Conscious vision in blindness: A new perceptual phenomenon implemented on the "wrong" side of the brain

Patients with lesions in the visual cortex are blind in corresponding regions of the visual field, but they still may process visual information, a phenomenon referred to as residual vision or "blindsight". Here we report behavioral and fMRI observations with a patient who reports conscious vision across an extended area of blindness for moving, but not for stationary stimuli. This completion effect is shown to be of perceptual and not of conceptual origin, most likely mediated by spared representations of the visual field in the striate cortex. The neural output to extra-striate areas from regions of the deafferented striate cortex is apparently still intact; this is, for instance, indicated by preserved size constancy of visually completed stimuli. Neural responses as measured with fMRI reveal an activation only for moving stimuli, but importantly on the ipsilateral side of the brain. In a conceptual model this shift of activation to the "wrong" hemisphere is explained on the basis of an imbalance of excitatory and inhibitory interactions within and between the striate cortices due to the brain injury. The observed neuroplasticity indicated by this shift together with the behavioral observations provide important new insights into the functional architecture of the human visual system and provide new insight into the concept of consciousness.