Sound-encoded faces activate the left fusiform face area in the early blind.

Face perception in humans and nonhuman primates is accomplished by a patchwork of specialized cortical regions. How these regions develop has remained controversial. In sighted individuals, facial information is primarily conveyed via the visual modality. Early blind individuals, on the other hand, can recognize shapes using auditory and tactile cues. Here we demonstrate that such individuals can learn to distinguish faces from houses and other shapes by using a sensory substitution device (SSD) presenting schematic faces as sound-encoded stimuli in the auditory modality. Using functional MRI, we then asked whether a face-selective brain region like the fusiform face area (FFA) shows selectivity for faces in the same subjects, and indeed, we found evidence for preferential activation of the left FFA by sound-encoded faces. These results imply that FFA development does not depend on experience with visual faces per se but may instead depend on exposure to the geometry of facial configurations.

A key role of the prefrontal cortex in the maintenance of chronic tinnitus: An fMRI study using a Stroop task.

INTRODUCTION: Since we recently showed in behavioural tasks that the top-down cognitive control was specifically altered in tinnitus sufferers, here we wanted to establish the link between this impaired executive function and brain alterations in the frontal cortex in tinnitus patients. METHOD: Using functional magnetic resonance imaging (fMRI), we monitored the brain activity changes in sixteen tinnitus patients (TP) and their control subjects (CS) while they were performing a spatial Stroop task, both in audition and vision. RESULTS: We observed that TP differed from CS in their functional recruitment of the dorsolateral prefrontal cortex (dlPFC, BA46), the cingulate gyrus and the ventromedial prefrontal cortex (vmPFC, BA10). This recruitment was higher during interference conditions in tinnitus participants than in controls, whatever the sensory modality. Furthermore, the brain activity level in the right dlPFC and vmPFC correlated with the performance in the Stroop task in TP. CONCLUSION: Due to the direct link between poor executive functions and prefrontal cortex alterations in TP, we postulate that a lack of inhibitory modulation following an impaired top-down cognitive control may maintain tinnitus by hampering habituation mechanisms. This deficit in executive functions caused by prefrontal cortex alterations would be a key-factor in the generation and persistence of tinnitus.

Hearing, feeling or seeing a beat recruits a supramodal network in the auditory dorsal stream.

Hearing a beat recruits a wide neural network that involves the auditory cortex and motor planning regions. Perceiving a beat can potentially be achieved via vision or even touch, but it is currently not clear whether a common neural network underlies beat processing. Here, we used functional magnetic resonance imaging (fMRI) to test to what extent the neural network involved in beat processing is supramodal, that is, is the same in the different sensory modalities. Brain activity changes in 27 healthy volunteers were monitored while they were attending to the same rhythmic sequences (with and without a beat) in audition, vision and the vibrotactile modality. We found a common neural network for beat detection in the three modalities that involved parts of the auditory dorsal pathway. Within this network, only the putamen and the supplementary motor area (SMA) showed specificity to the beat, while the brain activity in the putamen covariated with the beat detection speed. These results highlighted the implication of the auditory dorsal stream in beat detection, confirmed the important role played by the putamen in beat detection and indicated that the neural network for beat detection is mostly supramodal. This constitutes a new example of convergence of the same functional attributes into one centralized representation in the brain.

Cortical Plasticity and Olfactory Function in Early Blindness.

Over the last decade, functional brain imaging has provided insight to the maturation processes and has helped elucidate the pathophysiological mechanisms involved in brain plasticity in the absence of vision. In case of congenital blindness, drastic changes occur within the deafferented "visual" cortex that starts receiving and processing non visual inputs, including olfactory stimuli. This functional reorganization of the occipital cortex gives rise to compensatory perceptual and cognitive mechanisms that help blind persons achieve perceptual tasks, leading to superior olfactory abilities in these subjects. This view receives support from psychophysical testing, volumetric measurements and functional brain imaging studies in humans, which are presented here.

Altered inhibitory control and increased sensitivity to cross-modal interference in tinnitus during auditory and visual tasks.

Tinnitus is the perception of sound in the absence of external stimulus. Currently, the pathophysiology of tinnitus is not fully understood, but recent studies indicate that alterations in the brain involve non-auditory areas, including the prefrontal cortex. In experiment 1, we used a go/no-go paradigm to evaluate the target detection speed and the inhibitory control in tinnitus participants (TP) and control subjects (CS), both in unimodal and bimodal conditions in the auditory and visual modalities. We also tested whether the sound frequency used for target and distractors affected the performance. We observed that TP were slower and made more false alarms than CS in all unimodal auditory conditions. TP were also slower than CS in the bimodal conditions. In addition, when comparing the response times in bimodal and auditory unimodal conditions, the expected gain in bimodal conditions was present in CS, but not in TP when tinnitus-matched frequency sounds were used as targets. In experiment 2, we tested the sensitivity to cross-modal interference in TP during auditory and visual go/no-go tasks where each stimulus was preceded by an irrelevant pre-stimulus in the untested modality (e.g. high frequency auditory pre-stimulus in visual no/no-go condition). We observed that TP had longer response times than CS and made more false alarms in all conditions. In addition, the highest false alarm rate occurred in TP when tinnitus-matched/high frequency sounds were used as pre-stimulus. We conclude that the inhibitory control is altered in TP and that TP are abnormally sensitive to cross-modal interference, reflecting difficulties to ignore irrelevant stimuli. The fact that the strongest interference effect was caused by tinnitus-like auditory stimulation is consistent with the hypothesis according to which such stimulations generate emotional responses that affect cognitive processing in TP. We postulate that executive functions deficits play a key-role in the perception and maintenance of tinnitus.

Altered top-down cognitive control and auditory processing in tinnitus: evidences from auditory and visual spatial stroop.

PURPOSE: Tinnitus is the perception of a sound in the absence of external stimulus. Currently, the pathophysiology of tinnitus is not fully understood, but recent studies indicate that alterations in the brain involve non-auditory areas, including the prefrontal cortex. Here, we hypothesize that these brain alterations affect top-down cognitive control mechanisms that play a role in the regulation of sensations, emotions and attention resources. METHODS: The efficiency of the executive control as well as simple reaction speed and processing speed were evaluated in tinnitus participants (TP) and matched control subjects (CS) in both the auditory and the visual modalities using a spatial Stroop paradigm. RESULTS: TP were slower and less accurate than CS during both the auditory and the visual spatial Stroop tasks, while simple reaction speed and stimulus processing speed were affected in TP in the auditory modality only. CONCLUSIONS: Tinnitus is associated both with modality-specific deficits along the auditory processing system and an impairment of cognitive control mechanisms that are involved both in vision and audition (i.e. that are supra-modal). We postulate that this deficit in the top-down cognitive control is a key-factor in the development and maintenance of tinnitus and may also explain some of the cognitive difficulties reported by tinnitus sufferers.

Relationship Between Cortical Thickness and Functional Activation in the Early Blind.

Early blindness results in both structural and functional changes of the brain. However, these changes have rarely been studied in relation to each other. We measured alterations in cortical thickness (CT) caused by early visual deprivation and their relationship with cortical activity. Structural and functional magnetic resonance imaging was performed in 12 early blind (EB) humans and 12 sighted controls (SC). Experimental conditions included one-back tasks for auditory localization and pitch identification, and a simple sound-detection task. Structural and functional data were analyzed in a whole-brain approach and within anatomically defined regions of interest in sensory areas of the spared (auditory) and deprived (visual) modalities. Functional activation during sound-localization or pitch-identification tasks correlated negatively with CT in occipital areas of EB (calcarine sulcus, lingual gyrus, superior and middle occipital gyri, and cuneus) and in nonprimary auditory areas of SC. These results suggest a link between CT and activation and demonstrate that the relationship between cortical structure and function may depend on early sensory experience, probably via selective pruning of exuberant connections. Activity-dependent effects of early sensory deprivation and long-term practice are superimposed on normal maturation and aging. Together these processes shape the relationship between brain structure and function over the lifespan.

Improved beat asynchrony detection in early blind individuals.

Although early blind (EB) individuals are thought to have a better musical sense than sighted subjects, no study has investigated the musical rhythm and beat processing abilities in EB individuals. Using an adaptive 'up and down' procedure, we measured the beat asynchrony detection threshold and the duration discrimination threshold, in the auditory and vibrotactile modalities in both EB and sighted control (SC) subjects matched for age, gender, and musical experience. We observed that EB subjects were better than SC in the beat asynchrony detection task; that is, they showed lower thresholds than SC, both in the auditory and in the vibrotactile modalities. In addition, EB subjects had a lower threshold than SC for duration discrimination in the vibrotactile modality only. These improved beat asynchrony detection abilities may contribute to the known excellent musical abilities often observed in many blind subjects.

Tinnitus specifically alters the top-down executive control sub-component of attention: evidence from the Attention Network Task.

Tinnitus can be defined as the perception of noxious disabling internal sounds in the absence of external stimulation. While most individuals with tinnitus show some habituation to these internal sounds, many of them experience significant daily life impairments. There is now convincing evidence that impairment in attentional processes may be involved in tinnitus, particularly by hampering the habituation mechanism related to the prefrontal cortex activity. However, it is thus still unclear whether this deficit is an alteration of alerting and orienting attentional abilities, or the consequence of more general alteration in the executive control of attention. In the present study, 20 tinnitus patients were compared to 20 matched healthy controls using the Attention Network Test, to clarify which attentional networks, among alerting, orienting, and executive networks, show differences between the groups. The results showed that patients with tinnitus do not present a general attentional deficit but rather a specific deficit for top-down executive control of attention. This deficit was highly correlated with patient characteristics of years of tinnitus duration and the frequency of coping strategies employed to alleviate tinnitus distress in daily life. These findings are discussed in terms of recent neurobiological models suggesting that prefrontal cortex activity might especially be related to tinnitus habituation. Therapeutic perspectives focusing both on rehabilitation of the executive control of attention and neuromodulation are also discussed.

Does visual experience influence the spatial distribution of auditory attention?

Sighted individuals are less accurate and slower to localize sounds coming from the peripheral space than sounds coming from the frontal space. This specific bias in favour of the frontal auditory space seems reduced in early blind individuals, who are particularly better than sighted individuals at localizing sounds coming from the peripheral space. Currently, it is not clear to what extent this bias in the auditory space is a general phenomenon or if it applies only to spatial processing (i.e. sound localization). In our approach we compared the performance of early blind participants with that of sighted subjects during a frequency discrimination task with sounds originating either from frontal or peripheral locations. Results showed that early blind participants discriminated faster than sighted subjects both peripheral and frontal sounds. In addition, sighted subjects were faster at discriminating frontal sounds than peripheral ones, whereas early blind participants showed equal discrimination speed for frontal and peripheral sounds. We conclude that the spatial bias observed in sighted subjects reflects an unbalance in the spatial distribution of auditory attention resources that is induced by visual experience.

Cortical plasticity and preserved function in early blindness.

The "neural Darwinism" theory predicts that when one sensory modality is lacking, as in congenital blindness, the target structures are taken over by the afferent inputs from other senses that will promote and control their functional maturation (Edelman, 1993). This view receives support from both cross-modal plasticity experiments in animal models and functional imaging studies in man, which are presented here.

Right occipital cortex activation correlates with superior odor processing performance in the early blind.

Using functional magnetic resonance imaging (fMRI) in ten early blind humans, we found robust occipital activation during two odor-processing tasks (discrimination or categorization of fruit and flower odors), as well as during control auditory-verbal conditions (discrimination or categorization of fruit and flower names). We also found evidence for reorganization and specialization of the ventral part of the occipital cortex, with dissociation according to stimulus modality: the right fusiform gyrus was most activated during olfactory conditions while part of the left ventral lateral occipital complex showed a preference for auditory-verbal processing. Only little occipital activation was found in sighted subjects, but the same right-olfactory/left-auditory-verbal hemispheric lateralization was found overall in their brain. This difference between the groups was mirrored by superior performance of the blind in various odor-processing tasks. Moreover, the level of right fusiform gyrus activation during the olfactory conditions was highly correlated with individual scores in a variety of odor recognition tests, indicating that the additional occipital activation may play a functional role in odor processing.

Dysregulation of limbic and auditory networks in tinnitus.

Tinnitus is a common disorder characterized by ringing in the ear in the absence of sound. Converging evidence suggests that tinnitus pathophysiology involves damage to peripheral and/or central auditory pathways. However, whether auditory system dysfunction is sufficient to explain chronic tinnitus is unclear, especially in light of evidence implicating other networks, including the limbic system. Using functional magnetic resonance imaging and voxel-based morphometry, we assessed tinnitus-related functional and anatomical anomalies in auditory and limbic networks. Moderate hyperactivity was present in the primary and posterior auditory cortices of tinnitus patients. However, the nucleus accumbens exhibited the greatest degree of hyperactivity, specifically to sounds frequency-matched to patients' tinnitus. Complementary structural differences were identified in ventromedial prefrontal cortex, another limbic structure heavily connected to the nucleus accumbens. Furthermore, tinnitus-related anomalies were intercorrelated in the two limbic regions and between limbic and primary auditory areas, indicating the importance of auditory-limbic interactions in tinnitus.

Development of a fully automated system for delivering odors in an MRI environment.

We describe the development and evaluation of a computer-controlled system for delivering odors in a magnetic resonance imaging (MRI) environment. The system allows a timely presentation of different odors in synchrony with MRI sequences and participant's inspiration phase. The rise/fall time of odor deliverance has been optimized to generate prompt and strong stimulations. Equipped with a user-friendly programming interface, the system can be used reliably in a wide range of experimental paradigms. We have paid particular attention to developing a portable system that is relatively easy, rapid, and inexpensive to replicate. The equipment has been tested in a 3-Tesla MRI in a boxcar paradigm, in which stimulation conditions alternated with rest periods (no stimulation). The experiment demonstrated the good functioning of the device and its efficiency in producing the expected activation in the olfactory cortex; it also revealed some methodological and technical aspects to be improved.

Increased olfactory bulb volume and olfactory function in early blind subjects.

It has been shown that the volume of the olfactory bulb (OB) changes with function. The aim of this study was to investigate whether the OB volume and the olfactory function in early blind (EB) subjects increase compared with controls. Psychophysical testing of olfactory performances and OB volumetric measurements assessed by an MRI scan were studied. Quantitative olfactory function expressed in the odor discrimination and odor-free identification scores was higher in EB subjects compared with controls. The mean of right, left and total OB volume was 65.40, 75.48, and 140.89 mm, respectively for the EB subjects and 54.47, 52.11, and 106.60 mm, respectively for the controls, with these differences being significant. EB subjects have superior olfactory abilities and presented with significantly higher OB volume than the sighted controls. OB plasticity may explain this compensatory mechanism between visual deprivation and enhanced olfactory perception.

Preserved functional specialization for spatial processing in the middle occipital gyrus of the early blind.

The occipital cortex (OC) of early-blind humans is activated during various nonvisual perceptual and cognitive tasks, but little is known about its modular organization. Using functional MRI we tested whether processing of auditory versus tactile and spatial versus nonspatial information was dissociated in the OC of the early blind. No modality-specific OC activation was observed. However, the right middle occipital gyrus (MOG) showed a preference for spatial over nonspatial processing of both auditory and tactile stimuli. Furthermore, MOG activity was correlated with accuracy of individual sound localization performance. In sighted controls, most of extrastriate OC, including the MOG, was deactivated during auditory and tactile conditions, but the right MOG was more activated during spatial than nonspatial visual tasks. Thus, although the sensory modalities driving the neurons in the reorganized OC of blind individuals are altered, the functional specialization of extrastriate cortex is retained regardless of visual experience.

Vision substitution and depth perception: early blind subjects experience visual perspective through their ears.

AIM: Sensory substitution (SS) represents a unique opportunity to provide congenitally blind persons with visual-like experience. Although visual experience influences the way we perceive the external world, little is known about the effects of SS experience. PURPOSE: To investigate the effects of perceptual experience (visual versus sensory substitution) on depth perception through an SS system, object localization abilities of early blind (n = 10), and blindfolded sighted control subjects (n = 20) were assessed before and after a practicing period with a visual-to-auditory SS device. METHOD: During the pre- and post-test, subjects had to replace, by hand, an object previously localized using the device. The practicing phase consisted of three sessions during which subjects tried to localize and grasp an object using the device. Results. At the pre-test, sighted subjects spontaneously used efficiently different pictorial depth cues to estimate object distance while the blind subjects were affected by their lack of visual experience and were significantly less accurate. Post-test showed that the brief practicing phase sufficed to enable blind subjects to acquire the rules of visual depth and to use them efficiently with the device. CONCLUSIONS: These results suggest the possibility to compensate for some effects of early and long-lasting blindness by providing visual-like experience via SS. Theoretical implications are discussed.

Multisensory integration of sounds and vibrotactile stimuli in processing streams for "what" and "where".

The segregation between cortical pathways for the identification and localization of objects is thought of as a general organizational principle in the brain. Yet, little is known about the unimodal versus multimodal nature of these processing streams. The main purpose of the present study was to test whether the auditory and tactile dual pathways converged into specialized multisensory brain areas. We used functional magnetic resonance imaging (fMRI) to compare directly in the same subjects the brain activation related to localization and identification of comparable auditory and vibrotactile stimuli. Results indicate that the right inferior frontal gyrus (IFG) and both left and right insula were more activated during identification conditions than during localization in both touch and audition. The reverse dissociation was found for the left and right inferior parietal lobules (IPL), the left superior parietal lobule (SPL) and the right precuneus-SPL, which were all more activated during localization conditions in the two modalities. We propose that specialized areas in the right IFG and the left and right insula are multisensory operators for the processing of stimulus identity whereas parts of the left and right IPL and SPL are specialized for the processing of spatial attributes independently of sensory modality.

Odour discrimination and identification are improved in early blindness.

Previous studies showed that early blind humans develop superior abilities in the use of their remaining senses, hypothetically due to a functional reorganization of the deprived visual brain areas. While auditory and tactile functions have been investigated for long, little is known about the effects of early visual deprivation on olfactory processing. However, blind humans make an extensive use of olfactory information in their daily life. Here we investigated olfactory discrimination and identification abilities in early blind subjects and age-matched sighted controls. Three levels of cuing were used in the identification task, i.e., free-identification (no cue), categorization (semantic cues) and multiple choice (semantic and phonological cues). Early blind subjects significantly outperformed the controls in odour discrimination, free-identification and categorization. In addition, the larger group difference was observed in the free-identification as compared to the categorization and the multiple choice conditions. This indicated that a better access to the semantic information from odour perception accounted for part of the improved olfactory performances in odour identification in the blind. We concluded that early blind subjects have both improved perceptual abilities and a better access to the information stored in semantic memory than sighted subjects.

Vertical-horizontal illusion present for sighted but not early blind humans using auditory substitution of vision.

This experiment was undertaken to investigate the effect of sensory modality (vision vs. audition) and of visual status (early blind vs. sighted) on susceptibility to the vertical-horizontal illusion. Early blind volunteers and blindfolded sighted subjects explored variants of the vertical-horizontal illusion using a device that substituted audition for vision, whereas sighted subjects from an independent group inspected the same stimuli visually. Sensitivity to the vertical-horizontal illusion, including an illusion of moderate strength when using the sensory substitution device, was observed only in the two sighted groups. The existence of an illusion effect when using such a device supports the idea of a visual perception provided by sensory substitution, whereas the attenuation of the vertical-horizontal illusion strength is consistent with the visual field shape theory (Künnapas, 1955a). The absence of the illusion effect in early blind subjects suggests that the sensory experience influences the nature of perception and that the visual experience plays a crucial role in the vertical-horizontal illusion, in accordance with the size-constancy scaling theory (Gregory, 1963).