Blind individuals often demonstrate enhanced nonvisual perceptual abilities. However, the neural substrate that underlies this improved performance remains to be fully understood. An earlier behavioral study demonstrated that some early-blind people localize sounds more accurately than sighted controls using monaural cues. In order to investigate the neural basis of these behavioral differences in humans, we carried out functional imaging studies using positron emission tomography and a speaker array that permitted pseudo-free-field presentations within the scanner. During binaural sound localization, a sighted control group showed decreased cerebral blood flow in the occipital lobe, which was not seen in early-blind individuals. During monaural sound localization (one ear plugged), the subgroup of early-blind subjects who were behaviorally superior at sound localization displayed two activation foci in the occipital cortex. This effect was not seen in blind persons who did not have superior monaural sound localization abilities, nor in sighted individuals. The degree of activation of one of these foci was strongly correlated with sound localization accuracy across the entire group of blind subjects. The results show that those blind persons who perform better than sighted persons recruit occipital areas to carry out auditory localization under monaural conditions. We therefore conclude that computations carried out in the occipital cortex specifically underlie the enhanced capacity to use monaural cues. Our findings shed light not only on intermodal compensatory mechanisms, but also on individual differences in these mechanisms and on inhibitory patterns that differ between sighted individuals and those deprived of vision early in life.

The study of the congenitally blind (CB) represents a unique opportunity to explore experience-dependant plasticity in a sensory region deprived of its natural inputs since birth. Although several studies have shown occipital regions of CB to be involved in nonvisual processing, whether the functional organization of the visual cortex observed in sighted individuals (SI) is maintained in the rewired occipital regions of the blind has only been recently investigated. In the present functional MRI study, we compared the brain activity of CB and SI processing either the spatial or the pitch properties of sounds carrying information in both domains (i.e., the same sounds were used in both tasks), using an adaptive procedure specifically designed to adjust for performance level. In addition to showing a substantial recruitment of the occipital cortex for sound processing in CB, we also demonstrate that auditory–spatial processing mainly recruits the right cuneus and the right middle occipital gyrus, two regions of the dorsal occipital stream known to be involved in visuospatial/motion processing in SI. Moreover, functional connectivity analyses revealed that these reorganized occipital regions are part of an extensive brain network including regions known to underlie audiovisual spatial abilities (i.e., intraparietal sulcus, superior frontal gyrus). We conclude that some regions of the right dorsal occipital stream do not require visual experience to develop a specialization for the processing of spatial information and to be functionally integrated in a preexisting brain network dedicated to this ability.

Contrasting the impact of congenital versus late-onset acquired blindness provides a unique model to probe how experience at different developmental periods shapes the functional organization of the occipital cortex. We used functional magnetic resonance imaging to characterize brain activations of congenitally blind, late-onset blind and two groups of sighted control individuals while they processed either the pitch or the spatial attributes of sounds. Whereas both blind groups recruited occipital regions for sound processing, activity in bilateral cuneus was only apparent in the congenitally blind, highlighting the existence of region-specific critical periods for crossmodal plasticity. Most importantly, the preferential activation of the right dorsal stream (middle occipital gyrus and cuneus) for the spatial processing of sounds was only observed in the congenitally blind. This demonstrates that vision has to be lost during an early sensitive period in order to transfer its functional specialization for space processing toward a non-visual modality. We then used a combination of dynamic causal modelling with Bayesian model selection to demonstrate that auditory-driven activity in primary visual cortex is better explained by direct connections with primary auditory cortex in the congenitally blind whereas it relies more on feedback inputs from parietal regions in the late-onset blind group. Taken together, these results demonstrate the crucial role of the developmental period of visual deprivation in (re)shaping the functional architecture and the connectivity of the occipital cortex. Such findings are clinically important now that a growing number of medical interventions may restore vision after a period of visual deprivation.