Montreal Neurological Institute, McGill University, Montreal, Canada.
Montreal Neurological Institute, McGill University, Montreal, Canada.
Neuropsychologia. 2020 Jun;143:107463. doi: 10.1016/j.neuropsychologia.2020.107463. Epub 2020 Apr 7.
Blindsight is the ability of patients with primary visual cortex (V1) damage to process information in their clinically blind visual field in the absence of conscious awareness. In addition to those with localized V1 lesions, some patients exhibiting this phenomenon have had a cerebral hemisphere removed or disconnected from the rest of the brain for the treatment of drug-resistant epilepsy (hemispherectomy). Research into the underlying neural substrates of blindsight has long implicated the intact visual cortex in maintaining residual vision and supporting visuo-guided responses to stimuli presented ipsilaterally within the blind visual field while operating outside the geniculo-striate pathway. A recent study demonstrated functional reorganization in the dorsal visual areas of the intact hemisphere, thereby supporting its compensatory role in non-conscious vision. In this study, we used cortical thickness analysis to examine anatomical differences in the visual cortex of the intact hemisphere of three subjects with varying degrees of cortical damage and well documented blindsight: two with a right hemispherectomy (complete and partial), and one with a left V1 lesion. T1-weighted MRI data were obtained for the subjects while control data were chosen from publicly available NKI-dataset to match closely the acquisition parameters of our blindsight cases. Our results show significant increases in cortical thickness in the visual cortex of all blindsight subjects compared to healthy controls, irrespective of age-onset, etiology, and extent of the damage. Our findings add to accumulating evidence from behavioral, functional imaging, and tractography studies of cerebral compensation and reorganization.
盲视是指原发性视皮层(V1)损伤患者在没有意识的情况下,能够在临床盲视区域处理信息的能力。除了那些 V1 局部损伤的患者外,一些表现出这种现象的患者已经接受了大脑半球切除或与大脑其余部分断开连接,以治疗耐药性癫痫(半球切除术)。对盲视潜在神经基质的研究长期以来一直暗示完整的视皮层在维持残留视力和支持视觉引导的反应方面发挥作用,这些反应是在盲视区域的同侧呈现刺激时发生的,而不在神经节状纹状体通路内。最近的一项研究表明,完整半球的背侧视觉区域发生了功能重组,从而支持其在非意识视觉中的代偿作用。在这项研究中,我们使用皮质厚度分析来检查三个具有不同程度皮质损伤和明确盲视的完整半球视觉皮层的解剖学差异:两个是右半球切除术(完全和部分),一个是左 V1 损伤。我们对受试者进行了 T1 加权 MRI 数据采集,而对照组数据则从公开的 NKI 数据集选择,以与我们的盲视病例的采集参数紧密匹配。我们的结果表明,所有盲视受试者的视觉皮层皮质厚度与健康对照组相比都显著增加,而与年龄发病、病因和损伤程度无关。我们的发现增加了行为、功能成像和追踪研究中关于大脑代偿和重组的累积证据。