We investigated localization performance of simple targets in patient TN, who suffered bilateral damage of his primary visual cortex and shows complete cortical blindness. Using a two-alternative forced-choice paradigm, TN was asked to guess the position of left–right targets with goal-directed and discrete manual responses. The results indicate a clear dissociation between goal-directed and discrete responses. TN pointed toward the correct target location in approximately 75% of the trials but was at chance level with discrete responses. This indicates that the residual ability to localize an unseen stimulus depends critically on the possibility to translate a visual signal into a goal-directed motor output at least in certain forms of blindsight.

Following destruction or deafferentation of primary visual cortex (area V1, striate cortex), clinical blindness ensues, but residual visual functions may, nevertheless, persist without perceptual consciousness (a condition termed blindsight ). The study of patients with such lesions thus offers a unique opportunity to investigate what visual capacities are mediated by the extrastriate pathways that bypass V1. Here we provide evidence for a crucial role of the collicular–extrastriate pathway in nonconscious visuomotor integration by showing that, in the absence of V1, the superior colliculus (SC) is essential to translate visual signals that cannot be consciously perceived into motor outputs. We found that a gray stimulus presented in the blind field of a patient with unilateral V1 loss, although not consciously seen, can influence his behavioral and pupillary responses to consciously perceived stimuli in the intact field (implicit bilateral summation). Notably, this effect was accompanied by selective activations in the SC and in occipito-temporal extrastriate areas. However, when instead of gray stimuli we presented purple stimuli, which predominantly draw on S-cones and are thus invisible to the SC, any evidence of implicit visuomotor integration disappeared and activations in the SC dropped significantly. The present findings show that the SC acts as an interface between sensory and motor processing in the human brain, thereby providing a contribution to visually guided behavior that may remain functionally and anatomically segregated from the geniculo-striate pathway and entirely outside conscious visual experience.

Survival depends to some extent on the ability to detect salient signals and prepare an appropriate response even when attention is engaged elsewhere. Fearful body language is a salient signal of imminent danger, easily observable from a distance and indicating to the observer which adaptive action to prepare for. Here we investigated for the first time whether fearful body language modulates the spatial distribution of attention and enhances visual awareness in neurological patients with severe attentional disorders. Patients with visual extinction and hemispatial neglect following right parietal injury have a rightward attentional bias accompanied by loss of awareness for contralesional left stimuli, especially when competing stimuli appear to the right. Three such patients were tested with pictures of fearful, happy, and neutral bodily expressions briefly presented either unilaterally in the left or right visual field, or to both fields simultaneously. On bilateral trials, unattended and task-irrelevant fearful bodily expressions modulated attentional selection and visual awareness. Fearful bodily expressions presented in the contralesional unattended visual field simultaneously with neutral bodies in the ipsilesional field were detected more often than left-side neutral or happy bodies. This demonstrates that despite pathological inattention and parietal damage, emotion and action-related information in fearful body language may be extracted automatically, biasing attentional selection and visual awareness. Our findings open new perspectives on the role of bodily expressions in attentional selection and suggest that a neural network in intact fronto-limbic and visual areas may still mediate reorienting of attention and preparation for action upon perceiving fear in others.

Behavioral studies indicate a right hemisphere advantage for processing a face as a whole and a left hemisphere superiority for processing based on face features. The present PET study identifies the anatomical localization of these effects in well-defined regions of the middle fusiform gyri of both hemispheres. The right middle fusiform gyrus, previously described as a face-specific region, was found to be more activated when matching whole faces than face parts whereas this pattern of activity was reversed in the left homologous region. These lateralized differences appeared to be specific to faces since control objects processed either as wholes or parts did not induce any change of activity within these regions. This double dissociation between two modes of face processing brings new evidence regarding the lateralized localization of face individualization mechanisms in the human brain.