Visual rehabilitation: visual scanning, multisensory stimulation and vision restoration trainings

Modern brain imaging techniques have now made it possible to study the neural sites and mechanisms underlying crossmodal processing in the human brain. This paper reviews positron emission tomography, functional magnetic resonance imaging (fMRI), event-related potential and magnetoencephalographic studies of crossmodal matching, the crossmodal integration of content and spatial information, and crossmodal learning. These investigations are beginning to produce some consistent findings regarding the neuronal networks involved in these distinct crossmodal operations. Increasingly, specific roles are being defined for the superior temporal sulcus, the inferior parietal sulcus, regions of frontal cortex, the insula cortex and claustrum. The precise network of brain areas implicated in any one study, however, seems to be heavily dependent on the experimental paradigms used, the nature of the information being combined and the particular combination of modalities under investigation. The different analytic strategies adopted by different groups may also be a significant factor contributing to the variability in findings. In this paper, we demonstrate the impact of computing intersections, conjunctions and interaction effects on the identification of audiovisual integration sites using existing fMRI data from our own laboratory. This exercise highlights the potential value of using statistical interaction effects to model electrophysiological responses to crossmodal stimuli in order to identify possible sites of multisensory integration in the human brain.

Perceptual learning is a lifelong process. We begin by encoding information about the basic structure of the natural world and continue to assimilate information about specific patterns with which we become familiar. The specificity of the learning suggests that all areas of the cerebral cortex are plastic and can represent various aspects of learned information. The neural substrate of perceptual learning relates to the nature of the neural code itself, including changes in cortical maps, in the temporal characteristics of neuronal responses, and in modulation of contextual influences. Top-down control of these representations suggests that learning involves an interaction between multiple cortical areas.

Neurophysiological studies have shown in animals that a sudden sound enhanced perceptual processing of subsequent visual stimuli. In the present study, we explored the possibility that such enhancement also exists in humans and can be explained through crossmodal integration effects, whereby the interaction occurs at the level of bimodal neurons. Subjects were required to detect visual stimuli in a unimodal visual condition or in crossmodal audio-visual conditions. The spatial and the temporal proximity of multisensory stimuli were systematically varied. An enhancement of the perceptual sensitivity (d') for luminance detection was found when the audiovisual stimuli followed a rather clear spatial and temporal rule, governing multisensory integration at the neuronal level.