In the present study, we investigated the possibility that bimodal audiovisual stimulation of the affected hemifield can improve perception of the visual events in the blind hemifield of hemianopic patients, as it was previously demonstrated in neglect patients. Moreover, it has been shown that “hetero-modal” and “sensory-specific” cortices are involved in cross-modal integration. Thus, the second aim of the present study was to examine whether audiovisual integration influences visual detection in patients with different cortical lesions responsible of different kinds of visual disorders. More specifically, we investigated cross-modal, audiovisual integration in patients with visual impairment due to a visual field deficit (e.g., hemianopia) or visuospatial attentional deficit (e.g., neglect) and patients with both hemianopia and neglect. Patients were asked to detect visual stimuli presented alone or in combination with auditory stimuli that could be spatially aligned or not with the visual ones. The results showed an enhancement of visual detection in cross-modal condition (spatially aligned condition) comparing to unimodal visual condition only in patients with hemianopia or neglect; by contrast, the multi-sensory integration did not occur when patients presented both deficits. These data suggest that patients with visual disorders can enormously benefit the multisensory integration. Moreover, they showed a different influence of cortical lesion on multi-sensory integration. Thus, the present results show the important adaptive meaning of multisensory integration and are very promising with respect to the possibility of recovery from visual and spatial impairments.

Significance: Sensitive periods in human functional brain development were tested in humans who had been blind from birth and whose sight was restored as long as 14 y later. In investigating this rare population, our data demonstrate a general principle of brain development: rather than being born with highly specialized neural systems (e.g., for specific object categories such as faces), the functional differentiation of neural circuits seems to depend on early (visual) experience involving a decrease in responsiveness to certain events during sensitive periods. The functional tuning of neural systems seems necessary to achieve high processing proficiency.

Individuals with profound deafness rely critically on vision to interact with their environment. Improvement of visual performance as a consequence of auditory deprivation is assumed to result from cross-modal changes occurring in late stages of visual processing. Here we measured reaction times and event-related potentials (ERPs) in profoundly deaf adults and hearing controls during a speeded visual detection task, to assess to what extent the enhanced reactivity of deaf individuals could reflect plastic changes in the early cortical processing of the stimulus. We found that deaf subjects were faster than hearing controls at detecting the visual targets, regardless of their location in the visual field (peripheral or peri-foveal). This behavioural facilitation was associated with ERP changes starting from the first detectable response in the striate cortex (C1 component) at about 80 ms after stimulus onset, and in the P1 complex (100–150 ms). In addition, we found that P1 peak amplitudes predicted the response times in deaf subjects, whereas in hearing individuals visual reactivity and ERP amplitudes correlated only at later stages of processing. These findings show that long-term auditory deprivation can profoundly alter visual processing from the earliest cortical stages. Furthermore, our results provide the first evidence of a co-variation between modified brain activity (cortical plasticity) and behavioural enhancement in this sensory-deprived population.

Purpose: Several studies have reported faster response time to visual stimuli in profoundly deaf individuals. This result is often linked to the processing of peripheral targets, and it is assumed to occur in relation to attention orienting. We evaluated whether enhanced reactivity to visual events in profoundly deaf individuals can be explained by faster orienting of visual attention alone. Methods: We examined 11 deaf individuals and 11 hearing controls, in a simple detection task and in a shape discrimination task. While simple detection can be performed under distributed attention, shape discrimination requires orienting of spatial attention to the target. The same visual targets served for both tasks, presented at central or peripheral locations and corrected for cortical magnification. Results: The simple detection task revealed faster RTs in deaf than hearing controls, regardless of target location. Moreover, while hearing controls paid a cost in responding to peripheral than central targets, deaf participants performed equally well regardless of target eccentricity. In the shape discrimination task deaf never outperformed hearing controls. Conclusions: These findings reveal that enhanced reactivity to visual stimuli in the deaf cannot be explained only by faster orienting of visual attention and can emerge for central as well as peripheral targets. Moreover, the persisting advantage for peripheral locations in the deaf, observed here under distributed attention, suggests that this spatially-selective effect could result from reorganised sensory processing rather than different attentional gradients.