Neuroplasticity in cerebral visual impairment (CVI): Assessing functional vision and the neurophysiological correlates of dorsal stream dysfunction

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.

Visual Neuropsychology in Development: Anatomo-Functional Brain Mechanisms of Action/Perception Binding in Health and Disease

“…As one of the most common causes of visual impairment of cortical origin, cerebral visual impairment (CVI) can result from early brain damage, including a potentially large panel of correlated deficits beyond vision due to damages of the dorsal stream, the ventral stream, or both (Bennett et al, 2020). Behaviorally, it is possible to detect CVI by means of dedicated questionnaires (Gorrie et al, 2019;Fazzi and Micheletti, 2020).…”

Motion Processing Deficits in Children With Cerebral Visual Impairment and Good Visual Acuity

“…Nonetheless, much remains to be done to tease out the spectrum of visual deficits in children with CVI and the influence of comorbid conditions. 74 , 75 …”

Exploratory Investigation of Brain MRI Lesions According to Whole Sample and Visual Function Subtyping in Children With Cerebral Visual Impairment

“…Convergent evidence suggests that congenital CVI is associated with widespread diffuse changes in the structural and functional integrity of gray and white matter pathways, including optic radiations from the optic nerves to the occipital cortex; these have been associated with reduced visual acuity and visual perceptual dysfunctions ( Ortibus et al, 2012 ; Bauer et al, 2014 ; Bauer and Papadelis, 2019 ; Bennett et al, 2020 ; Pamir et al, 2021 ). Thalamic involvement has been associated with severe visual impairment ( Cioni et al, 1996 , 1997 , 2000 ; Ricci et al, 2006 ; Ortibus et al, 2009 ; Merabet et al, 2017 ).…”