The visual cortex may be more modifiable than previously considered. Using functional magnetic resonance imaging (fMRI) in ten congenitally blind human participants, we found robust occipital activation during a verbal-memory task (in the absence of any sensory input), as well as during verb generation and Braille reading. We also found evidence for reorganization and specialization of the occipital cortex, along the anterior-posterior axis. Whereas anterior regions showed preference for Braille, posterior regions (including V1) showed preference for verbal-memory and verb generation (which both require memory of verbal material). No such occipital activation was found in sighted subjects. This difference between the groups was mirrored by superior performance of the blind in various verbal-memory tasks. Moreover, the magnitude of V1 activation during the verbal-memory condition was highly correlated with the blind individual's abilities in a variety of verbal-memory tests, suggesting that the additional occipital activation may have a functional role.
Recently we showed that the occipital cortex of congenitally blind humans is activated during verbal-memory tasks. Activation was found in regions corresponding to the retinotopic visual areas of sighted humans, including the calcarine sulcus (V1). No such occipital activation was found in sighted humans. One year later, the same blind subjects participated in a second fMRI scan, to study the contribution of semantic elements and episodic memory to the occipital activation. The subjects performed an episodic-memory task, requiring recognition of words that were originally presented in the first scan. We demonstrate here that the magnitude of V1 activation during the recognition task is correlated with memory performance, assessed during the scan. Across the blind, the better-remembered set of words elicited greater V1 activation than words from the poorly-remembered set, although the semantic components and the behavioral task were similar in the two sets. This indicates that on top of semantic processing (suggested previously), V1 activation in the blind is probably associated with long-term episodic memory. Indeed, within the blind, those who showed better recognition-memory performance had greater V1 activation compared with the poorer performers. We conclude that the posterior occipital cortex (including V1) of the congenitally blind is likely to be involved in episodic retrieval.
In the absence of vision, perception of space is likely to be highly dependent on memory. As previously stated, the blind tend to code spatial information in the form of "route-like" sequential representations [1-3]. Thus, serial memory, indicating the order in which items are encountered, may be especially important for the blind to generate a mental picture of the world. In accordance, we find that the congenitally blind are remarkably superior to sighted peers in serial memory tasks. Specifically, subjects heard a list of 20 words and were instructed to recall the words according to their original order in the list. The blind recalled more words than the sighted (indicating better item memory), but their greatest advantage was in recalling longer word sequences (according to their original order). We further show that the serial memory superiority of the blind is not merely a result of their advantage in item recall per se (as we additionally confirm via a separate recognition memory task). These results suggest the refinement of a specific cognitive ability to compensate for blindness in humans.
Conduction velocity in the visual pathways correlated closely with dynamic visual functions, implicating the need for rapid transmission of visual input to perceive motion. Motion perception level may serve as a tool to assess the magnitude of myelination in the visual pathways. The constancy across patients may serve as a baseline to assess the efficacy of currently developing neuroprotective and regenerative therapeutic strategies, targeting myelination in the central nervous system.
Sustained motion perception deficit following ON may explain the continued visual complaints of patients long after recovery of visual acuity. Cortical activation patterns suggest that if plastic processes in higher visual regions contribute to the recovery of vision, this may be limited to static visual functions. Alternatively, cortical activation may reflect the visual percept (intact for visual acuity and impaired for motion perception), rather than demonstrating plastic processes. We suggest that motion perception should be included in the routine ophthalmologic tests following ON.
Delayed latencies in the fellow eyes may reflect adaptive mechanisms at the cortical level that improve binocular integration over time to adjust for the damage incurred. These data provide a unique demonstration of temporal reorganization that compensates for delayed transmittal of visual information to the cortex.
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