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Audiovisual Rehabilitation in Hemianopia: A Model-Based Theoretical Investigation

机译:Hemianopia的视听康复:基于模型的理论研究

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摘要

Hemianopic patients exhibit visual detection improvement in the blind field when audiovisual stimuli are given in spatiotemporally coincidence. Beyond this “online” multisensory improvement, there is evidence of long-lasting, “offline” effects induced by audiovisual training: patients show improved visual detection and orientation after they were trained to detect and saccade toward visual targets given in spatiotemporal proximity with auditory stimuli. These effects are ascribed to the Superior Colliculus (SC), which is spared in these patients and plays a pivotal role in audiovisual integration and oculomotor behavior. Recently, we developed a neural network model of audiovisual cortico-collicular loops, including interconnected areas representing the retina, striate and extrastriate visual cortices, auditory cortex, and SC. The network simulated unilateral V1 lesion with possible spared tissue and reproduced “online” effects. Here, we extend the previous network to shed light on circuits, plastic mechanisms, and synaptic reorganization that can mediate the training effects and functionally implement visual rehabilitation. The network is enriched by the oculomotor SC-brainstem route, and Hebbian mechanisms of synaptic plasticity, and is used to test different training paradigms (audiovisual/visual stimulation in eye-movements/fixed-eyes condition) on simulated patients. Results predict different training effects and associate them to synaptic changes in specific circuits. Thanks to the SC multisensory enhancement, the audiovisual training is able to effectively strengthen the retina-SC route, which in turn can foster reinforcement of the SC-brainstem route (this occurs only in eye-movements condition) and reinforcement of the SC-extrastriate route (this occurs in presence of survived V1 tissue, regardless of eye condition). The retina-SC-brainstem circuit may mediate compensatory effects: the model assumes that reinforcement of this circuit can translate visual stimuli into short-latency saccades, possibly moving the stimuli into visual detection regions. The retina-SC-extrastriate circuit is related to restitutive effects: visual stimuli can directly elicit visual detection with no need for eye movements. Model predictions and assumptions are critically discussed in view of existing behavioral and neurophysiological data, forecasting that other oculomotor compensatory mechanisms, beyond short-latency saccades, are likely involved, and stimulating future experimental and theoretical investigations.
机译:当时空重合给予视听刺激时,偏盲患者在盲区显示出视觉检测的改善。除了这种“在线”多感官改善之外,还有视听训练引起的持久“离线”效应的证据:患者经过训练以发现并朝着听觉刺激在时空上接近的视觉目标进行训练后,表现出更好的视觉检测和定向。这些影响归因于上腔囊(SC),这些患者可以幸免,并且在视听整合和动眼行为中起关键作用。最近,我们开发了视听皮质-皮质环的神经网络模型,包括代表视网膜,横纹和横纹视觉皮层,听觉皮层和SC的互连区域。该网络模拟了单侧V1病变以及可能的备用组织,并再现了“在线”效应。在这里,我们扩展了以前的网络,以阐明电路,塑性机制和突触重组,它们可以介导训练效果并在功能上实现视觉康复。该网络通过动眼SC-brainstem途径和Hebbian突触可塑性机制得以丰富,并用于在模拟患者上测试不同的训练范例(视听/视觉刺激的眼动/固定眼条件)。结果预测了不同的训练效果,并将它们与特定电路中的突触变化相关联。由于SC多感官增强,视听训练能够有效地增强视网膜-SC路径,从而可以增强SC-脑干路径的增强(这仅在眼球运动条件下发生)和SC硬脑膜的增强途径(无论眼睛状况如何,这种情况都会在存在存活的V1组织的情况下发生)。视网膜-SC-脑干电路可能介导补偿作用:模型假设该电路的增强可以将视觉刺激转换为短时延扫视,可能会将刺激移至视觉检测区域。视网膜SC过度循环与恢复作用有关:视觉刺激可以直接引起视觉检测,而无需眼睛运动。考虑到现有的行为和神经生理学数据,对模型的预测和假设进行了严格的讨论,预测除了短时延扫视之外,可能还会涉及其他动眼补偿机制,并刺激未来的实验和理论研究。

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