Behavioral and neuroplastic changes in the blind: evidence for functionally relevant cross-modal interactions

The study of blind individuals provides insight into the brain re-organization and behavioral compensations that occur following sensory deprivation. While behavioral studies have yielded conflicting results in terms of performance levels within the remaining senses, deafferentation of visual cortical areas through peripheral blindness results in clear neuroplastic changes. Most striking is the activation of occipital cortex in response to auditory and tactile stimulation. Indeed, parts of the "unimodal" visual cortex are recruited by other sensory modalities to process sensory information in a functionally relevant manner. In addition, a larger area of the sensorimotor cortex is devoted to the representation of the reading finger in blind Braille readers. The "visual" function of the deafferented occipital cortex is also altered, where transcranial magnetic stimulation-induced phosphenes can be elicited in only 20% of blind subjects. The neural mechanisms underlying these changes remain elusive but recent data showing rapid cross-modal plasticity in blindfolded, sighted subjects argue against the establishment of new connections to explain cross-modal interactions in the blind. Rather, latent pathways that participate in multisensory percepts in sighted subjects might be unmasked and may be potentiated in the event of complete loss of visual input. These issues have important implications for the development of visual prosthesis aimed at restoring some degree of vision in the blind.