Perception of the McGurk effect in people with one eye depends on whether the eye is removed during infancy or adulthood.

Background: The visual system is not fully mature at birth and continues to develop throughout infancy until it reaches adult levels through late childhood and adolescence. Disruption of vision during this postnatal period and prior to visual maturation results in deficits of visual processing and in turn may affect the development of complementary senses. Studying people who have had one eye surgically removed during early postnatal development is a useful model for understanding timelines of sensory development and the role of binocularity in visual system maturation. Adaptive auditory and audiovisual plasticity following the loss of one eye early in life has been observed for both low-and high-level visual stimuli. Notably, people who have had one eye removed early in life perceive the McGurk effect much less than binocular controls. Methods: The current study investigates whether multisensory compensatory mechanisms are also present in people who had one eye removed late in life, after postnatal visual system maturation, by measuring whether they perceive the McGurk effect compared to binocular controls and people who have had one eye removed early in life. Results: People who had one eye removed late in life perceived the McGurk effect similar to binocular viewing controls, unlike those who had one eye removed early in life. Conclusion: This suggests differences in multisensory compensatory mechanisms based on age at surgical eye removal. These results indicate that cross-modal adaptations for the loss of binocularity may be dependent on plasticity levels during cortical development.

Assessment of implicit COVID-19 attitudes using affective priming for pro-vaccine and vaccine-hesitant individuals.

The COVID-19 pandemic has resulted in the introduction of pharmaceutical and non-pharmaceutical interventions such as precautionary behaviours. The current study used affective priming to evaluate COVID-19 attitudes in vaccine-hesitant and pro-vaccine participants. Explicitly, both groups rated their overall perception of risk associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. Pro-vaccine participants rated their perception of necessary precautions higher compared to vaccine-hesitant participants. During baseline measures, both groups classified COVID-19 affiliated words as unpleasant. Affective priming was observed for congruent prime-target pleasant and unpleasant word pairs but was not observed for COVID-19 related word pairs. Differences between groups in the perception of necessary public health precautions points to different underlying pathways for reduced perceived risk and lack of affective priming. These results refine previous findings indicating that implicit attitudes towards COVID-19 can be measured using the affective priming paradigm.

Continuous and intermittent theta burst stimulation of primary visual cortex do not modulate resting state functional connectivity: A sham-controlled multi-echo fMRI study.

INTRODUCTION: Theta burst stimulation (TBS) is a type of rTMS protocol which has the advantage of a shorter delivery time over traditional rTMS. When applied to motor cortex, intermittent TBS (iTBS) has been shown to yield excitatory aftereffects, whereas continuous TBS (cTBS) may lead to inhibitory aftereffects, both lasting from minutes to hours. The majority of TBS research has targeted motor, frontal, and parietal regions, and to date very few studies have examined its efficacy at visual areas. We designed a sham-controlled study to investigate the immediate poststimulation and short-term (1 h post-stimulation) effects of iTBS and cTBS to V1. METHODS: Using multiecho functional magnetic resonance imaging, we measured the direct and indirect effects of TBS by comparing resting state functional connectivity (FC) before and after stimulation in whole brain networks, and seeds from V1 (stimulation site) and neighboring occipital and parietal visual networks. In addition, we also measured pre- and post-TBS phosphene thresholds (PTs) to examine the modulatory effects of TBS on cortical excitability. RESULTS: We found no changes in FC for iTBS, cTBS or sham stimulation conditions from baseline to poststimulation timepoints. Additionally, cTBS and iTBS had no effect on visual cortical excitability. CONCLUSIONS: Our results indicate that unlike our previous low frequency rTMS to V1 study, which resulted in widespread FC changes up to at least 1 h after stimulation, TBS to V1 does not affect FC. Contrary to the studies showing comparable TBS and rTMS aftereffects in motor and frontal regions, our findings suggest that a single session of cTBS or iTBS to V1 at 80% PT using a standard protocol of 600 pulses may not be effective in targeting FC, especially in clinical settings where therapy for pathological networks is the goal.

Within-subject reliability of concurrent TMS-fMRI during a single session.

Concurrent transcranial magnetic stimulation with functional MRI (concurrent TMS-fMRI) allows real-time causative probing of brain connectivity. However, technical challenges, safety, and tolerability may limit the number of trials employed during a concurrent TMS-fMRI experiment. We leveraged an existing data set with 100 trials of active TMS compared to a sub-threshold control condition to assess the reliability of the evoked BOLD response during concurrent TMS-fMRI. This data will permit an analysis of the minimum number of trials that should be employed in a concurrent TMS-fMRI protocol in order to achieve reliable spatial changes in activity. Single-subject maps of brain activity were created by splitting the trials within the same experimental session into groups of 50, 40, 30, 25, 20, 15, or 10 trials, correlations (R) between t-maps derived from paired subsets of trials within the same individual were calculated as reliability. R was moderate-high for 50 trials (mean R = .695) and decreased as the number of trials decreased. Consistent with previous findings of high individual variability in the spatial patterns of evoked neuronal changes following a TMS pulse, the spatial pattern of Rs differed across participants, but regional R was correlated with the magnitude of TMS-evoked activity. These results demonstrate concurrent TMS-fMRI produces a reliable pattern of activity at the individual level at higher trial numbers, particularly within localized regions. The spatial pattern of reliability is individually idiosyncratic and related to the individual pattern of evoked changes.

Modulating intrinsic functional connectivity with visual cortex using low-frequency repetitive transcranial magnetic stimulation.

INTRODUCTION: Intrinsic network connectivity becomes altered in pathophysiology. Noninvasive brain stimulation can modulate pathological functional networks in an attempt to restore the inherent response. To determine its usefulness for visual-related disorders, we developed procedures investigating repetitive transcranial magnetic stimulation (rTMS) protocols targeting the visual cortex on modulating connectivity associated with the visual network and default mode network (DMN). METHODS: We compared two low-frequency (1 Hz) rTMS protocols to the visual cortex (V1)-a single 20 min session and five successive 20 min sessions (accelerated/within-session rTMS)-using multi-echo resting-state functional magnetic resonance whole-brain imaging and resting-state functional connectivity (rsFC). We also explored the relationship between rsFC and rTMS-induced changes in key inhibitory and excitatory neurotransmitters, γ-aminobutyric acid (GABA) and glutamate. GABA (GABA+) and glutamate (Glx) concentrations were measured in vivo using magnetic resonance spectroscopy. RESULTS: Acute disruption with a single rTMS session caused widespread connectivity reconfiguration with nodes of interest. Changes were not evident immediately post-rTMS but were observed at 1 h post-rTMS. Accelerated sessions resulted in weak alterations in connectivity, producing a relatively homeostatic response. Changes in GABA+ and Glx concentrations with network connectivity were dependent on the rTMS protocol. CONCLUSIONS: This proof-of-concept study offers new perspectives to assess stimulation-induced neural processes involved in intrinsic functional connectivity and the potential for rTMS to modulate nodes interconnected with the visual cortex. The differential effects of single-session and accelerated rTMS on physiological markers are crucial for furthering the advancement of treatment modalities in visual cortex related disorders.

Continuous and intermittent theta burst stimulation to the visual cortex do not alter GABA and glutamate concentrations measured by magnetic resonance spectroscopy.

BACKGROUND: Theta burst stimulation (TBS), a form of repetitive transcranial magnetic stimulation (rTMS), uses repeated high-frequency bursts to non-invasively modulate neural processes in the brain. An intermittent TBS (iTBS) protocol is generally considered "excitatory," while continuous TBS (cTBS) is considered "inhibitory." However, the majority of work that has led to these effects being associated with the respective protocols has been done in the motor cortex, and it is well established that TMS can have variable effects across the brain. OBJECTIVES AND METHOD: We investigated the effects of iTBS and cTBS to the primary visual cortex (V1) on composite levels of gamma-aminobutyric acid + co-edited macromolecules (GABA+) and glutamate + glutamine (Glx) since these are key inhibitory and excitatory neurotransmitters, respectively. Participants received a single session of cTBS, iTBS, or sham TBS to V1. GABA+ and Glx were quantified in vivo at the stimulation site using spectral-edited proton magnetic resonance spectroscopy (1 H-MRS) at 3T. Baseline pre-TBS GABA+ and Glx levels were compared to immediate post-TBS and 1 h post-TBS levels. RESULTS: There were no significant changes in GABA+ or Glx following either of the TBS conditions. Visual cortical excitability, measured using phosphene thresholds, remained unchanged following both cTBS and iTBS conditions. There was no relationship between excitability thresholds and GABA+ or Glx levels. However, TBS did alter the relationship between GABA+ and Glx for up to 1 h following stimulation. CONCLUSIONS: These findings demonstrate that a single session of TBS to the visual cortex can be used without significant effects on the tonic levels of these key neurotransmitters; and add to our understanding that TBS has differential effects at visual, motor, and frontal cortices.

Lack of affective priming indicates attitude-behaviour discrepancy for COVID-19 affiliated words.

The ongoing novel coronavirus (COVID-19) pandemic has resulted in the enforcement of national public health safety measures including precautionary behaviours such as border closures, movement restrictions, total or partial lockdowns, social distancing, and face mask mandates in order to reduce the spread of this disease. The current study uses affective priming, an indirect behavioural measure of implicit attitude, to evaluate COVID-19 attitudes. Explicitly, participants rated their overall risk perception associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. During baseline trials, participants explicitly rated COVID-19 affiliated words as unpleasant, similar to traditional unpleasant word stimuli. Despite rating the COVID-19 affiliated words as unpleasant, affective priming was not observed for congruent prime-target COVID-19 affiliated word pairs when compared to congruent prime-target pleasant and unpleasant words. Overall, these results provide quantitative evidence that COVID-19 affiliated words do not invoke the same implicit attitude response as traditional pleasant and unpleasant word stimuli, despite conscious explicit rating of the COVID-19 words as unpleasant. This reduction in unpleasant attitude towards COVID-19 related words may contribute towards decreased fear-related behaviours and increased incidences of risky-behaviour facilitating the movement of the virus.

Assessing differential effects of single and accelerated low-frequency rTMS to the visual cortex on GABA and glutamate concentrations.

BACKGROUND: The application of repetitive transcranial magnetic stimulation (rTMS) for therapeutic use in visual-related disorders and its underlying mechanisms in the visual cortex is under-investigated. Additionally, there is little examination of rTMS adverse effects particularly with regards to visual and cognitive function. Neural plasticity is key in rehabilitation and recovery of function; thus, effective therapeutic strategies must be capable of modulating plasticity. Glutamate and γ-aminobutyric acid (GABA)-mediated changes in the balance between excitation and inhibition are prominent features in visual cortical plasticity. OBJECTIVES AND METHOD: We investigated the effects of low-frequency (1 Hz) rTMS to the visual cortex on levels of neurotransmitters GABA and glutamate to determine the therapeutic potential of 1 Hz rTMS for visual-related disorders. Two rTMS regimes commonly used in clinical applications were investigated: participants received rTMS to the visual cortex either in a single 20-min session or five accelerated 20-min sessions (not previously investigated at the visual cortex). Proton (1H) magnetic resonance spectroscopy for in vivo quantification of GABA (assessed via GABA+) and glutamate (assessed via Glx) concentrations was performed pre- and post-rTMS. RESULTS: GABA+ and Glx concentrations were unaltered following a single session of rTMS to the visual cortex. One day of accelerated rTMS significantly reduced GABA+ concentration for up to 24 hr, with levels returning to baseline by 1-week post-rTMS. Basic visual and cognitive function remained largely unchanged. CONCLUSION: Accelerated 1 Hz rTMS to the visual cortex has greater potential for approaches targeting plasticity or in cases with altered GABAergic responses in visual disorders. Notably, these results provide preliminary insight into a critical window of plasticity with accelerated rTMS (e.g., 24 hr) in which adjunct therapies may offer better functional outcome. We describe detailed procedures to enable further exploration of these protocols.

Brain Activation for Audiovisual Information in People With One Eye Compared to Binocular and Eye-Patched Viewing Controls.

Blindness caused by early vision loss results in complete visual deprivation and subsequent changes in the use of the remaining intact senses. We have also observed adaptive plasticity in the case of partial visual deprivation. The removal of one eye, through unilateral eye enucleation, results in partial visual deprivation and is a unique model for examining the consequences of the loss of binocularity. Partial deprivation of the visual system from the loss of one eye early in life results in behavioral and structural changes in the remaining senses, namely auditory and audiovisual systems. In the current study we use functional neuroimaging data to relate function and behavior of the audiovisual system in this rare patient group compared to controls viewing binocularly or with one eye patched. In Experiment 1, a whole brain analysis compared common regions of cortical activation between groups, for auditory, visual and audiovisual stimuli. People with one eye demonstrated a trend for increased activation for low-level audiovisual stimuli compared to patched viewing controls but did not differ from binocular viewing controls. In Experiment 2, a region of interest (ROI) analysis for auditory, visual, audiovisual and illusory McGurk stimuli revealed that people with one eye had an increased trend for left hemisphere audiovisual activation for McGurk stimuli compared to binocular viewing controls. This aligns with current behavioral analysis and previous research showing reduced McGurk Effect in people with one eye. Furthermore, there is no evidence of a correlation between behavioral performance on the McGurk Effect task and functional activation. Together with previous behavioral work, these functional data contribute to the broader understanding of cross-sensory effects of early sensory deprivation from eye enucleation. Overall, these results contribute to a better understanding of the sensory deficits experienced by people with one eye, as well as, the relationship between behavior, structure and function in order to better predict the outcome of early partial visual deafferentation.

Altered white matter structure in auditory tracts following early monocular enucleation.

PURPOSE: Similar to early blindness, monocular enucleation (the removal of one eye) early in life results in crossmodal behavioral and morphological adaptations. Previously it has been shown that partial visual deprivation from early monocular enucleation results in structural white matter changes throughout the visual system (Wong et al., 2018). The current study investigated structural white matter of the auditory system in adults who have undergone early monocular enucleation compared to binocular control participants. METHODS: We reconstructed four auditory and audiovisual tracts of interest using probabilistic tractography and compared microstructural properties of these tracts to binocularly intact controls using standard diffusion indices. RESULTS: Although both groups demonstrated asymmetries in indices in intrahemispheric tracts, monocular enucleation participants showed asymmetries opposite to control participants in the auditory and A1-V1 tracts. Monocular enucleation participants also demonstrated significantly lower fractional anisotropy in the audiovisual projections contralateral to the enucleated eye relative to control participants. CONCLUSIONS: Partial vision loss from early monocular enucleation results in altered structural connectivity that extends into the auditory system, beyond tracts primarily dedicated to vision.

Short and long-term visual deprivation leads to adapted use of audiovisual information for face-voice recognition.

Person identification is essential for everyday social interactions. We quickly identify people from cues such as a person's face or the sound of their voice. A change in sensory input, such as losing one's vision, can alter how one uses sensory information. We asked how people with only one eye, who have had reduced visual input during postnatal maturation of the visual system, use faces and voices for person identity recognition. We used an old/new paradigm to investigate unimodal (visual or auditory) and bimodal (audiovisual) identity recognition of people (face, voice and face-voice) and a control category, objects (car, horn and car-horn). Participants learned the identity of 10 pairs of faces and voices (Experiment 1) and 10 cars and horns (Experiment 2) and were asked to identify the learned face/voice or car/horn among 20 distractors. People with one eye were more sensitive to voice identification compared to controls viewing binocularly or with an eye-patch. However, both people with one eye and eye-patched viewing controls use combined audiovisual information for person identification more equally than binocular viewing controls, who favour vision. People with one eye were no different from controls at object identification. The observed visual dominance for binocular controls is larger for person compared to object identification, indicating that faces (vision) play a larger role in person identification and that person identity processing is unique from that for objects. People with long-term visual deprivation from the loss of one eye may have adaptive strategies, such as placing less reliance on vision to achieve intact performance, particularly for face processing.

Early monocular enucleation selectively disrupts neural development of face perception in the occipital face area.

Retinoblastoma generally occurs before 5 years of age and often requires enucleation (surgical removal of one eye) of the cancerous eye. We have previously shown using behavioural methods that this disruption in binocular vision during the critical period of visual development results in impaired face perception. In this case series study, we sought to determine the underlying neural correlates of this face perception deficit by examining brain activity in regions of cortex that preferentially respond to visual images of faces and places in 6 adults who had one eye enucleated early in life due to retinoblastoma. A group of 10 binocularly-intact adult controls were recruited for comparison. Functional magnetic resonance imaging (fMRI) was conducted over two separate runs for each participant in one scanning session. Each run consisted of 6 blocks each of face, place, and object images. Region-of-interest analyses were conducted to locate face-preferential [fusiform face area (FFA), occipital face area (OFA)] and place-preferential [parahippocampal place area (PPA), transverse occipital sulcus (TOS)] regions-of-interest. Descriptive statistics are reported. Results. Enucleated adults exhibited reduced functional activation in face-preferential regions (left FFA, right OFA, left OFA), but similar activation within the face-preferential right FFA and the place-preferential regions (bilateral PPA and TOS). Conclusions. These results indicate that early monocular enucleation prevents robust development of late-maturing face processing capabilities and that this disruption is specific to face networks and not to networks supporting other visual image categories.

Spread of activity following TMS is related to intrinsic resting connectivity to the salience network: A concurrent TMS-fMRI study.

Transcranial magnetic stimulation (TMS) modulates activity at local and regions distal to the site of simulation. TMS has also been found to modulate brain networks, and it has been hypothesized that functional connectivity may predict the neuronal changes at local and distal sites in response to a TMS pulse. However, a direct relationship between resting connectivity and change in TMS-induced brain activation has yet to be demonstrated. Concurrent TMS-fMRI is a technique to directly measure this spread activity following TMS in real time. In twenty-two participants, resting-state fMRI scans were acquired, followed by four ten minute sessions of concurrent TMS-fMRI over the left dorsolateral prefrontal cortex (DLPFC). Seed-based functional connectivity to the individualized TMS target was examined using the baseline resting fMRI scan data, and the change of activity resulting from TMS was determined using a general linear model (High vs Low intensity TMS). While at the group level the spatial pattern of resting connectivity related to the pattern of TMS-induced cortical changes, there was substantial variability across individuals. This variability was further probed by examining individual's connectivity from the TMS target to six resting state networks. Only connectivity between the salience network (SN) and the TMS target site correlated with the RSC-TMS score. This suggests that resting state connectivity is correlated with TMS-induced changes in activity following DLPFC stimulation, particularly when the DLPFC target interacts with the SN. These results highlight the importance of examining such relationships at the individual level and may help to guide individual treatment in clinical populations.

Altered white matter connectivity associated with visual hallucinations following occipital stroke.

INTRODUCTION: Visual hallucinations that arise following vision loss stem from aberrant functional activity in visual cortices and an imbalance of activity across associated cortical and subcortical networks subsequent to visual pathway damage. We sought to determine if structural changes in white matter connectivity play a role in cases of chronic visual hallucinations associated with visual cortical damage. METHODS: We performed diffusion tensor imaging (DTI) and probabilistic fiber tractography to assess white matter connectivity in a patient suffering from continuous and disruptive phosphene (simple) visual hallucinations for more than 2 years following right occipital stroke. We compared these data to that of healthy age-matched controls. RESULTS: Probabilistic tractography to reconstruct white matter tracts suggests regeneration of terminal fibers of the ipsilesional optic radiations in the patient. However, arrangement of the converse reconstruction of these tracts, which were seeded from the ipsilesional visual cortex to the intrahemispheric lateral geniculate body, remained disrupted. We further observed compromised structural characteristics, and changes in diffusion (measured using diffusion tensor indices) of white matter tracts in the patient connecting the visual cortex with frontal and temporal regions, and also in interhemispheric connectivity between visual cortices. CONCLUSIONS: Cortical remapping and the disruption of communication between visual cortices and remote regions are consistent with our previous functional magnetic resonance imaging (fMRI) data showing imbalanced functional activity of the same regions in this patient (Rafique et al, 2016, Neurology, 87, 1493-1500). Long-term adaptive and disruptive changes in white matter connectivity may account for the rare nature of cases presenting with chronic and continuous visual hallucinations.

Normal temporal binding window but no sound-induced flash illusion in people with one eye.

Integrating vision and hearing is an important way in which we process our rich sensory environment. Partial deprivation of the visual system from the loss of one eye early in life results in adaptive changes in the remaining senses (e.g., Hoover et al. in Exp Brain Res 216:565-74, 2012). The current study investigates whether losing one eye early in life impacts the temporal window in which audiovisual events are integrated and whether there is vulnerability to the sound-induced flash illusion. In Experiment 1, we measured the temporal binding window with a simultaneity judgement task where low-level auditory and visual stimuli were presented at different stimulus onset asynchronies. People with one eye did not differ in the width of their temporal binding window, but they took longer to make judgements compared to binocular viewing controls. In Experiment 2, we measured how many light flashes were perceived when a single flash was paired with multiple auditory beeps in close succession (sound induced flash illusion). Unlike controls, who perceived multiple light flashes with two, three or four beeps, people with one eye were not susceptible to the sound-induced flash illusion. In addition, they took no longer to respond compared to both binocular and monocular (eye-patched) viewing controls. Taken together, these results suggest that the lack of susceptibility to the sound-induced flash illusion in people with one eye cannot be accounted for by the width of the temporal binding window. These results provide evidence for adaptations in audiovisual integration due to the reduction of visual input from the loss of one eye early in life.

Audiovisual plasticity following early abnormal visual experience: Reduced McGurk effect in people with one eye.

Previously, we have shown that people who have had one eye surgically removed early in life during visual development have enhanced sound localization [1] and lack visual dominance, commonly observed in binocular and monocular (eye-patched) viewing controls [2]. Despite these changes, people with one eye integrate auditory and visual components of multisensory events optimally [3]. The current study investigates how people with one eye perceive the McGurk effect, an audiovisual illusion where a new syllable is perceived when visual lip movements do not match the corresponding sound [4]. We compared individuals with one eye to binocular and monocular viewing controls and found that they have a significantly smaller McGurk effect compared to binocular controls. Additionally, monocular controls tended to perceive the McGurk effect less often than binocular controls suggesting a small transient modulation of the McGurk effect. These results suggest altered weighting of the auditory and visual modalities with both short and long-term monocular viewing. These results indicate the presence of permanent adaptive perceptual accommodations in people who have lost one eye early in life that may serve to mitigate the loss of binocularity during early brain development.

Altered white matter structure in the visual system following early monocular enucleation.

Partial visual deprivation from early monocular enucleation (the surgical removal of one eye within the first few years of life) results in a number of long-term morphological adaptations in adult cortical and subcortical visual, auditory, and multisensory brain regions. In this study, we investigated whether early monocular enucleation also results in the altered development of white matter structure. Diffusion tensor imaging and probabilistic tractography were performed to assess potential differences in visual system white matter in adult participants who had undergone early monocular enucleation compared to binocularly intact controls. To examine the microstructural properties of these tracts, mean diffusion parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were extracted bilaterally. Asymmetries opposite to those observed in controls were found for FA, MD, and RD in the optic radiations, the projections from primary visual cortex (V1) to the lateral geniculate nucleus (LGN), and the interhemispheric V1 projections of early monocular enucleation participants. Early monocular enucleation was also associated with significantly lower FA bidirectionally in the interhemispheric V1 projections. These differences were consistently greater for the tracts contralateral to the enucleated eye, and are consistent with the asymmetric LGN volumes and optic tract diameters previously demonstrated in this group of participants. Overall, these results indicate that early monocular enucleation has long-term effects on white matter structure in the visual pathway that results in reduced fiber organization in tracts contralateral to the enucleated eye. Hum Brain Mapp 39:133-144, 2018. © 2017 Wiley Periodicals, Inc.

Intact Dynamic Visual Capture in People With One Eye.

Observing motion in one modality can influence the perceived direction of motion in a second modality (dynamic capture). For example observing a square moving in depth can influence the perception of a sound to increase in loudness. The current study investigates whether people who have lost one eye are susceptible to audiovisual dynamic capture in the depth plane similar to binocular and eye-patched viewing control participants. Partial deprivation of the visual system from the loss of one eye early in life results in changes in the remaining intact senses such as hearing. Linearly expanding or contracting discs were paired with increasing or decreasing tones and participants were asked to indicate the direction of the auditory stimulus. Magnitude of dynamic visual capture was measured in people with one eye compared to eye-patched and binocular viewing controls. People with one eye have the same susceptibility to dynamic visual capture as controls, where they perceived the direction of the auditory signal to be moving in the direction of the incongruent visual signal, despite previously showing a lack of visual dominance for audiovisual cues. This behaviour may be the result of directing attention to the visual modality, their partially deficient sense, in order to gain important information about approaching and receding stimuli which in the former case could be life-threatening. These results contribute to the growing body of research showing that people with one eye display unique accommodations with respect to audiovisual processing that are likely adaptive in each unique sensory situation.

Consecutive TMS-fMRI reveals remote effects of neural noise to the "occipital face area".

The human cortical system for face perception comprises a network of connected regions including the middle fusiform gyrus ("fusiform face area" or FFA), the inferior occipital gyrus ("occipital face area" or OFA), and the posterior superior temporal sulcus (pSTS). Here, we sought to investigate how transcranial magnetic stimulation (TMS) to the OFA affects activity within the face processing network. We used offline repetitive TMS to temporarily introduce neural noise in the right OFA in healthy subjects. We then immediately performed functional magnetic resonance imaging (fMRI) to measure changes in blood oxygenation level dependent (BOLD) signal across the face network using an fMR-adaptation (fMR-A) paradigm. We hypothesized that TMS to the right OFA would induce abnormal face identity coding throughout the face processing network in regions to which it has direct or indirect connections. Indeed, BOLD signal for face identity, but not non-face (butterfly) identity, decreased in the right OFA and FFA following TMS to the right OFA compared to both sham TMS and TMS to a control site, the nearby object-related lateral occipital area (LO). Further, TMS to the right OFA decreased face-related activation in the left FFA, without any effect in the left OFA. Our findings indicate that TMS to the right OFA selectively disrupts face coding at both the stimulation site and bilateral FFA. TMS to the right OFA also decreased BOLD signal for different identity stimuli in the right pSTS. Together with mounting evidence from patient studies, we demonstrate connectivity of the OFA within the face network and that its activity modulates face processing in bilateral FFA as well as the right pSTS. Moreover, this study shows that deep regions within the face network can be remotely probed by stimulating structures closer to the cortical surface.

rTMS reduces cortical imbalance associated with visual hallucinations after occipital stroke.

OBJECTIVE: To investigate the efficacy of multiday repetitive transcranial magnetic stimulation (rTMS) to the occipital cortex in a patient with continuous visual phosphene hallucinations for more than 2 years following occipital stroke. METHODS: Low-frequency rTMS (1 Hz) was applied to the lesion site for 30 minutes daily over 5 consecutive days. Functional MRI (fMRI) was performed before and after rTMS treatment. RESULTS: Increased application of rTMS corresponded with a reduction in intensity of visual phosphene hallucinations and was reflected in altered blood oxygen level-dependent signal. fMRI revealed focal excitatory discharges at the border of the lesion, highlighting the origin of phosphenes. Post-rTMS, rTMS did not simply suppress activity in the patient but rather redistributed the previously imbalanced cortical activity not only at the stimulation site but in remote cortical regions so that it more closely resembled that of controls. CONCLUSIONS: This case is rare in its presentation of chronic continuous visual phosphene hallucinations following occipital stroke. We present a case of multiday application of rTMS to visual cortex and demonstrate that rTMS provides a valuable therapeutic intervention in modulating visual hallucinations following occipital damage. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence in a single-case report that multiday rTMS reduces intrahemispheric and interhemispheric imbalance and associated visual phosphene hallucinations following occipital stroke.