Cross-modal plasticity in a blind jazz pianist and prodigy

Musical improvisation requires complex cognitive operations, including idea generation, retrieval, and evaluation, supported by continuous sensory feedback. The neural reorganization that accompanies sensory loss has been described, but its impact on improvisation remains poorly understood. We present a case study of Matthew Whitaker (MW), a blind jazz piano prodigy with retinopathy of prematurity, to examine how cortical plasticity supports musical expertise. Functional magnetic resonance imaging (fMRI) was used to probe neural activity during three paradigms: music perception, proprioceptive sound-to-space mapping, and improvisation. As no suitable control group exists for a blind musical prodigy, internal controls contrasted experimental conditions to a matched control task for each paradigm. Results revealed recruitment of occipital visual regions during music perception, engagement of fusiform face areas during proprioceptive keyboard navigation, and coordinated activation and deactivation of frontal and occipital regions during improvisation. These findings demonstrate extensive cross-modal plasticity. As a musician who is blind, MW has undergone functional neural reorganization, recruiting his unused visual areas to aid him in his musical pursuits, from listening to navigating the keyboard to improvising.