Functional specialization for auditory-spatial processing in the occipital cortex of congenitally blind humans.

The study of the congenitally blind (CB) represents a unique opportunity to explore experience-dependant plasticity in a sensory region deprived of its natural inputs since birth. Although several studies have shown occipital regions of CB to be involved in nonvisual processing, whether the functional organization of the visual cortex observed in sighted individuals (SI) is maintained in the rewired occipital regions of the blind has only been recently investigated. In the present functional MRI study, we compared the brain activity of CB and SI processing either the spatial or the pitch properties of sounds carrying information in both domains (i.e., the same sounds were used in both tasks), using an adaptive procedure specifically designed to adjust for performance level. In addition to showing a substantial recruitment of the occipital cortex for sound processing in CB, we also demonstrate that auditory-spatial processing mainly recruits the right cuneus and the right middle occipital gyrus, two regions of the dorsal occipital stream known to be involved in visuospatial/motion processing in SI. Moreover, functional connectivity analyses revealed that these reorganized occipital regions are part of an extensive brain network including regions known to underlie audiovisual spatial abilities (i.e., intraparietal sulcus, superior frontal gyrus). We conclude that some regions of the right dorsal occipital stream do not require visual experience to develop a specialization for the processing of spatial information and to be functionally integrated in a preexisting brain network dedicated to this ability.

The ventriloquist in periphery: impact of eccentricity-related reliability on audio-visual localization.

The relative reliability of separate sensory estimates influences the way they are merged into a unified percept. We investigated how eccentricity-related changes in reliability of auditory and visual stimuli influence their integration across the entire frontal space. First, we surprisingly found that despite a strong decrease in auditory and visual unisensory localization abilities in periphery, the redundancy gain resulting from the congruent presentation of audio-visual targets was not affected by stimuli eccentricity. This result therefore contrasts with the common prediction that a reduction in sensory reliability necessarily induces an enhanced integrative gain. Second, we demonstrate that the visual capture of sounds observed with spatially incongruent audio-visual targets (ventriloquist effect) steadily decreases with eccentricity, paralleling a lowering of the relative reliability of unimodal visual over unimodal auditory stimuli in periphery. Moreover, at all eccentricities, the ventriloquist effect positively correlated with a weighted combination of the spatial resolution obtained in unisensory conditions. These findings support and extend the view that the localization of audio-visual stimuli relies on an optimal combination of auditory and visual information according to their respective spatial reliability. All together, these results evidence that the external spatial coordinates of multisensory events relative to an observer's body (e.g., eyes' or head's position) influence how this information is merged, and therefore determine the perceptual outcome.

Patients' perceptions on active surveillance for the treatment of small renal masses.

BACKGROUND: Most patients diagnosed with a small renal mass (SRM) are treated with definitive treatments such as surgery or thermal ablation. Given that some SRMs are benign or have low metastatic potential, active surveillance seeks to reduce the overtreatment and the potential complications. Active surveillance is an alternative that is being increasingly considered. Active surveillance has already been shown to be effective, but there is a current knowledge gap regarding patients' perceptions of active surveillance and factors influencing their decision. OBJECTIVE: To describe patients' perceptions of active surveillance of SRMs and to identify factors influencing those perceptions. DESIGN, SETTING, AND PARTICIPANTS: This multicenter descriptive qualitative study recruited patients diagnosed with a renal mass from three institutions, using purposeful sampling. Data were collected using focus group discussions, which were recorded and transcribed. A mixed thematic analysis was performed. RESULTS: Six focus group discussions were conducted with a total of 24 participants. Participants perceived active surveillance as an option to avoid definitive treatments and their potential risks. Active surveillance was, however, perceived to be a temporary solution that would affect their chance of survival and their quality of life. Seven factors were documented as influencing patients' perceptions of active surveillance, the most important being their physician's recommendation. CONCLUSIONS: Perceptions of patients with SRMs toward active surveillance varies among individuals. The development of more patient-oriented information tools is needed to educate patients, to reduce physician influence on the decision-making process and to ensure that the patients' decision reflects their own values and preferences.

Within- and Cross-Modal Integration and Attention in the Autism Spectrum.

Although impairment in sensory integration is suggested in the autism spectrum (AS), empirical evidences remain equivocal. We assessed the integration of low-level visual and tactile information within and across modalities in AS and typically developing (TD) individuals. TD individuals demonstrated increased redundancy gain for cross-modal relative to double tactile or visual stimulation, while AS individuals showed similar redundancy gain between cross-modal and double tactile conditions. We further observed that violation of the race model inequality for cross-modal conditions was observed over a wider proportion of the reaction times distribution in TD than AS individuals. Importantly, the reduced cross-modal integration in AS individuals was not related to atypical attentional shift between modalities. We conclude that AS individuals displays selective decrease of cross-modal integration of low-level information.

Odor localization and sniffing.

For humans, the localization of an odorant seems only possible if the odorant also stimulates the trigeminal nerve. There is, however, some evidence that active sniffing may affect this ability and facilitate the localization of pure odorants. Therefore, we tested the ability of 40 subjects to localize a pure odorant and a mixed olfactory/trigeminal stimulus under 2 stimulation conditions: either odors were blown into the subjects' nostrils (passive) or subjects had to actively sniff the odors (active). Subjects could only reliably localize the mixed olfactory/trigeminal stimulus. However, we found a significant interaction between stimulation condition and nature of the odorant. So, the mixed olfactory/trigeminal stimulus was more localizable in the passive condition, whereas the pure odorant was better localized in the active condition. Interestingly, subjects had more correct answers after stimulation of the right nostril than of the left nostril (where subjects performed significantly below chance when stimulated with the pure odorant), suggesting possible laterality effects. These results suggest that active sniffing may affect our ability to localize odors. Other than mixed olfactory trigeminal stimuli, pure odorants are, however, not localizable even in active condition of sniffing.

Recollection rejection of new items in individuals with first-episode psychosis.

Many objects seen for the first time look familiar because they resemble known objects. To overcome this feeling of familiarity and detect novelty, memories of known objects must be recollected and compared to new objects. This experiment examines whether recollection performed when perceiving new items (i.e., recollection rejection) is abnormal in people who experienced a first episode of psychosis (FEP). Recollection of old items is impaired in this clinical population but it has not yet been demonstrated that this impairment influences the processing of new items. Eighteen FEP participants and 19 healthy controls completed an episodic memory task consisting of a study phase and a recognition phase. All the new objects looked familiar because they resembled the studied objects. Brain activity underlying false recognition and correct rejection of new objects was measured with functional resonance magnetic imaging and compared across groups. Behavioral responses to new items were not significantly different between the 2 groups. However, the between-groups analysis revealed significant differences in brain activity in the left middle frontal gyrus, the left inferior parietal lobule, the right superior parietal lobule, and the right temporal fusiform gyrus during the correct rejection of new items. This activity seems related to recollection rejection and suggests that FEP patients do not normally recollect information of past events when they process new items.

Multilevel alterations in the processing of audio-visual emotion expressions in autism spectrum disorders.

The abilities to recognize and integrate emotions from another person's facial and vocal expressions are fundamental cognitive skills involved in the effective regulation of social interactions. Deficits in such abilities have been suggested as a possible source for certain atypical social behaviors manifested by persons with autism spectrum disorders (ASD). In the present study, we assessed the recognition and integration of emotional expressions in ASD using a validated set of ecological stimuli comprised of dynamic visual and auditory (non-verbal) vocal clips. Autistic participants and typically developing controls (TD) were asked to discriminate between clips depicting expressions of disgust and fear presented either visually, auditorily or audio-visually. The group of autistic participants was less efficient to discriminate emotional expressions across all conditions (unimodal and bimodal). Moreover, they necessitated a higher signal-to-noise ratio for the discrimination of visual or auditory presentations of disgust versus fear expressions. These results suggest an altered sensitivity to emotion expressions in this population that is not modality-specific. In addition, the group of autistic participants benefited from exposure to bimodal information to a lesser extent than did the TD group, indicative of a decreased multisensory gain in this population. These results are the first to compellingly demonstrate joint alterations for both the perception and the integration of multisensory emotion expressions in ASD.

Reduced multisensory facilitation in persons with autism.

Although the literature concerning auditory and visual perceptual capabilities in the autism spectrum is growing, our understanding of multisensory integration (MSI) is rather limited. In the present study, we assessed MSI in autism by measuring whether participants benefited from an auditory cue presented in synchrony with the color change of a target during a complex visual search task. The synchronous auditory pip typically increases search efficacy (pip and pop effect), indicative of the beneficial use of sensory input from both modalities. We found that for conditions without auditory information, autistic participants were better at visual search compared to neurotypical participants. Importantly, search efficiency was increased by the presence of auditory pip for neurotypical participants only. The simultaneous occurrence of superior unimodal performance with altered audio-visual integration in autism suggests autonomous sensory processing in this population.

Early visual deprivation alters multisensory processing in peripersonal space.

Multisensory peripersonal space develops in a maturational process that is thought to be influenced by early sensory experience. We investigated the role of vision in the effective development of audiotactile interactions in peripersonal space. Early blind (EB), late blind (LB) and sighted control (SC) participants were asked to lateralize auditory, tactile and audiotactile stimuli. The experiment was conducted with the hands uncrossed or crossed over the body midline in order to alter the relationship between personal and peripersonal spatial representations. First, we observed that the crossed posture results in a greater detrimental effect for tactile performance in sighted subjects but a greater deficit in auditory performance in early blind ones. This result is interpreted as evidence for a visually driven developmental process that automatically remaps tactile and proprioceptive spatial representation into an external framework. Second, we demonstrate that improved reaction times observed in the bimodal conditions in SC and LB exceeds that predicted by probability summation in both conditions of postures, indicating neural integration of different sensory information. In EB, nonlinear summation was obtained in the uncrossed but not in the crossed posture. We argue that the default use of an anatomically anchored reference system in EB prevents effective audiotactile interactions in the crossed posture due to the poorly aligned spatial coordinates of these two modalities in such conditions. Altogether, these results provide compelling evidence for the critical role of early vision in the development of multisensory perception and action control in peripersonal space.