Neural correlates of perceptual filling-in: fMRI evidence in the foveal projection zone of patients with central scotoma

Patients with juvenile retinal dystrophy often report that they are unaware of their central scotoma, suggesting the presence of perceptual filling-in. We used functional Magnetic Resonance Imaging (fMRI) to determine possible neural correlates of perceptual filling-in in patients with retinal distrophy and clinically established central scotoma in both eyes. The data of 5 patients (Stargardt disease, cone-rod dystrophy; mean age 45 yrs; scotoma diameter 10-20°) and of 5 normally sighted controls were analyzed. Fixation behaviour and perimetry were measured with a Nidek microperimeter. Magnetic resonance imaging was performed using a Siemens 3T Allegra scanner. We stimulated the central visual field (30 deg) with a vertically oriented, low spatial frequency (1 c/deg) high-contrast sinewave grating that was either a) continuous, or b) was interrupted by a central grey disk. The disk was either slightly larger than the scotoma (detectable on 75% of trials) or slightly smaller (detectable on 25% of trials). To control for attention, an eccentric fixation task was performed during scanning. Data were analyzed using SPM8 (GLM with ROI analysis to obtain percent signal change for foveal projection zone). Results: for all patients, the BOLD signal in the foveal projection area was significantly higher for the small disk (i.e., condition leading to complete filling-in) than for the large disk (i.e., no filling-in). This effect was absent in the control subjects. Our findings support the existence of an active neural process that leads to filling-in in patients with central visual field scotomata. Meeting abstract presented at VSS 2012