysis pipeline focusing on time frequency decomposition of alpha oscillatory activity. We found that individuals with CVI showed an overall impairment in visual search performance (as indexed by decreased success rate, as well as increased reaction time, visual search area, and gaze error) compared to controls with neurotypical development. Analysis of captured EEG activity following stimulus onset revealed that in the CVI group, there was a distinct lack of strong and well defined posterior alpha desynchronization; an important signal involved in the coordination of neural activity related to visual processing. Finally, an exploratory analysis revealed that in CVI, the magnitude of alpha desynchronization was associated with impaired visual search performance as well as decreased volume of specific thalamic nuclei implicated in visual processing. These results suggest that impairments in visuospatial processing related to visual search in CVI are associated with alterations in alpha band oscillations as well as early neurological injury at the level of visual thalamic nuclei.
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Affiliation(s)
- Christopher R Bennett
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Corinna M Bauer
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Peter J Bex
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
| | | | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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15
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Pamir Z, Bauer CM, Bennett CR, Kran BS, Merabet LB. Visual perception supported by verbal mediation in an individual with cerebral visual impairment (CVI). Neuropsychologia 2021; 160:107982. [PMID: 34364903 DOI: 10.1016/j.neuropsychologia.2021.107982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/16/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
Cerebral visual impairment (CVI) often presents with deficits associated with higher order visual processing. We report a case of an individual with CVI who uses a verbal mediation strategy to perceive and interact with his visual surroundings. Visual perceptual performance was assessed using a virtual reality based visual search task combined with eye tracking. Functional magnetic resonance imaging (fMRI) was employed to identify the neural correlates associated with this strategy. We found that when using verbal mediation, the individual could readily detect and track the target within the visual scene which was associated with robust activation within a network of occipito-parieto-temporal visual cortical areas. In contrast, when not using verbal mediation, the individual was completely unable to perform the task, and this was associated with dramatically reduced visual cortical activation. This unique compensatory strategy may be related to the individual's use of verbal working memory for the purposes of understanding complex visual information.
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Affiliation(s)
- Zahide Pamir
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Corinna M Bauer
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Christopher R Bennett
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Barry S Kran
- New England College of Optometry, Boston, MA, USA; NECO Clinical Network, Perkins School for the Blind, Watertown, MA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
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16
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Abstract
Daily activities require the constant searching and tracking of visual targets in dynamic and complex scenes. Classic work assessing visual search performance has been dominated by the use of simple geometric shapes, patterns, and static backgrounds. Recently, there has been a shift toward investigating visual search in more naturalistic dynamic scenes using virtual reality (VR)-based paradigms. In this direction, we have developed a first-person perspective VR environment combined with eye tracking for the capture of a variety of objective measures. Participants were instructed to search for a preselected human target walking in a crowded hallway setting. Performance was quantified based on saccade and smooth pursuit ocular motor behavior. To assess the effect of task difficulty, we manipulated factors of the visual scene, including crowd density (i.e., number of surrounding distractors) and the presence of environmental clutter. In general, results showed a pattern of worsening performance with increasing crowd density. In contrast, the presence of visual clutter had no effect. These results demonstrate how visual search performance can be investigated using VR-based naturalistic dynamic scenes and with high behavioral relevance. This engaging platform may also have utility in assessing visual search in a variety of clinical populations of interest.
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Affiliation(s)
- Christopher R Bennett
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Peter J Bex
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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17
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Rinaldi L, Ciricugno A, Merabet LB, Vecchi T, Cattaneo Z. The Effect of Blindness on Spatial Asymmetries. Brain Sci 2020; 10:brainsci10100662. [PMID: 32977398 PMCID: PMC7597958 DOI: 10.3390/brainsci10100662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 11/27/2022] Open
Abstract
The human cerebral cortex is asymmetrically organized with hemispheric lateralization pervading nearly all neural systems of the brain. Whether the lack of normal visual development affects hemispheric specialization subserving the deployment of visuospatial attention asymmetries is controversial. In principle, indeed, the lack of early visual experience may affect the lateralization of spatial functions, and the blind may rely on a different sensory input compared to the sighted. In this review article, we thus present a current state-of-the-art synthesis of empirical evidence concerning the effects of visual deprivation on the lateralization of various spatial processes (i.e., including line bisection, mirror symmetry, and localization tasks). Overall, the evidence reviewed indicates that spatial processes are supported by a right hemispheric network in the blind, hence, analogously to the sighted. Such a right-hemisphere dominance, however, seems more accentuated in the blind as compared to the sighted as indexed by the greater leftward bias shown in different spatial tasks. This is possibly the result of the more pronounced involvement of the right parietal cortex during spatial tasks in blind individuals compared to the sighted, as well as of the additional recruitment of the right occipital cortex, which would reflect the cross-modal plastic phenomena that largely characterize the blind brain.
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Affiliation(s)
- Luca Rinaldi
- Department of Brain and Behavioural Science, University of Pavia, Piazza Botta 6, 27100 Pavia, Italy;
- Correspondence:
| | | | - Lotfi B. Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02115, USA;
| | - Tomaso Vecchi
- Department of Brain and Behavioural Science, University of Pavia, Piazza Botta 6, 27100 Pavia, Italy;
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (A.C.); (Z.C.)
| | - Zaira Cattaneo
- IRCCS Mondino Foundation, 27100 Pavia, Italy; (A.C.); (Z.C.)
- Department of Psychology, University of Milano-Bicocca, 20126 Milano, Italy
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18
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Molinaro A, Micheletti S, Rossi A, Gitti F, Galli J, Merabet LB, Fazzi EM. Autistic-Like Features in Visually Impaired Children: A Review of Literature and Directions for Future Research. Brain Sci 2020; 10:E507. [PMID: 32752249 PMCID: PMC7465914 DOI: 10.3390/brainsci10080507] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
There remains great interest in understanding the relationship between visual impairment (VI) and autism spectrum disorder (ASD) due to the extraordinarily high prevalence of ASD in blind and visually impaired children. The broad variability across individuals and assessment methodologies have made it difficult to understand whether autistic-like symptoms shown by some children with VI might reflect the influence of the visual deficit, or represent a primary neurodevelopmental condition that occurs independently of the VI itself. In the absence of a valid methodology adapted for the visually impaired population, diagnosis of ASD in children with VI is often based on non-objective clinical impression, with inconclusive prevalence data. In this review, we discuss the current state of knowledge and suggest directions for future research.
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Affiliation(s)
- Anna Molinaro
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
| | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
| | - Filippo Gitti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
| | - Jessica Galli
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02115, USA
| | - Elisa Maria Fazzi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, 25121 Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
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19
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Ciricugno A, Rinaldi L, Vecchi T, Merabet LB, Cattaneo Z. The Role of Binocular Vision in Driving Pseudoneglect in Visual and Haptic Bisection: Evidence From Strabismic and Monocular Blind Individuals. Multisens Res 2020; 33:549-567. [PMID: 31059488 DOI: 10.1163/22134808-20191347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022]
Abstract
Prior studies have shown that strabismic amblyopes do not exhibit pseudoneglect in visual line bisection, suggesting that the right-hemisphere dominance in the control of spatial attention may depend on a normally developing binocular vision. In this study, we aimed to investigate whether an abnormal binocular childhood experience also affects spatial attention in the haptic modality, thus reflecting a supramodal effect. To this aim, we compared the performance of normally sighted, strabismic and early monocular blind participants in a visual and a haptic line bisection task. In visual line bisection, strabismic individuals tended to err to the right of the veridical midpoint, in contrast with normally sighted participants who showed pseudoneglect. Monocular blind participants exhibited high variability in their visual performance, with a tendency to bisect toward the direction of the functioning eye. In turn, in haptic bisection, all participants consistently erred towards the left of the veridical midpoint. Taken together, our findings support the view that pseudoneglect in the visual and haptic modality relies on different functional and neural mechanisms.
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Affiliation(s)
- Andrea Ciricugno
- 1Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Luca Rinaldi
- 2Department of Psychology, University of Milano-Bicocca, Milan, Italy.,3NeuroMI, Milan Center for Neuroscience, Milan, Italy
| | - Tomaso Vecchi
- 1Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,4IRCCS Mondino Foundation, Pavia, Italy
| | - Lotfi B Merabet
- 5The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA
| | - Zaira Cattaneo
- 2Department of Psychology, University of Milano-Bicocca, Milan, Italy.,4IRCCS Mondino Foundation, Pavia, Italy
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20
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Bennett CR, Bauer CM, Bailin ES, Merabet LB. Neuroplasticity in cerebral visual impairment (CVI): Assessing functional vision and the neurophysiological correlates of dorsal stream dysfunction. Neurosci Biobehav Rev 2020; 108:171-181. [PMID: 31655075 PMCID: PMC6949360 DOI: 10.1016/j.neubiorev.2019.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 10/15/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
Cerebral visual impairment (CVI) results from perinatal injury to visual processing structures and pathways and is the most common individual cause of pediatric visual impairment and blindness in developed countries. While there is mounting evidence demonstrating extensive neuroplastic reorganization in early onset, profound ocular blindness, how the brain reorganizes in the setting of congenital damage to cerebral (i.e. retro-geniculate) visual pathways remains comparatively poorly understood. Individuals with CVI exhibit a wide range of visual deficits and, in particular, present with impairments of higher order visual spatial processing (referred to as "dorsal stream dysfunction") as well as object recognition (associated with processing along the ventral stream). In this review, we discuss the need for ongoing work to develop novel, neuroscience-inspired approaches to investigate functional visual deficits in this population. We also outline the role played by advanced structural and functional neuroimaging in helping to elucidate the underlying neurophysiology of CVI, and highlight key differences with regard to patterns of neural reorganization previously described in ocular blindness.
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Affiliation(s)
- Christopher R Bennett
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Corinna M Bauer
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Emma S Bailin
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Lotfi B Merabet
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States.
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21
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Affiliation(s)
- Corinna M Bauer
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Lotfi B Merabet
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA..
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22
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Abstract
The complete assessment of vision-related abilities should consider visual function (the performance of components of the visual system) and functional vision (visual task-related ability). Assessment methods are highly dependent upon individual characteristics (eg, the presence and type of visual impairment). Typical visual function tests assess factors such as visual acuity, contrast sensitivity, color, depth, and motion perception. These properties each represent an aspect of visual function and may impact an individual's level of functional vision. The goal of any functional vision assessment should be to measure the visual task-related ability under real-world scenarios. Recent technological advancements such as virtual reality can provide new opportunities to improve traditional vision assessments by providing novel objective and ecologically valid measurements of performance, and allowing for the investigation of their neural basis. In this review, visual function and functional vision evaluation approaches are discussed in the context of traditional and novel acquisition methods.
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Affiliation(s)
- Christopher R Bennett
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Peter J Bex
- Translational Vision Lab, Department of Psychology, Northeastern University, Boston, MA
| | - Corinna M Bauer
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
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23
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Saleh Velez FG, Pinto CB, Bailin ES, Münger M, Ellison A, Costa BT, Crandell D, Bolognini N, Merabet LB, Fregni F. Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain. J Vis Exp 2019. [PMID: 31058883 DOI: 10.3791/58800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
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Affiliation(s)
- Faddi G Saleh Velez
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital; University of Chicago Medical Center, Department of Neurology, University of Chicago
| | - Camila B Pinto
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital; Department of Neuroscience and Behavior, Psychology Institute, University of Sao Paulo
| | - Emma S Bailin
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Marionna Münger
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital
| | - Andrew Ellison
- Center for Biomedical Imaging, Department of Anatomy and Neurobiology, Boston University School of Medicine
| | - Beatriz T Costa
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital
| | - David Crandell
- Spaulding Rehabilitation Hospital, Harvard Medical School
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience, University of Milano-Bicocca; Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Auxologico Italiano
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Felipe Fregni
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital;
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24
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Sabel BA, Flammer J, Merabet LB. Residual vision activation and the brain-eye-vascular triad: Dysregulation, plasticity and restoration in low vision and blindness - a review. Restor Neurol Neurosci 2019; 36:767-791. [PMID: 30412515 PMCID: PMC6294586 DOI: 10.3233/rnn-180880] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Vision loss due to ocular diseases such as glaucoma, optic neuropathy, macular degeneration, or diabetic retinopathy, are generally considered an exclusive affair of the retina and/or optic nerve. However, the brain, through multiple indirect influences, has also a major impact on functional visual impairment. Such indirect influences include intracerebral pressure, eye movements, top-down modulation (attention, cognition), and emotionally triggered stress hormone release affecting blood vessel dysregulation. Therefore, vision loss should be viewed as the result of multiple interactions within a “brain-eye-vascular triad”, and several eye diseases may also be considered as brain diseases in disguise. While the brain is part of the problem, it can also be part of the solution. Neuronal networks of the brain can “amplify” residual vision through neuroplasticity changes of local and global functional connectivity by activating, modulating and strengthening residual visual signals. The activation of residual vision can be achieved by different means such as vision restoration training, non-invasive brain stimulation, or blood flow enhancing medications. Modulating brain functional networks and improving vascular regulation may offer new opportunities to recover or restore low vision by increasing visual field size, visual acuity and overall functional vision. Hence, neuroscience offers new insights to better understand vision loss, and modulating brain and vascular function is a promising source for new opportunities to activate residual vision to achieve restoration and recovery to improve quality of live in patients suffering from low vision.
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Affiliation(s)
- Bernhard A Sabel
- Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| | - Josef Flammer
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Lotfi B Merabet
- Department of Ophthalmology, The Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA
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25
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Galli J, Ambrosi C, Micheletti S, Merabet LB, Pinardi C, Gasparotti R, Fazzi E. White matter changes associated with cognitive visual dysfunctions in children with cerebral palsy: A diffusion tensor imaging study. J Neurosci Res 2018; 96:1766-1774. [PMID: 30027677 DOI: 10.1002/jnr.24307] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 11/10/2022]
Abstract
Children with cerebral palsy often present with cognitive-visual dysfunctions characterized by visuo-perceptual and/or visuo-spatial deficits associated with a malfunctioning of visual-associative areas. The neurofunctional model of this condition remains poorly understood due to the lack of a clear correlation between cognitive-visual deficit and morphological brain anomalies. The aim of our study was to quantify the pattern of white matter abnormalities within the whole brain in children with cerebral palsy, and to identify white matter tracts sub-serving cognitive-visual functions, in order to better understand the basis of cognitive-visual processing. Nine subjects (three males, mean age 8 years 9 months) with cerebral palsy underwent a visual and cognitive-visual evaluation. Conventional brain MRI and diffusion tensor imaging were performed. The fractional anisotropy maps were calculated for every child and compared with data from 13 (four males, mean age 10 years 7 months) healthy children. Children with cerebral palsy showed decreased fractional anisotropy (a marker of white matter integrity) in corticospinal tract bilaterally, left superior longitudinal fasciculus and bilateral hippocampus. Focusing on the superior longitudinal fasciculus, the mean fractional anisotropy values were significantly lower in children affected by cerebral palsy with cognitive-visual deficits than in those without cognitive-visual deficits. Our findings reveal an association between cognitive-visual profile and the superior longitudinal fasciculus integrity in children with cerebral palsy, supporting the hypothesis that visuo-associative deficits are related to changes in fibers connecting the occipital cortex with the parietal-frontal cortices. Decreased fractional anisotropy within the superior longitudinal fasciculus could be considered a biomarker for cognitive-visual dysfunctions.
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Affiliation(s)
- Jessica Galli
- Clinical and Experimental Sciences Department, University of Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy
| | | | - Serena Micheletti
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA
| | - Chiara Pinardi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberto Gasparotti
- Neuroradiology Unit, ASST Spedali Civili of Brescia, Italy.,Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Italy
| | - Elisa Fazzi
- Clinical and Experimental Sciences Department, University of Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Italy
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26
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Singh AK, Phillips F, Merabet LB, Sinha P. Why Does the Cortex Reorganize after Sensory Loss? Trends Cogn Sci 2018; 22:569-582. [PMID: 29907530 DOI: 10.1016/j.tics.2018.04.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/01/2018] [Accepted: 04/17/2018] [Indexed: 01/05/2023]
Abstract
A growing body of evidence demonstrates that the brain can reorganize dramatically following sensory loss. Although the existence of such neuroplastic crossmodal changes is not in doubt, the functional significance of these changes remains unclear. The dominant belief is that reorganization is compensatory. However, results thus far do not unequivocally indicate that sensory deprivation results in markedly enhanced abilities in other senses. Here, we consider alternative reasons besides sensory compensation that might drive the brain to reorganize after sensory loss. One such possibility is that the cortex reorganizes not to confer functional benefits, but to avoid undesirable physiological consequences of sensory deafferentation. Empirical assessment of the validity of this and other possibilities defines a rich program for future research.
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Affiliation(s)
- Amy Kalia Singh
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Flip Phillips
- Department of Psychology and Neuroscience, Skidmore College, Saratoga Springs, NY, USA
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Pawan Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
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27
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Rinaldi L, Merabet LB, Vecchi T, Cattaneo Z. The spatial representation of number, time, and serial order following sensory deprivation: A systematic review. Neurosci Biobehav Rev 2018; 90:371-380. [PMID: 29746876 DOI: 10.1016/j.neubiorev.2018.04.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 03/15/2018] [Accepted: 04/27/2018] [Indexed: 11/16/2022]
Abstract
The spatial representation of numerical and temporal information is thought to be rooted in our multisensory experiences. Accordingly, we may expect visual or auditory deprivation to affect the way we represent numerical magnitude and time spatially. Here, we systematically review recent findings on how blind and deaf individuals represent abstract concepts such as magnitude and time (e.g., past/future, serial order of events) in a spatial format. Interestingly, available evidence suggests that sensory deprivation does not prevent the spatial "re-mapping" of abstract information, but differences compared to normally sighted and hearing individuals may emerge depending on the specific dimension considered (i.e., numerical magnitude, time as past/future, serial order). Herein we discuss how the study of sensory deprived populations may shed light on the specific, and possibly distinct, mechanisms subserving the spatial representation of these concepts. Furthermore, we pinpoint unresolved issues that need to be addressed by future studies to grasp a full understanding of the spatial representation of abstract information associated with visual and auditory deprivation.
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Affiliation(s)
- Luca Rinaldi
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMI, Milan Center for Neuroscience, Milano, Italy.
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA
| | - Tomaso Vecchi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Zaira Cattaneo
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; IRCCS Mondino Foundation, Pavia, Italy.
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Doruk D, Chanes L, Malavera A, Merabet LB, Valero-Cabré A, Fregni F. Cross-modal cueing effects of visuospatial attention on conscious somatosensory perception. Heliyon 2018; 4:e00595. [PMID: 29736429 PMCID: PMC5934691 DOI: 10.1016/j.heliyon.2018.e00595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 01/26/2018] [Accepted: 04/03/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The impact of visuospatial attention on perception with supraliminal stimuli and stimuli at the threshold of conscious perception has been previously investigated. In this study, we assess the cross-modal effects of visuospatial attention on conscious perception for near-threshold somatosensory stimuli applied to the face. METHODS Fifteen healthy participants completed two sessions of a near-threshold cross-modality cue-target discrimination/conscious detection paradigm. Each trial began with an endogenous visuospatial cue that predicted the location of a weak near-threshold electrical pulse delivered to the right or left cheek with high probability (∼75%). Participants then completed two tasks: first, a forced-choice somatosensory discrimination task (felt once or twice?) and then, a somatosensory conscious detection task (did you feel the stimulus and, if yes, where (left/right)?). Somatosensory discrimination was evaluated with the response reaction times of correctly detected targets, whereas the somatosensory conscious detection was quantified using perceptual sensitivity (d') and response bias (beta). A 2 × 2 repeated measures ANOVA was used for statistical analysis. RESULTS In the somatosensory discrimination task (1st task), participants were significantly faster in responding to correctly detected targets (p < 0.001). In the somatosensory conscious detection task (2nd task), a significant effect of visuospatial attention on response bias (p = 0.008) was observed, suggesting that participants had a less strict criterion for stimuli preceded by spatially valid than invalid visuospatial cues. CONCLUSIONS We showed that spatial attention has the potential to modulate the discrimination and the conscious detection of near-threshold somatosensory stimuli as measured, respectively, by a reduction of reaction times and a shift in response bias toward less conservative responses when the cue predicted stimulus location. A shift in response bias indicates possible effects of spatial attention on internal decision processes. The lack of significant results in perceptual sensitivity (d') could be due to weaker effects of endogenous attention on perception.
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Affiliation(s)
- Deniz Doruk
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Lorena Chanes
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA
- Université Pierre et Marie Curie, CNRS UMR 7225-INSERM UMRS S975, Centre de Recherche de l'Institut du Cerveau et la Moelle (ICM), 75013 Paris, France
- Department of Clinical and Health Psychology, Serra Húnter Fellow, Universitat Autònoma de Barcelona, Catalunya, Spain
| | - Alejandra Malavera
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Lotfi B. Merabet
- Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
| | - Antoni Valero-Cabré
- Université Pierre et Marie Curie, CNRS UMR 7225-INSERM UMRS S975, Centre de Recherche de l'Institut du Cerveau et la Moelle (ICM), 75013 Paris, France
- Laboratory for Cerebral Dynamics Plasticity & Rehabilitation, Boston University School of Medicine, Boston, MA 02118, USA
- Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), 08035 Barcelona, Spain
| | - Felipe Fregni
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Bauer CM, Cattaneo Z, Merabet LB. Early blindness is associated with increased volume of the uncinate fasciculus. Eur J Neurosci 2018; 47:427-432. [PMID: 29380459 DOI: 10.1111/ejn.13848] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 01/08/2018] [Accepted: 01/15/2018] [Indexed: 12/13/2022]
Abstract
Growing evidence demonstrates dramatic structural and functional neuroplastic changes in individuals born with early-onset blindness. For example, cross-modal sensory processing at the level of the occipital cortex appears to be associated with adaptive behaviors in the blind. However, detailed studies examining the structural properties of key white matter pathways in other regions of the brain remain limited. Given that blind individuals rely heavily on their sense of hearing, we examined the structural properties of two important pathways involved with auditory processing, namely the uncinate and arcuate fasciculi. High angular resolution diffusion imaging (HARDI) tractography was used to examine structural parameters (i.e., tract volume and quantitative anisotropy, or QA) of these two fasciculi in a sample of 13 early blind individuals and 14 normally sighted controls. Compared to controls, early blind individuals showed a significant increase in the volume of the left uncinate fasciculus. A small area of increased QA was also observed halfway along the right arcuate fasciculus in the blind group. These findings contribute to our knowledge regarding the broad neuroplastic changes associated with profound early blindness.
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Affiliation(s)
- Corinna M Bauer
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 20 Staniford Street, Boston, MA, 02114, USA
| | - Zaira Cattaneo
- Department of Psychology, University of Milano-Biococca, Milan, Italy.,Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 20 Staniford Street, Boston, MA, 02114, USA
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Rinaldi L, Vecchi T, Fantino M, Merabet LB, Cattaneo Z. The ego-moving metaphor of time relies on visual experience: No representation of time along the sagittal space in the blind. J Exp Psychol Gen 2017; 147:444-450. [PMID: 29154613 DOI: 10.1037/xge0000373] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In many cultures, humans conceptualize the past as behind the body and the future as in front. Whether this spatial mapping of time depends on visual experience is still not known. Here, we addressed this issue by testing early-blind participants in a space-time motor congruity task requiring them to classify a series of words as referring to the past or the future by moving their hand backward or forward. Sighted participants showed a preferential mapping between forward movements and future-words and backward movements and past-words. Critically, blind participants did not show any such preferential time-space mapping. Furthermore, in a questionnaire requiring participants to think about past and future events, blind participants did not appear to perceive the future as psychologically closer than the past, as it is the case of sighted individuals. These findings suggest that normal visual development is crucial for representing time along the sagittal space. (PsycINFO Database Record
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Affiliation(s)
- Luca Rinaldi
- Department of Brain and Behavioral Sciences, University of Pavia
| | - Tomaso Vecchi
- Department of Brain and Behavioral Sciences, University of Pavia
| | - Micaela Fantino
- Department of Brain and Behavioral Sciences, University of Pavia
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Harvard Medical School
| | - Zaira Cattaneo
- Center, C. Mondino National Neurological Institute, University of Milano-Bicocca
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31
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Ferrari C, Vecchi T, Merabet LB, Cattaneo Z. Blindness and social trust: The effect of early visual deprivation on judgments of trustworthiness. Conscious Cogn 2017; 55:156-164. [PMID: 28869844 DOI: 10.1016/j.concog.2017.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/17/2017] [Accepted: 08/18/2017] [Indexed: 11/17/2022]
Abstract
Investigating the impact of early visual deprivation on evaluations related to social trust has received little attention to date. This is despite consistent evidence suggesting that early onset blindness may interfere with the normal development of social skills. In this study, we investigated whether early blindness affects judgments of trustworthiness regarding the actions of an agent, with trustworthiness representing the fundamental dimension in the social evaluation. Specifically, we compared performance between a group of early blind individuals with that of sighted controls in their evaluation of trustworthiness of an agent after hearing a pair of two positive or two negative social behaviors (impression formation). Participants then repeated the same evaluation following the presentation of a third (consistent or inconsistent) behavior regarding the same agent (impression updating). Overall, blind individuals tended to give similar evaluations compared to their sighted counterparts. However, they also valued positive behaviors significantly more than sighted controls when forming their impression of an agent's trustworthiness. Moreover, when inconsistent information was provided, blind individuals were more prone to revise their initial evaluation compared to controls. These results suggest that early visual deprivation may have a dramatic effect on the evaluation of social factors such as trustworthiness.
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Affiliation(s)
- C Ferrari
- Department of Psychology, University of Milano-Bicocca, Milan 20126, Italy.
| | - T Vecchi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia 27100, Italy; Brain Connectivity Center, C. Mondino National Neurological Institute, Pavia 27100, Italy
| | - L B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Z Cattaneo
- Department of Psychology, University of Milano-Bicocca, Milan 20126, Italy; Brain Connectivity Center, C. Mondino National Neurological Institute, Pavia 27100, Italy
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32
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Rossi A, Gnesi M, Montomoli C, Chirico G, Malerba L, Merabet LB, Fazzi E. Neonatal Assessment Visual European Grid (NAVEG): Unveiling neurological risk. Infant Behav Dev 2017; 49:21-30. [PMID: 28688291 DOI: 10.1016/j.infbeh.2017.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/05/2017] [Accepted: 06/07/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Andrea Rossi
- Child and Adolescent Neurology and Psychiatry Unit, Children Hospital, ASST Spedali Civili of Brescia, Italy.
| | - Marco Gnesi
- Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, Italy
| | - Cristina Montomoli
- Department of Public Health, Experimental and Forensic Medicine, Section of Biostatistics and Clinical Epidemiology, University of Pavia, Italy
| | - Gaetano Chirico
- Department of Neonatology and Neonatal Intensive Care Unit, Children Hospital, ASST Spedali Civili of Brescia, Italy
| | - Laura Malerba
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | | | - Elisa Fazzi
- Child and Adolescent Neurology and Psychiatry Unit, Children Hospital, ASST Spedali Civili of Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Italy
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Pinto CB, Vélez FGS, French MN, Zeng D, Crandell D, Bolognini N, Merabet LB, Fregni F. STRATEGIES TO ENHANCE RECRUITMENT METHODS IN PHANTOM LIMB PAIN CLINICAL TRIALS. ACTA ACUST UNITED AC 2017; 4:72-79. [PMID: 29683138 DOI: 10.18203/2349-3259.ijct20171917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Phantom Limp Pain (PLP) was first described in 1551. To date, its mechanisms and novel interventions remain mostly untested. Only limited conclusions can be drawn from few and small randomized clinical trials (RCTs) on PLP. In this scenario, recruitment strategies are crucial in order to overcome inherent challenges to recruit PLP subjects for clinical trials. Although there are many methods to enhance recruitment and also retention, in this article we discuss these methods based on a common topic: dissemination. We summarize and discuss 10 strategies of recruitment related to the dissemination of information based on the notion that an increase in trial awareness may lead to both increased recruitment and also increased external generalizability. In addition, in our discussion we included insights based on our experience recruiting PLP patients for our large NIH-sponsored clinical trial. Although specific regulatory considerations need to be considered when choosing the methods of recruitment, which may vary across different countries and Institutional Review Boards (IRBs), these strategies may be applicable to most of research settings.
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Affiliation(s)
- Camila Bonin Pinto
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA.,Department of Neuroscience and Behavior, Psychology Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Faddi Ghassan Saleh Vélez
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - Melanie N French
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - Dian Zeng
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - David Crandell
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - Nadia Bolognini
- Department of Psychology, Milan Center for Neuroscience - NeuroMi, University of Milano-Bicocca, Milano, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA
| | - Felipe Fregni
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
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Bauer CM, Hirsch GV, Zajac L, Koo BB, Collignon O, Merabet LB. Multimodal MR-imaging reveals large-scale structural and functional connectivity changes in profound early blindness. PLoS One 2017; 12:e0173064. [PMID: 28328939 PMCID: PMC5362049 DOI: 10.1371/journal.pone.0173064] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 02/14/2017] [Indexed: 11/21/2022] Open
Abstract
In the setting of profound ocular blindness, numerous lines of evidence demonstrate the existence of dramatic anatomical and functional changes within the brain. However, previous studies based on a variety of distinct measures have often provided inconsistent findings. To help reconcile this issue, we used a multimodal magnetic resonance (MR)-based imaging approach to provide complementary structural and functional information regarding this neuroplastic reorganization. This included gray matter structural morphometry, high angular resolution diffusion imaging (HARDI) of white matter connectivity and integrity, and resting state functional connectivity MRI (rsfcMRI) analysis. When comparing the brains of early blind individuals to sighted controls, we found evidence of co-occurring decreases in cortical volume and cortical thickness within visual processing areas of the occipital and temporal cortices respectively. Increases in cortical volume in the early blind were evident within regions of parietal cortex. Investigating white matter connections using HARDI revealed patterns of increased and decreased connectivity when comparing both groups. In the blind, increased white matter connectivity (indexed by increased fiber number) was predominantly left-lateralized, including between frontal and temporal areas implicated with language processing. Decreases in structural connectivity were evident involving frontal and somatosensory regions as well as between occipital and cingulate cortices. Differences in white matter integrity (as indexed by quantitative anisotropy, or QA) were also in general agreement with observed pattern changes in the number of white matter fibers. Analysis of resting state sequences showed evidence of both increased and decreased functional connectivity in the blind compared to sighted controls. Specifically, increased connectivity was evident between temporal and inferior frontal areas. Decreases in functional connectivity were observed between occipital and frontal and somatosensory-motor areas and between temporal (mainly fusiform and parahippocampus) and parietal, frontal, and other temporal areas. Correlations in white matter connectivity and functional connectivity observed between early blind and sighted controls showed an overall high degree of association. However, comparing the relative changes in white matter and functional connectivity between early blind and sighted controls did not show a significant correlation. In summary, these findings provide complimentary evidence, as well as highlight potential contradictions, regarding the nature of regional and large scale neuroplastic reorganization resulting from early onset blindness.
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Affiliation(s)
- Corinna M. Bauer
- Laboratory for Visual Neuroplasticity. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - Gabriella V. Hirsch
- Laboratory for Visual Neuroplasticity. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
| | - Lauren Zajac
- Center for Biomedical Imaging. Boston University School of Medicine, Boston, MA, United States of America
| | - Bang-Bon Koo
- Center for Biomedical Imaging. Boston University School of Medicine, Boston, MA, United States of America
| | - Olivier Collignon
- Crossmodal Perception and Plasticity Laboratory. University of Trento, Trento, Italy
| | - Lotfi B. Merabet
- Laboratory for Visual Neuroplasticity. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States of America
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Abstract
OBJECTIVE Emotion processing is known to be mediated by a complex network of cortical and subcortical regions with evidence of specialized hemispheric lateralization within the brain. In light of prior evidence indicating that lateralization of cognitive functions (such as language) may depend on normal visual development, we investigated whether the lack of prior visual experience would have an impact on the development of specialized hemispheric lateralization in emotional processing. METHOD We addressed this issue by comparing performance in early blind and sighted controls on a dichotic listening task requiring the detection of specific emotional vocalizations (i.e., suggestive of happiness or sadness) presented independently to either ear. RESULTS Consistent with previous studies, we found that sighted individuals showed enhanced detection of positive vocalizations when presented in the right ear (i.e., processed within the left hemisphere) and negative vocalizations when presented in the left ear (i.e., right hemisphere). It is interesting to note that although blind individuals were as accurate as sighted controls in detecting the valance of the vocalization, performance was not consistent with any pattern of specialized hemispheric lateralization. CONCLUSIONS Overall, these results suggest that although the lack of prior visual experience may not lead to impaired emotion processing performance, the underlying neurophysiological substrate (i.e., degree of special hemispheric lateralization) may depend on normal visual development. (PsycINFO Database Record
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Affiliation(s)
- Lucile Gamond
- Department of Psychology, University of Milano-Bicocca
| | - Tomaso Vecchi
- Department of Brain and Behavioral Sciences, University of Pavia
| | | | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
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36
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Occelli V, Lacey S, Stephens C, Merabet LB, Sathian K. Enhanced verbal abilities in the congenitally blind. Exp Brain Res 2017; 235:1709-1718. [PMID: 28280879 DOI: 10.1007/s00221-017-4931-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/21/2017] [Indexed: 11/28/2022]
Abstract
Numerous studies have found that congenitally blind individuals have better verbal memory than their normally sighted counterparts. However, it is not known whether this reflects superiority of verbal or memory abilities. In order to distinguish between these possibilities, we tested congenitally blind participants and normally sighted control participants, matched for age and education, on a range of verbal and spatial tasks. Congenitally blind participants were significantly better than sighted controls on all the verbal tasks but the groups did not differ significantly on the spatial tasks. Thus, the congenitally blind appear to have superior verbal, but not spatial, abilities. This may reflect greater reliance on verbal information and the involvement of visual cortex in language processing in the congenitally blind.
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Affiliation(s)
- Valeria Occelli
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Simon Lacey
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Careese Stephens
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Rehabilitation R&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, USA
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - K Sathian
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, 30322, USA.
- Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
- Psychology, Emory University, Atlanta, GA, USA.
- Rehabilitation R&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, USA.
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Martín MBC, Santos-Lozano A, Martín-Hernández J, López-Miguel A, Maldonado M, Baladrón C, Bauer CM, Merabet LB. Cerebral versus Ocular Visual Impairment: The Impact on Developmental Neuroplasticity. Front Psychol 2016; 7:1958. [PMID: 28082927 PMCID: PMC5183596 DOI: 10.3389/fpsyg.2016.01958] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/30/2016] [Indexed: 11/13/2022] Open
Abstract
Cortical/cerebral visual impairment (CVI) is clinically defined as significant visual dysfunction caused by injury to visual pathways and structures occurring during early perinatal development. Depending on the location and extent of damage, children with CVI often present with a myriad of visual deficits including decreased visual acuity and impaired visual field function. Most striking, however, are impairments in visual processing and attention which have a significant impact on learning, development, and independence. Within the educational arena, current evidence suggests that strategies designed for individuals with ocular visual impairment are not effective in the case of CVI. We propose that this variance may be related to differences in compensatory neuroplasticity related to the type of visual impairment, as well as underlying alterations in brain structural connectivity. We discuss the etiology and nature of visual impairments related to CVI, and how advanced neuroimaging techniques (i.e., diffusion-based imaging) may help uncover differences between ocular and cerebral causes of visual dysfunction. Revealing these differences may help in developing future strategies for the education and rehabilitation of individuals living with visual impairment.
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Affiliation(s)
- Maria B C Martín
- GIDFYS, European University Miguel de Cervantes Valladolid, Spain
| | - Alejandro Santos-Lozano
- GIDFYS, European University Miguel de CervantesValladolid, Spain; Research Institute of Hospital 12 de Octubre (i+12)Madrid, Spain
| | | | - Alberto López-Miguel
- Refractive Surgery and Visual Rehabilitation, Ophthalmology, Instituto Universitario de Oftalmobiología Aplicada, Eye Institute Valladolid, Spain
| | - Miguel Maldonado
- Refractive Surgery and Visual Rehabilitation, Ophthalmology, Instituto Universitario de Oftalmobiología Aplicada, Eye Institute Valladolid, Spain
| | - Carlos Baladrón
- GIDFYS, European University Miguel de Cervantes Valladolid, Spain
| | - Corinna M Bauer
- Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
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Pinto CB, Saleh Velez FG, Bolognini N, Crandell D, Merabet LB, Fregni F. Optimizing Rehabilitation for Phantom Limb Pain Using Mirror Therapy and Transcranial Direct Current Stimulation: A Randomized, Double-Blind Clinical Trial Study Protocol. JMIR Res Protoc 2016; 5:e138. [PMID: 27383993 PMCID: PMC4954918 DOI: 10.2196/resprot.5645] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/30/2016] [Accepted: 04/18/2016] [Indexed: 12/20/2022] Open
Abstract
Background Despite the multiple available pharmacological and behavioral therapies for the management of chronic phantom limb pain (PLP) in lower limb amputees, treatment for this condition is still a major challenge and the results are mixed. Given that PLP is associated with maladaptive brain plasticity, interventions that promote cortical reorganization such as non-invasive brain stimulation and behavioral methods including transcranial direct current stimulation (tDCS) and mirror therapy (MT), respectively, may prove to be beneficial to control pain in PLP. Due to its complementary effects, a combination of tDCS and MT may result in synergistic effects in PLP. Objective The objective of this study is to evaluate the efficacy of tDCS and MT as a rehabilitative tool for the management of PLP in unilateral lower limb amputees. Methods A prospective, randomized, placebo-controlled, double-blind, factorial, superiority clinical trial will be carried out. Participants will be eligible if they meet the following inclusion criteria: lower limb unilateral traumatic amputees that present PLP for at least 3 months after the amputated limb has completely healed. Participants (N=132) will be randomly allocated to the following groups: (1) active tDCS and active MT, (2) sham tDCS and active MT, (3) active tDCS and sham MT, and (4) sham tDCS and sham MT. tDCS will be applied with the anodal electrode placed over the primary motor cortex (M1) contralateral to the amputation side and the cathode over the contralateral supraorbital area. Stimulation will be applied at the same time of the MT protocol with the parameters 2 mA for 20 minutes. Pain outcome assessments will be performed at baseline, before and after each intervention session, at the end of MT, and in 2 follow-up visits. In order to assess cortical reorganization and correlate with clinical outcomes, participants will undergo functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) before and after the intervention. Results This clinical trial received institutional review board (IRB) approval in July of 2015 and enrollment started in December of 2015. To date 2 participants have been enrolled. The estimate enrollment rate is about 30 to 35 patients per year; thus we expect to complete enrollment in 4 years. Conclusions This factorial design will provide relevant data to evaluate whether tDCS combined with MT is more effective than each therapy alone, as well as with no intervention (sham/sham) in patients with chronic PLP after unilateral lower limb amputation. In addition, this randomized clinical trial will help to investigate the neurophysiological mechanisms underlying the disease, which could potentially provide relevant findings for further management of this chronic condition and also help to optimize the use of this novel intervention. Trial Registration Clinicaltrials.gov NCT02487966; https://clinicaltrials.gov/ct2/show/NCT02487966 (Archived by WebCite at http://www.webcitation.org/6i3GrKMyf)
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Affiliation(s)
- Camila Bonin Pinto
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
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Abstract
Studying the brains of blind individuals provides a unique opportunity to investigate how the brain changes and adapts in response to afferent (input) and efferent (output) demands. We discuss evidence suggesting that regions of the brain normally associated with the processing of visual information undergo remarkable dynamic change in response to blindness. These neuroplastic changes implicate not only processing carried out by the remaining senses but also higher cognitive functions such as language and memory. A strong emphasis is placed on evidence obtained from advanced neuroimaging techniques that allow researchers to identify areas of human brain activity, as well as from lesion approaches (both reversible and irreversible) to address the functional relevance and role of these activated areas. A possible mechanism and conceptual framework for these physiological and behavioral changes is proposed.
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Affiliation(s)
- Amir Amedi
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center
| | - Lotfi B. Merabet
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center
| | - Felix Bermpohl
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center
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40
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Merabet LB, Devaney KJ, Bauer CM, Panja A, Heidary G, Somers DC. Characterizing Visual Field Deficits in Cerebral/Cortical Visual Impairment (CVI) Using Combined Diffusion Based Imaging and Functional Retinotopic Mapping: A Case Study. Front Syst Neurosci 2016; 10:13. [PMID: 26941619 PMCID: PMC4766290 DOI: 10.3389/fnsys.2016.00013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/05/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Kathryn J Devaney
- The Attention and Perception Neuroimaging Laboratory, Department of Psychological and Brain Sciences, Boston University Boston, MA, USA
| | - Corinna M Bauer
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Aparna Panja
- The Attention and Perception Neuroimaging Laboratory, Department of Psychological and Brain Sciences, Boston University Boston, MA, USA
| | - Gena Heidary
- Pediatric Neuro-Ophthalmology Service, Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School Boston, MA, USA
| | - David C Somers
- The Attention and Perception Neuroimaging Laboratory, Department of Psychological and Brain Sciences, Boston University Boston, MA, USA
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Hirsch GV, Bauer CM, Merabet LB. Using structural and functional brain imaging to uncover how the brain adapts to blindness. Ann Neurosci Psychol 2015; 2:5. [PMID: 30288502 PMCID: PMC6168211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Advances in neuroimaging technology have been instrumental in uncovering the dramatic neurological changes that result from blindness, as well as revealing the inner workings of the human brain. Specifically, modern imaging techniques enable us to examine how the brain adapts and "re-wires" itself as a result of changes in behavior, the environment, injury, or disease; a process referred to as neuroplasticity. Following an overview of commonly employed neuroimaging techniques, we discuss structural and functional neuroplastic brain changes associated with profound visual deprivation. In particular, we highlight how associated structural changes often occur within areas that process intact senses (such as hearing, touch, and smell) while functional changes tend to implicate areas of the brain normally ascribed to the processing of visual information. Evidence will primarily focus on profound blindness due to ocular cause, but related work in cerebral/cortical visual impairment (CVI) will also be discussed. The potential importance of these findings within the context of education and rehabilitation is proposed.
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Sánchez J, de Borba Campos M, Espinoza M, Merabet LB. Audio Haptic Videogaming for Developing Wayfinding Skills in Learners Who are Blind. IUI 2014; 2014:199-208. [PMID: 25485312 DOI: 10.1145/2557500.2557519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Interactive digital technologies are currently being developed as a novel tool for education and skill development. Audiopolis is an audio and haptic based videogame designed for developing orientation and mobility (O&M) skills in people who are blind. We have evaluated the cognitive impact of videogame play on O&M skills by assessing performance on a series of behavioral tasks carried out in both indoor and outdoor virtual spaces. Our results demonstrate that the use of Audiopolis had a positive impact on the development and use of O&M skills in school-aged learners who are blind. The impact of audio and haptic information on learning is also discussed.
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Affiliation(s)
- Jaime Sánchez
- Department of Computer Science and Center for Advanced Research in Education (CARE), University of Chile Santiago, Chile
| | - Marcia de Borba Campos
- Faculty of Informatics, Pontifical Catholic University of Rio Grande do Sul Rio Grande do Sul, Brazil
| | - Matías Espinoza
- Department of Computer Science and Center for Advanced Research in Education (CARE), University of Chile Santiago, Chile
| | - Lotfi B Merabet
- Dept. Ophthalmology Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
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43
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Bauer C, Yazzolino L, Hirsch G, Cattaneo Z, Vecchi T, Merabet LB. Neural correlates associated with superior tactile symmetry perception in the early blind. Cortex 2014; 63:104-117. [PMID: 25243993 DOI: 10.1016/j.cortex.2014.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/07/2014] [Accepted: 08/15/2014] [Indexed: 10/24/2022]
Abstract
Symmetry is an organizational principle that is ubiquitous throughout the visual world. However, this property can also be detected through non-visual modalities such as touch. The role of prior visual experience on detecting tactile patterns containing symmetry remains unclear. We compared the behavioral performance of early blind and sighted (blindfolded) controls on a tactile symmetry detection task. The tactile patterns used were similar in design and complexity as in previous visual perceptual studies. The neural correlates associated with this behavioral task were identified with functional magnetic resonance imaging (fMRI). In line with growing evidence demonstrating enhanced tactile processing abilities in the blind, we found that early blind individuals showed significantly superior performance in detecting tactile symmetric patterns compared to sighted controls. Furthermore, comparing patterns of activation between these two groups identified common areas of activation (e.g. superior parietal cortex) but key differences also emerged. In particular, tactile symmetry detection in the early blind was also associated with activation that included peri-calcarine cortex, lateral occipital (LO), and middle temporal (MT) cortex, as well as inferior temporal and fusiform cortex. These results contribute to the growing evidence supporting superior behavioral abilities in the blind, and the neural correlates associated with crossmodal neuroplasticity following visual deprivation.
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Affiliation(s)
- Corinna Bauer
- Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary. Harvard Medical School. 20 Staniford Street. Boston, MA, USA
| | - Lindsay Yazzolino
- Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary. Harvard Medical School. 20 Staniford Street. Boston, MA, USA
| | - Gabriella Hirsch
- Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary. Harvard Medical School. 20 Staniford Street. Boston, MA, USA
| | - Zaira Cattaneo
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1 - 20126, Milano, Italy.,Brain Connectivity Center, National Neurological Institute C. Mondino, Via Mondino 2, Pavia, Italy
| | - Tomaso Vecchi
- Brain Connectivity Center, National Neurological Institute C. Mondino, Via Mondino 2, Pavia, Italy.,. Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta, 6, 27100, Pavia, Italy
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity. Department of Ophthalmology, Massachusetts Eye and Ear Infirmary. Harvard Medical School. 20 Staniford Street. Boston, MA, USA
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44
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Marques LM, Lapenta OM, Merabet LB, Bolognini N, Boggio PS. Tuning and disrupting the brain-modulating the McGurk illusion with electrical stimulation. Front Hum Neurosci 2014; 8:533. [PMID: 25140136 PMCID: PMC4121538 DOI: 10.3389/fnhum.2014.00533] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 06/30/2014] [Indexed: 11/13/2022] Open
Abstract
In the so-called McGurk illusion, when the synchronized presentation of the visual stimulus /ga/ is paired with the auditory stimulus /ba/, people in general hear it as /da/. Multisensory integration processing underlying this illusion seems to occur within the Superior Temporal Sulcus (STS). Herein, we present evidence demonstrating that bilateral cathodal transcranial direct current stimulation (tDCS) of this area can decrease the McGurk illusion-type responses. Additionally, we show that the manipulation of this audio-visual integrated output occurs irrespective of the number of eye-fixations on the mouth of the speaker. Bilateral anodal tDCS of the Parietal Cortex also modulates the illusion, but in the opposite manner, inducing more illusion-type responses. This is the first demonstration of using non-invasive brain stimulation to modulate multisensory speech perception in an illusory context (i.e., both increasing and decreasing illusion-type responses to a verbal audio-visual integration task). These findings provide clear evidence that both the superior temporal and parietal areas contribute to multisensory integration processing related to speech perception. Specifically, STS seems fundamental for the temporal synchronization and integration of auditory and visual inputs. For its part, posterior parietal cortex (PPC) may adjust the arrival of incoming audio and visual information to STS thereby enhancing their interaction in this latter area.
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Affiliation(s)
- Lucas Murrins Marques
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Olivia Morgan Lapenta
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Lotfi B Merabet
- Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, and IRCCS Istituto Auxologico Italiano Milano, Italy
| | - Paulo Sérgio Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
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45
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Bauer CM, Heidary G, Koo BB, Killiany RJ, Bex P, Merabet LB. Abnormal white matter tractography of visual pathways detected by high-angular-resolution diffusion imaging (HARDI) corresponds to visual dysfunction in cortical/cerebral visual impairment. J AAPOS 2014; 18:398-401. [PMID: 25087644 PMCID: PMC4150820 DOI: 10.1016/j.jaapos.2014.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/18/2014] [Accepted: 03/23/2014] [Indexed: 11/29/2022]
Abstract
Cortical (cerebral) visual impairment (CVI) is characterized by visual dysfunction associated with damage to the optic radiations and/or visual cortex. Typically it results from pre- or perinatal hypoxic damage to postchiasmal visual structures and pathways. The neuroanatomical basis of this condition remains poorly understood, particularly with regard to how the resulting maldevelopment of visual processing pathways relates to observations in the clinical setting. We report our investigation of 2 young adults diagnosed with CVI and visual dysfunction characterized by difficulties related to visually guided attention and visuospatial processing. Using high-angular-resolution diffusion imaging (HARDI), we characterized and compared their individual white matter projections of the extrageniculo-striate visual system with a normal-sighted control. Compared to a sighted control, both CVI cases revealed a striking reduction in association fibers, including the inferior frontal-occipital fasciculus as well as superior and inferior longitudinal fasciculi. This reduction in fibers associated with the major pathways implicated in visual processing may provide a neuroanatomical basis for the visual dysfunctions observed in these patients.
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Affiliation(s)
- Corinna M Bauer
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Gena Heidary
- Pediatric Neuro-Ophthalmology Service, Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston
| | - Bang-Bon Koo
- Center for Biomedical Imaging, Boston University School of Medicine, Boston
| | - Ronald J Killiany
- Center for Biomedical Imaging, Boston University School of Medicine, Boston
| | - Peter Bex
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary-Schepens Eye Research Institute, Harvard Medical School, Boston
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
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Cattaneo Z, Bona S, Monegato M, Pece A, Vecchi T, Herbert AM, Merabet LB. Visual symmetry perception in early onset monocular blindness. Visual Cognition 2014. [DOI: 10.1080/13506285.2014.938712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Affiliation(s)
- Nyssa Connell
- From the VA Boston Healthcare System and New England College of Optometry (N.C.); and The Laboratory for Visual Neuroplasticity (L.B.M.), Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
| | - Lotfi B Merabet
- From the VA Boston Healthcare System and New England College of Optometry (N.C.); and The Laboratory for Visual Neuroplasticity (L.B.M.), Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
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48
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Cattaneo Z, Lega C, Gardelli C, Merabet LB, Cela-Conde CJ, Nadal M. The role of prefrontal and parietal cortices in esthetic appreciation of representational and abstract art: a TMS study. Neuroimage 2014; 99:443-50. [PMID: 24857715 DOI: 10.1016/j.neuroimage.2014.05.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 10/25/2022] Open
Abstract
To explain the biological foundations of art appreciation is to explain one of our species' distinctive traits. Previous neuroimaging and electrophysiological studies have pointed to the prefrontal and the parietal cortex as two critical regions mediating esthetic appreciation of visual art. In this study, we applied transcranial magnetic stimulation (TMS) over the left prefrontal cortex and the right posterior parietal cortex while participants were evaluating whether they liked, and by how much, a particular painting. By depolarizing cell membranes in the targeted regions, TMS transiently interferes with the activity of specific cortical areas, which allows clarifying their role in a given task. Our results show that both regions play a fundamental role in mediating esthetic appreciation. Critically though, the effects of TMS varied depending on the type of art considered (i.e. representational vs. abstract) and on participants' a-priori inclination toward one or the other.
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Affiliation(s)
- Zaira Cattaneo
- Department of Psychology, University of Milano - Bicocca, Milano, Italy; Brain Connectivity Center, IRCCS Mondino, Pavia, Italy.
| | - Carlotta Lega
- Department of Psychology, University of Milano - Bicocca, Milano, Italy
| | - Chiara Gardelli
- Department of Psychology, University of Milano - Bicocca, Milano, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, MA Eye and Ear Infirmary, Harvard Medical School, Boston, USA
| | | | - Marcos Nadal
- Department of Basic Psychological Research and Research Methods, University of Vienna, Austria
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49
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Connors EC, Chrastil ER, Sánchez J, Merabet LB. Virtual environments for the transfer of navigation skills in the blind: a comparison of directed instruction vs. video game based learning approaches. Front Hum Neurosci 2014; 8:223. [PMID: 24822044 PMCID: PMC4013463 DOI: 10.3389/fnhum.2014.00223] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 03/30/2014] [Indexed: 11/13/2022] Open
Abstract
For profoundly blind individuals, navigating in an unfamiliar building can represent a significant challenge. We investigated the use of an audio-based, virtual environment called Audio-based Environment Simulator (AbES) that can be explored for the purposes of learning the layout of an unfamiliar, complex indoor environment. Furthermore, we compared two modes of interaction with AbES. In one group, blind participants implicitly learned the layout of a target environment while playing an exploratory, goal-directed video game. By comparison, a second group was explicitly taught the same layout following a standard route and instructions provided by a sighted facilitator. As a control, a third group interacted with AbES while playing an exploratory, goal-directed video game however, the explored environment did not correspond to the target layout. Following interaction with AbES, a series of route navigation tasks were carried out in the virtual and physical building represented in the training environment to assess the transfer of acquired spatial information. We found that participants from both modes of interaction were able to transfer the spatial knowledge gained as indexed by their successful route navigation performance. This transfer was not apparent in the control participants. Most notably, the game-based learning strategy was also associated with enhanced performance when participants were required to find alternate routes and short cuts within the target building suggesting that a ludic-based training approach may provide for a more flexible mental representation of the environment. Furthermore, outcome comparisons between early and late blind individuals suggested that greater prior visual experience did not have a significant effect on overall navigation performance following training. Finally, performance did not appear to be associated with other factors of interest such as age, gender, and verbal memory recall. We conclude that the highly interactive and immersive exploration of the virtual environment greatly engages a blind user to develop skills akin to positive near transfer of learning. Learning through a game play strategy appears to confer certain behavioral advantages with respect to how spatial information is acquired and ultimately manipulated for navigation.
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Affiliation(s)
- Erin C Connors
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Elizabeth R Chrastil
- Department of Psychology, Center for Memory and Brain, Boston University Boston, MA, USA
| | - Jaime Sánchez
- Department of Computer Science, Center for Advanced Research in Education, University of Chile Santiago, Chile
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
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50
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Lega C, Cattaneo Z, Merabet LB, Vecchi T, Cucchi S. The effect of musical expertise on the representation of space. Front Hum Neurosci 2014; 8:250. [PMID: 24795605 PMCID: PMC4006044 DOI: 10.3389/fnhum.2014.00250] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/04/2014] [Indexed: 11/13/2022] Open
Abstract
Consistent evidence suggests that pitch height may be represented in a spatial format, having both a vertical and a horizontal representation. The spatial representation of pitch height results into response compatibility effects for which high pitch tones are preferentially associated to up-right responses, and low pitch tones are preferentially associated to down-left responses (i.e., the Spatial-Musical Association of Response Codes (SMARC) effect), with the strength of these associations depending on individuals’ musical skills. In this study we investigated whether listening to tones of different pitch affects the representation of external space, as assessed in a visual and haptic line bisection paradigm, in musicians and non musicians. Low and high pitch tones affected the bisection performance in musicians differently, both when pitch was relevant and irrelevant for the task, and in both the visual and the haptic modality. No effect of pitch height was observed on the bisection performance of non musicians. Moreover, our data also show that musicians present a (supramodal) rightward bisection bias in both the visual and the haptic modality, extending previous findings limited to the visual modality, and consistent with the idea that intense practice with musical notation and bimanual instrument training affects hemispheric lateralization.
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Affiliation(s)
- Carlotta Lega
- Department of Psychology, University of Milano-Bicocca Milano, Italy
| | - Zaira Cattaneo
- Department of Psychology, University of Milano-Bicocca Milano, Italy ; Brain Connectivity Center, National Neurological Institute C. Mondino Pavia, Italy
| | - Lotfi B Merabet
- The Laboratory for Visual Neuroplasticity, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School Boston, MA, USA
| | - Tomaso Vecchi
- Brain Connectivity Center, National Neurological Institute C. Mondino Pavia, Italy ; Department of Brain and Behavioural Sciences, University of Pavia Pavia, Italy
| | - Silvia Cucchi
- Department of Brain and Behavioural Sciences, University of Pavia Pavia, Italy
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