Abstract
Significant progress has been made in the development of visual neuroprostheses to restore vision in blind individuals. Appropriate delivery of electrical stimulation to intact visual structures can evoke patterned sensations of light in those who have been blind for many years. However, success in developing functional visual prostheses requires an understanding of how to communicate effectively with the visually deprived brain in order to merge what is perceived visually with what is generated electrically.
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References
Sharma, R. K. & Ehinger, B. Management of hereditary retinal degenerations: present status and future directions. Surv. Ophthalmol. 43, 427–444 (1999).
Marg, E. & Rudiak, D. Phosphenes induced by magnetic stimulation over the occipital brain: description and probable site of stimulation. Optom. Vis. Sci. 71, 301–311 (1994).
Gothe, J. et al. Changes in visual cortex excitability in blind subjects as demonstrated by transcranial magnetic stimulation. Brain 125, 479–490 (2002).
Rizzo, J. F. et al. Retinal prosthesis: an encouraging first decade with major challenges ahead. Ophthalmology 108, 13–14 (2001).
Maynard, E. M. Visual prostheses. Annu. Rev. Biomed. Eng. 3, 145–168 (2001).
Margalit, E. et al. Retinal prosthesis for the blind. Surv. Ophthalmol. 47, 335–356 (2002).
Zrenner, E. Will retinal implants restore vision? Science 295, 1022–1025 (2002).
Loewenstein, J. I., Montezuma, S. R. & Rizzo, J. F. Outer retinal degeneration: an electronic retinal prosthesis as a treatment strategy. Arch. Ophthalmol. 122, 587–596 (2004).
Brindley, G. S. & Lewin, W. S. The sensations produced by electrical stimulation of the visual cortex. J. Physiol. (Lond.) 196, 479–493 (1968).
Dobelle, W. H. Artificial vision for the blind by connecting a television camera to the visual cortex. ASAIO J. 46, 3–9 (2000).
Schmidt, E. M. et al. Feasibility of a visual prosthesis for the blind based on intracortical microstimulation of the visual cortex. Brain 119, 507–522 (1996).
Normann, R. A., Warren, D. J., Ammermuller, J., Fernandez, E. & Guillory, S. High-resolution spatio-temporal mapping of visual pathways using multi-electrode arrays. Vision Res. 41, 1261–1275 (2001).
Fernandez, E. et al. Towards a cortical visual neuro-prosthesis for the blind. IFMBE Proc. 3, 1690–1691 (2002).
Troyk, P. et al. A model for intracortical visual prosthesis research. Artif. Organs 27, 1005–1015 (2003).
Veraart, C., Wanet-Defalque, M. C., Gerard, B., Vanlierde, A. & Delbeke, J. Pattern recognition with the optic nerve visual prosthesis. Artif. Organs 27(11), 996–1004 (2003).
Klein, R., Klein, B. E., Jensen, S. C. & Meuer, S. M. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104, 7–21 (1997).
Hims, M. M., Diager, S. P. & Inglehearn, C. F. Retinitis pigmentosa: genes, proteins and prospects. Dev. Ophthalmol. 37, 109–125 (2003).
Humayun, M. S. et al. Visual perception elicited by electrical stimulation of retina in blind humans. Arch. Ophthalmol. 114, 40–46 (1996).
Chow, A. Y. et al. The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa. Arch. Ophthalmol. 122, 460–469 (2004).
Zrenner, E. et al. Can subretinal microphotodiodes successfully replace degenerated photoreceptors? Vision Res. 39, 2555–2567 (1999).
Rizzo, J. F., Wyatt, J., Loewenstein, J., Kelly, S. & Shire, D. Methods and perceptual thresholds for short-term electrical stimulation of human retina with microelectrode arrays. Invest. Ophthalmol. Vis. Sci. 44, 5355–5361 (2003).
Rizzo, J. F., Wyatt, J., Loewenstein, J., Kelly, S. & Shire, D. Perceptual efficacy of electrical stimulation of human retina with a microelectrode array during short-term surgical trials. Invest. Ophthalmol. Vis. Sci. 44, 5362–5369 (2003).
Humayun, M. S. et al. Visual perception in a blind subject with a chronic microelectronic retinal prosthesis. Vision Res. 43, 2573–2581 (2003).
Bavelier, D. & Neville, H. Cross-modal plasticity: where and how? Nature Rev. Neurosci. 3, 443–452 (2002).
Hollins, M. Understanding Blindness (Hillsdale, New Jersey: Erlbaum Associates, 1989).
Rauschecker, J. P. Compensatory plasticity and sensory substitution in the cerebral cortex. Trends Neurosci. 18, 36–43 (1995).
Rauschecker, J. P. & Korte, M. Auditory compensation for early blindness in cat cerebral cortex. J. Neurosci. 10, 4538–4548 (1993).
Roder, B. et al. Improved auditory spatial tuning in blind humans. Nature 400, 162–166 (1999).
Van Boven, R. W., Hamilton, R. H., Kauffman, T., Keenan, J. P. & Pascual-Leone, A. Tactile spatial resolution in blind Braille readers. Neurology 54, 2230–2236 (2000).
Hamilton, R. H., Pascual-Leone, A. & Schlaug, G. Absolute pitch in blind musicians. Neuroreport 15, 803–806 (2004).
Gougoux, F. et al. Neuropsychology: pitch discrimination in the early blind. Nature 430, 309 (2004).
Pascual-Leone, A., Hamilton, R., Tormos, J. M., Keenan, J. & Catala, M. D. in Neuroplasticity: Building a Bridge from the Laboratory to the Clinic (eds Grafman, J. & Christen, Y.) 93–108 (Springer, Munich & New York, 1998).
Sadato, N. et al. Activation of the primary visual cortex by Braille reading in blind subjects. Nature 380, 526–528 (1996).
Sadato, N. et al. Neural networks for Braille reading by the blind. Brain 121, 1213–1229 (1998).
Buchel, C., Price, C., Frackowiak, R. S. & Friston, K. Different activation patterns in the visual cortex of late and congenitally blind subjects. Brain 121, 409–419 (1998).
Burton, H. et al. Adaptive changes in early and late blind: a fMRI study of Braille reading. J. Neurophysiol. 87, 589–607 (2002).
Amedi, A., Jacobson, G., Hendler, T., Malach, R. & Zohary, E. Convergence of visual and tactile shape processing in the human lateral occipital complex. Cereb. Cortex. 12, 1202–1212 (2002).
Amedi, A., Raz, N., Pianka, P., Malach, R. & Zohary, E. Early 'visual' cortex activation correlates with superior verbal-memory performance in the blind. Nature Neurosci. 6, 758–766 (2003).
Cohen, L. G. et al. Functional relevance of cross-modal plasticity in blind humans. Nature 389, 180–183 (1997).
Hamilton, R. H. & Pascual-Leone, A. Cortical plasticity associated with Braille learning. Trends Cogn. Sci. 2, 168–174 (1998).
Hamilton, R., Keenan, J. P., Catala, M. D., Pascual-Leone, A. Alexia for Braille following bilateral occipital stroke in an early blind woman. Neuroreport 11, 237–240 (2000).
Merabet, L. et al. Feeling by sight or seeing by touch? Neuron 42, 173–179 (2004).
Kujala, T., Alho, K., Paavilainen, P., Summala, H. & Naatanen, R. Neural plasticity in processing of sound location by the early blind: an event-related potential study. Electroencephalogr. Clin. Neurophysiol. 84, 469–472 (1992).
Weeks, R. et al. A positron emission tomographic study of auditory localization in the congenitally blind. J. Neurosci. 20, 2664–2672 (2000).
Amedi, A., Floel, A., Knecht, S., Zohary, E. & Cohen, L. G. Transcranial magnetic stimulation of the occipital pole interferes with verbal processing in blind subjects. Nature Neurosci. 7, 1266–1270 (2004).
Pascual-Leone, A. & Hamilton, R. The metamodal organization of the brain. Prog. Brain Res. 134, 427–445 (2001).
Donoghue, J. P. Connecting cortex to machines: recent advances in brain interfaces. Nature Neurosci. 5, 1085–1088 (2002).
Nicolelis, M. A. Brain-machine interfaces to restore motor function and probe neural circuits. Nature Rev. Neurosci. 4, 417–422 (2003).
Loeb, G. E. Cochlear prosthetics. Annu. Rev. Neurosci. 13, 357–371 (1990).
Rauschecker, J. P. & Shannon, R. V. Sending sound to the brain. Science 295, 1025–1029 (2002).
Finney, E. M., Fine, I. & Dobkins, K. R. Visual stimuli activate auditory cortex in the deaf. Nature Neurosci. 4, 1171–1173 (2001).
Neville, H. J. et al. Cerebral organization for language in deaf and hearing subjects: biological constraints and effects of experience. Proc. Natl Acad. Sci. USA 95, 922–929 (1998).
Nishimura, H. et al. Sign language 'heard' in the auditory cortex. Nature 397, 116 (1999).
Giraud, A. L, Price, C. J, Graham, J. M, Truy, E. & Frackowiak, R. S. Cross-modal plasticity underpins language recovery after cochlear implantation. Neuron 30, 657–663 (2001).
Sharma, J., Angelucci, A. & Sur, M. Induction of visual orientation modules in auditory cortex. Nature 404, 841–847 (2000).
Lee, D. S. et al. Cross-modal plasticity and cochlear implants. Nature 409, 149–150 (2001).
Grill-Spector, K. The neural basis of object perception. Curr. Opin. Neurobiol. 13, 159–166 (2003).
Deibert, E., Kraut, M., Kremen, S. & Hart, J. Neural pathways in tactile object recognition. Neurology 52, 1413–1417 (1999).
James, T. W. et al. Haptic study of three-dimensional objects activates extrastriate visual areas. Neuropsychologia 40, 1706–1714 (2002).
Beauchamp, M. S., Lee, K. E., Argall, B. D. & Martin, A. Integration of auditory and visual information about objects in superior temporal sulcus. Neuron 41, 809–823 (2004).
Amedi, A., Malach, R., Hendler, T., Peled, S. & Zohary, E. Visuo-haptic object-related activation in the ventral visual pathway. Nature Neurosci. 4, 324–330 (2001).
Pietrini, P. et al. Beyond sensory images: object-based representation in the human ventral pathway. Proc. Natl Acad. Sci. USA 101, 5658–5663 (2004).
De Volder, A. P. et al. Auditory triggered mental imagery of shape involves visual association areas in early blind humans. Neuroimage 14, 129–139 (2001).
Johnson, K. O. & Hsiao, S. S. Neural mechanisms of tactual form and texture perception. Annu. Rev. Neurosci. 15, 227–250 (1992).
von Senden, M. Space and Sight: the Perception of Space and Shape in the Congenitally Blind Before and After Operation (Methuen, London, 1960).
Gregory, R. L. & Wallace, J. G. Recovery from early blindness: a case study. Exp. Psychol. Soc. Monogr. 2 (Heffers, Cambridge, 1963).
Fine, I. et al. Long-term deprivation affects visual perception and cortex. Nature Neurosci. 6, 915–916 (2003).
Acknowledgements
Funding for this work is provided by a National Research Service Award fellowship from the National Eye Institute to L.B.M., a Department of Veterans Affairs, Rehabilitation Research and Development Service grant to J.F.R., a National Science Foundation grant to D.C.S. and a National Science Foundation Science of Learning Centers Catalyst Award and National Center for Research Resources grant to A.P.L.
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Merabet, L., Rizzo, J., Amedi, A. et al. What blindness can tell us about seeing again: merging neuroplasticity and neuroprostheses. Nat Rev Neurosci 6, 71–77 (2005). https://doi.org/10.1038/nrn1586
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DOI: https://doi.org/10.1038/nrn1586
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