Advanced Spatiomotor Rehabilitation for Navigation in Blindness & Visual Impairment ABSTRACT We propose a radical new multidisciplinary approach to navigation training in blindness and visual impairment. Successful navigation requires the development of an accurate and flexible mental, or cognitive, map of the navigational space and of the route trajectory required to travel from the current to the target location. The Cognitive-Kinesthetic (C-K) Rehabilitation Training that we have developed in the preceding period utilizes a unique form of blind memory-guided drawing to develop cognitive mapping to a high level of proficiency. Particular reliance must be placed on such mental maps (supported only by tactile and auditory inputs), and on the ability to use them effectively for spatiomotor control, when vision with its built-in spatial functionality is lost. There is, however, a fundamental gap in the practice of Orientation and Mobility (O&M), which is the lack of a specific emphasis on enhancement of these cognitive roots of spatiomotor activity, despite their known importance for navigation in the visually impaired. We therefore propose a rigorous multidisciplinary approach to this issue, which lies at the intersection of the fields of spatiomotor rehabilitation, blindness assessment technologies, and brain function, each a focus of one Specific Aim. To train the spatial cognition abilities underlying successful navigation, the current proposal aims to translate the power of the C-K Rehabilitation Training, which we developed in the preceding grant period for the manual domain of operation, to the domain of navigation. The blind and visually impaired trainees will quickly learn how to generate precise and stable cognitive maps of haptically explored raised-line images or tactile maps, and how to use the formed cognitive maps to confidently guide both drawing ?hand navigation? on a map-scale, and whole-body blind navigation on the macro-scale. Once translated to navigation, our preliminary data show that this efficient and enjoyable training will rapidly and sustainably enhance spatial cognition functions both for improved navigation performance and for enhancement of more general spatial cognitive skills. Beyond its practical advantages, the training will also serve as an efficient tool to drive and study training-based neuroplasticity mechanisms through a comprehensive whole-brain multimodal brain imaging platform. These neuroplastic are difficult to study properly without a rapid and effective training protocol, which has not previously been available. Taken together, the research program will overcome the relative disconnect between expanding neuroscience knowledge and approaches to practical blindness rehabilitation. The knowledge gained will in turn inform and benefit further rehabilitative developments, both in navigation proficiency and in more general cognitive function in the blind population. !
HEALTH RELEVANCE Blind and visually impaired individuals often have trouble navigating independently, safely and efficiently, and as a result face barriers to employment and living an independent life; a major reason for this problem is that they cannot rely on the visuo-motor control mechanisms that forms the normal basis for navigation and preparatory route planning. In view of the challenge for the visually impaired of finding and following an optimal route from tactile maps, it is of prime importance to train their spatial cognition capabilities in this regard, and to enhance their spatial memory to be able to encode and retrieve the navigational features as they proceed along their route. In accordance with NEI strategic goals, this multidisciplinary project will promote the development of well-informed new approaches to navigational rehabilitation, and will also generate a large web-accessible database of new knowledge on rehabilitation-driven memory enhancement and cross- modal brain plasticity to benefit 'cutting edge' fields of mobile assistive technologies, vision restoration and memory facilitation for the aging brain.
| Cacciamani, Laura; Likova, Lora T (2017) Memory-guided drawing training increases Granger causal influences from the perirhinal cortex to V1 in the blind. Neurobiol Learn Mem 141:101-107 |
| Cacciamani, Laura; Likova, Lora T (2016) Tactile Object Familiarity in the Blind Brain Reveals the Supramodal Perceptual-Mnemonic Nature of the Perirhinal Cortex. Front Hum Neurosci 10:92 |
| Karim, A K M Rezaul; Proulx, Michael J; Likova, Lora T (2016) Anticlockwise or clockwise? A dynamic Perception-Action-Laterality model for directionality bias in visuospatial functioning. Neurosci Biobehav Rev 68:669-693 |
| Likova, Lora T; Tyler, Christopher W; Cacciamani, Laura et al. (2016) The Cortical Network for Braille Writing in the Blind. IS&T Int Symp Electron Imaging 2016: |
| Likova, Lora; Tyler, Christopher; Cacciamani, Laura et al. (2015) Effect of familiarity on Braille writing and reading in the blind: From graphemes to comprehension. J Vis 15:920 |
