盲人学习“电子蝙蝠耳”声音定位的康复及神经机制研究

The lost of vision has a negative influence on blind individuals and their families, and it could lead to public health and social problems. Current rehabilitation programs for the blind have limitations such as technical difficulty and high cost, which cannot solve the dilemma of the blind. Based on the principle of sensory substitution, our team developed the “Bat-ears” electronic device to help navigation of blind individuals. Our previous work showed that early blind subjects can obtain distance information from the “Bat-ears” sounds through 8 hours of training. However, it requires more optimized rehabilitation program for blind people to do sound localization with the “Bat-ears”. In addition, late blind individuals accounted for the majority of the blind population, whose visual cortex have cross-modal reorganization. In other words, late blind individuals also have the possibility of rehabilitation. The present study employs a new rehabilitation training program to evaluate the effectiveness of the “Bat-ears” device in improving the spatial resolution for both early and late blind individuals. Furthermore, fMRI is used to investigate the neural mechanism underlying sound localization with the "Bat-ears" sounds in blind individuals. The results of the study will further our understanding of the neural mechanisms of sound localization in blind, which provides a theoretical basis for optimization of the “Bat-ears” rehabilitation program for early and late blind individuals. Finally, it will bring new hope for blind’s rehabilitation.

失明给盲人及其家庭造成巨大影响，更是严重的公共健康和社会问题。目前临床上对盲人的康复方法具有技术困难、成本高等局限性，短期内不能解决盲人群体的困境。我们在前期工作中基于感觉替代原理研发“电子蝙蝠耳”装置帮助盲人用声音引路。研究显示，早期盲通过8小时训练即可从“电子蝙蝠耳”声音习得物体远近信息。盲人熟练掌握“电子蝙蝠耳”声音以辨别物体的准确位置则需更优化的康复训练方案。此外，晚期盲占盲人群体的大多数，且他们也有视觉皮层跨感觉通道重组，即也有康复的可能性。本项目将以早期盲和晚期盲为研究对象，采用新的康复训练方案进一步评估“电子蝙蝠耳”在提高其空间分辨能力中的作用，并通过功能核磁共振技术（fMRI）探究他们学习“电子蝙蝠耳”声音定位的神经机制。研究结果将加深对盲人学习“电子蝙蝠耳”声音定位的神经机制的理解，为分别优化早晚期盲“电子蝙蝠耳”康复训练奠定理论基础，并最终为盲人康复带来新希望。

失明是严重的公共健康和社会问题，但是其康复方法具有诸多局限性。本项目旨在评估感觉替代装置“电子蝙蝠耳”在提高早期盲和晚期盲空间分辨能力中的作用及其相应的神经机制。研究发现早期盲学习“电子蝙蝠耳”声音进行空间定位主要依靠边缘系统-多感官神经网络。按照视觉空间工作记忆的高低划分，晚期盲是一个不同质群体，其中视觉空间工作记忆高的晚期盲主要依靠楔前叶-舌回神经网络完成空间定位任务。以上结果提示部分晚期盲受早年视觉经验的影响发展出了较高能力的视觉空间工作记忆，这会加强他们的听觉空间定位能力，将视觉空间工作记忆训练融入“电子蝙蝠耳”康复训练方案，在晚期盲群体中可以达到最佳行为学效果。在此基础上，课题组进一步做了系统评价和meta分析，纳入55篇文献，结果提示早期盲的视觉双通路功能基本保存，即背侧通路主要加工空间信息，腹侧通路主要加工物体信息。以上研究结果加深对盲人跨感觉通道学习的神经机制的理解，为早期盲和晚期盲分别设计更优化的康复训练方案奠定重要理论基础，并最终为盲人的康复打开一扇新的希望之门。