Functional reorganization of population receptive fields in a hemispherectomy patient with blindsight

Blindsight refers to the ability of some patients with destruction of the primary visual cortex (V1) to respond to stimuli presented in their clinically blind visual field despite lack of visual awareness. Here we tested a rare and well-known patient with blindsight following hemispherectomy, DR, who has had the entire cortex in the right hemisphere removed, and in whom the right superior colliculus is the only post-chiasmatic visual structure remaining intact. Compared to more traditional cases of blindsight after damage confined to V1, the study of blindsight in hemispherectomy has offered the invaluable opportunity to examine directly two outstanding questions: the contribution of the intact hemisphere to visual processing without awareness, and the nature of plastic and compensatory changes in these remaining contralesional visual areas. Population receptive field (pRF) mapping was used to define retinotopic maps, delineate the boundaries between the visual areas, examine changes in the sizes of receptive field centres within each visual area, and their variability as a function of eccentricity. Aside from the dorsal visual areas showing blurred borders between V2d and V3d, not otherwise detected with perimetric mapping, the retinotopic maps of DR did not differ substantially from those of three matched healthy controls. Interestingly, those dorsal compartments showed a significant increase in the RF sizes toward values typical of higher-order processing cortices, while no differences were observed in the corresponding ventral visual areas. Findings showed that whereas receptive field sizes at foveal and parafoveal eccentricities (≤ 4°) were not measurably altered, the pRF size increased by ~ 270% at 4-6° of eccentricity, and the size difference reached ~ 300% between 8° and 10°. We interpret these findings to suggest that an increase in pRF sizes could be indicative of cerebral plasticity involving the retinotopic reorganization of the dorsal visual areas.