Visual experience shapes functional connectivity between occipital and non-visual networks

  1. Mengyu Tian
  2. Xiang Xiao
  3. Huiqing Hu
  4. Rhodri Cusack
  5. Marina Bedny

  • Curated by eLife

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    eLife Assessment

    This important study provides evidence supporting the hypothesis that postnatal visual experience shapes the patterns of functional connectivity between extrastriate visual cortex and frontal regions, by comparing neonates, blind and sighted adults using resting-state fMRI. The evidence supporting the main claim is convincing, and the authors' interpretations are appropriately calibrated in the discussion. Nevertheless, the study design and methodology are inherently limited to resolve the underlying mechanisms driving connectivity changes during neurodevelopment (experience-related plasticity vs post-natal experience-independent maturation). This study will be of broad interest to neuroscientists and neuroimaging researchers studying vision, plasticity and brain development.

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Abstract

Comparisons of visual cortex function across blind and sighted adults reveals effects of experience on human brain function. Since almost all research has been done with adults, little is known about the developmental origins of plasticity. We compared resting state functional connectivity of visual cortices of blind adults (n = 30), blindfolded sighted adults (n = 50) to a large cohort of infants (Developing Human Connectome Project, n = 475). Visual cortices of sighted adults show stronger coupling with non-visual sensory-motor networks (auditory, somatosensory/motor), than with higher-cognitive prefrontal cortices (PFC). In contrast, visual cortices of blind adults show stronger coupling with higher-cognitive PFC than with nonvisual sensory-motor networks. Are infant visual cortices functionally like those of sighted adults, with blindness leading to functional change? We find that, on the contrary that secondary visual cortices of infants are functionally more like those of blind adults: stronger coupling with PFC than with nonvisual sensory-motor networks, suggesting that visual experience modifies elements of the sighted-adult long-range functional connectivity profile. Infant primary visual cortices are in-between blind and sighted adults i.e., more balanced PFC and sensory-motor connectivity than either adult group. The lateralization of occipital-to-frontal connectivity in infants resembles the sighted adults, consistent with the idea that blindness leads to functional change. These results suggest that both vision and blindness modify functional connectivity through experience-driven (i.e., activity-dependent) plasticity.

Article activity feed

  1. Version published to 10.7554/elife.93067.3 on eLife
  2. Version published to 10.7554/elife.93067 on eLife
  3. eLife

    eLife Assessment

    This important study provides evidence supporting the hypothesis that postnatal visual experience shapes the patterns of functional connectivity between extrastriate visual cortex and frontal regions, by comparing neonates, blind and sighted adults using resting-state fMRI. The evidence supporting the main claim is convincing, and the authors' interpretations are appropriately calibrated in the discussion. Nevertheless, the study design and methodology are inherently limited to resolve the underlying mechanisms driving connectivity changes during neurodevelopment (experience-related plasticity vs post-natal experience-independent maturation). This study will be of broad interest to neuroscientists and neuroimaging researchers studying vision, plasticity and brain development.

  4. eLife

    Reviewer #1 (Public review):

    Summary:

    The present study evaluates the role of visual experience in shaping functional correlations between human extrastriate visual cortex and frontal regions. The authors used fMRI to assess "resting-state" temporal correlations in three groups: sighted adults, congenitally blind adults, and neonates. Previous research has already demonstrated differences in functional correlations between visual and frontal regions in sighted compared to early blind individuals. The novel contribution of the current study lies in the inclusion of an infant dataset, which allows for an assessment of the developmental origins of these differences.

    The main results of the study reveal that correlations between prefrontal and visual regions are more prominent in the blind and infant groups, with the blind group exhibiting greater lateralization. Conversely, correlations between visual and somato-motor cortices are more prominent in sighted adults. Based on these data, the authors conclude that visual experience shapes these cortical networks through activity-dependent plasticity. This study provides novel insights into the impact of visual experience on the development of temporal correlations in the brain.

    Strengths:

    The dissociations in functional correlations observed among the sighted adult, congenitally blind, and neonate groups provide strong support for the main conclusion regarding postnatal experience-driven shaping of visual-frontal connectivity.

    The neonatal data offers a unique and valuable developmental anchor for interpreting divergence between blind and sighted adults. This is a major advance over prior studies limited to adult comparisons.

    Convergence with prior findings in the blind and sighted adult groups reinforces the reliability and external validity of the present results.

    The split-half reliability analysis in the infant and adult data increases confidence in the robustness of the reported group differences.

    Weaknesses:

    The methodology cannot determine whether group differences in correlations reflect direct changes in communication between visual and frontal regions or indirect effects mediated by other structures.

    The cross-sectional design cannot reveal the timecourse over which visual experience shapes connectivity between infancy and adulthood.

    Whether the infant resting-state patterns imply similar functional capacity to blind adults (e.g., cross-modal task responses) remains untested.

    Comments on revisions:

    The authors have done a fantastic job addressing my remaining questions.

  5. eLife

    Reviewer #2 (Public review):

    Summary:

    Tian et al. explore the developmental origins of cortical reorganization in blindness. Previous work has found that a set of regions in the occipital cortex show different functional responses and patterns of functional correlations in blind vs. sighted adults. Here, Tian et al. explore how this organisation arises over development, asking whether the infant brain looks more like the blind adult pattern, or more like the sighted adult pattern. Their analyses reveal that the answer depends on the particular networks investigated. Some functional connections in infants look more like blind than sighted adults; other functional connections look more like sighted than blind adults; and others fall somewhere in the middle, or show an altogether different pattern in infants compared with both sighted and blind adults.

    Strengths:

    The paper addresses very important questions about the "starting state" in the developing visual cortex, and how cortical networks are shaped by experience. Another clear strength lies in the unequivocal nature of many results. Many results have very large effect sizes, critical interactions between regions and groups are tested and found, and infant analyses are replicated in split halves of the data.

    Weaknesses:

    While potential roles of experience (e.g., visual, cross-modal) are discussed in detail, little consideration is given to the role of experience-independent maturation. The infants scanned are extremely young, only 2 weeks old. It is possible that the sighted adult pattern may still emerge later in infancy or childhood, regardless of infant visual experience. If so, the blind adult pattern may depend on blindness-related experience only (which may or may not reflect "visual" experience per se). In short, it is not clear that the age range studied is a clear-cut "starting point" for development, after which all change can be attributed to experience.

  6. eLife

    Reviewer #3 (Public review):

    Summary

    This study aimed to investigate whether the differences observed in the organization of visual brain networks between blind and sighted adults result from a reorganization of an early functional architecture due to blindness, or whether the early architecture is immature at birth and requires visual experience to develop functional connections. This question was investigated through the comparison of 3 groups of subjects with resting-state functional MRI (rs-fMRI). Based on convincing analyses, the study suggests that: 1) secondary visual cortices showed higher connectivity to prefrontal cortical regions (PFC) than to non-visual sensory areas (S1/M1 and A1) in infants like in blind adults, in contrast to sighted adults; 2) the V1 connectivity pattern of infants lies between that of sighted adults (showing stronger functional connectivity with non-visual sensory areas than with PFC) and that of blind adults (showing stronger functional connectivity with PFC than with non-visual sensory areas); 3) the laterality of the connectivity patterns of infants resembled those of sighted adults more than those of blind adults, but infants showed a less differentiated fronto-occipital connectivity pattern than adults.

    Strengths

    - The question investigated in this article is important for understanding the mechanisms of plasticity during typical and impaired development, and the approach considered, which compares different groups of subjects including, neonates/infants and blind adults, is highly original.

    - Overall, the presented analyses are solid and well-detailed, and the results and discussion are convincing.

    Weaknesses

    - While it is informative to compare the "initial" state (close to birth) and the "final" states in blind and sighted adults to study the impact of post-natal and visual experience, this study does not analyze the chronology of this development and when the specialization of functional connections is completed. This would require investigating the evolution of functional connectivity of the visual system as a function of visual experience and thus as a function of age, at least during toddlerhood given the early and intense maturation of the visual system after birth. This could be achieved by analyzing different developmental periods using open databases such as the Baby Connectome Project.

    - The rationale for grouping full-term neonates and preterm infants (scanned at term-equivalent age) is not understandable when seeking to perform comparisons with adults. Even if the study results do not show differences between full-terms and preterms in terms of functional connectivity differences between regions and of connectivity patterns, preterms group had different neurodevelopment and post-natal (including visual) experiences (even a few weeks might have an impact). And actually they show reduced connectivity strength systematically for all regions compared with full-terms (Sup Fig 7). Considering a more homogeneous group of neonates would have strengthened the study design.

    - The rationale for presenting results on the connectivity of secondary visual cortices before the one of primary cortices (V1) could be clarified.

    - The authors acknowledge the methodological difficulties for defining regions of interest (ROIs) in infants in a similar way as adults. Since the brain development is not homogeneous and synchronous across brain regions (in particular with the frontal and parietal lobes showing a delayed growth), this poses major problems for registration. This raises the question of whether the study findings could be biased by differences in ROI positioning across groups.

    Comments on revisions:

    The authors have addressed my specific recommendations, but some weaknesses in the study remain, particularly the inclusion of preterm infants alongside full-term neonates.

  7. eLife

    Author response:

    The following is the authors’ response to the previous reviews

    Public Reviews:

    Reviewer #1 (Public review):

    Summary:

    The present study evaluates the role of visual experience in shaping functional correlations between human extrastriate visual cortex and frontal regions. The authors used fMRI to assess "resting-state" temporal correlations in three groups: sighted adults, congenitally blind adults, and neonates. Previous research has already demonstrated differences in functional correlations between visual and frontal regions in sighted compared to early blind individuals. The novel contribution of the current study lies in the inclusion of an infant dataset, which allows for an assessment of the developmental origins of these differences.

    The main results of the study reveal that correlations between prefrontal and visual regions are more prominent in the blind and infant groups, with the blind group exhibiting greater lateralization. Conversely, correlations between visual and somato-motor cortices are more prominent in sighted adults. Based on these data, the authors conclude that visual experience plays an instructive role in shaping these cortical networks. This study provides valuable insights into the impact of visual experience on the development of functional connectivity in the brain.

    Strengths:

    The dissociations in functional correlations observed among the sighted adult, congenitally blind, and neonate groups provide strong support for the main conclusion regarding postnatal experience-driven shaping of visual-frontal connectivity.

    The inclusion of neonates offers a unique and valuable developmental anchor for interpreting divergence between blind and sighted adults. This is a major advance over prior studies limited to adult comparisons.

    Convergence with prior findings in the blind and sighted adult groups reinforces the reliability and external validity of the present results.

    The split-half reliability analysis in the infant data increases confidence in the robustness of the reported group differences.

    Weaknesses:

    The manuscript risks overstating a mechanistic distinction between sighted and blind development by framing visual experience as "instructive" and blindness as "reorganizing." Similarly, the binary framing of visual experience and blindness as independent may oversimplify shared plasticity mechanisms.

    The interpretation of changes in temporal correlations as altered neural communication does not adequately consider how shifts in shared variance across networks may influence these measures without reflecting true biological reorganization.

    The discussion does not substantively engage with the longstanding debate over whether sensory experience plays an instructive or permissive role in cortical development.

    The relationship between resting-state and task-based findings in blindness remains unclear.

    Reviewer #2 (Public review):

    Summary:

    Tian et al. explore the developmental origins of cortical reorganization in blindness. Previous work has found that a set of regions in the occipital cortex show different functional responses and patterns of functional correlations in blind vs. sighted adults. Here, Tian et al. explore how this organization arises over development. Is the "starting state" more like the blind pattern, or more like the adult pattern? Their analyses reveal that the answer depends on the particular networks investigated. Some functional connections in infants look more like blind than sighted adults; other functional connections look more like sighted than blind adults; and others fall somewhere in the middle, or show an altogether different pattern in infants compared with both sighted and blind adults.

    Strengths:

    The paper addresses very important questions about the starting state in the developing visual cortex, and how cortical networks are shaped by experience. Another clear strength lies in the unequivocal nature of many results. Many results have very large effect sizes, critical interactions between regions and groups are tested and found, and infant analyses are replicated in split halves of the data.

    Weaknesses:

    While potential roles of experience (e.g., visual, cross-modal) are discussed in detail, little consideration is given to the role of experience-independent maturation. The infants scanned are extremely young, only 2 weeks old. It is possible then that the sighted adult pattern may still emerge later in infancy or childhood, regardless of infant visual experience. If so, the blind adult pattern may depend on blindness-related experience only (which may or may not reflect "visual" experience per se). In short, it is not clear that birth, or the first couple weeks of life, are a clear cut "starting point" for development, after which all change can be attributed to experience.

    Reviewer #3 (Public review):

    Summary

    This study aimed to investigate whether the differences observed in the organization of visual brain networks between blind and sighted adults result from a reorganization of an early functional architecture due to blindness, or whether the early architecture is immature at birth and requires visual experience to develop functional connections. This question was investigated through the comparison of 3 groups of subjects with resting-state functional MRI (rs-fMRI). Based on convincing analyses, the study suggests that: 1) secondary visual cortices showed higher connectivity to prefrontal cortical regions (PFC) than to non-visual sensory areas (S1/M1 and A1) in infants like in blind adults, in contrast to sighted adults; 2) the V1 connectivity pattern of infants lies between that of sighted adults (showing stronger functional connectivity with non-visual sensory areas than with PFC) and that of blind adults (showing stronger functional connectivity with PFC than with non-visual sensory areas); 3) the laterality of the connectivity patterns of infants resembled those of sighted adults more than those of blind adults, but infants showed a less differentiated fronto-occipital connectivity pattern than adults.

    Strengths

    - The question investigated in this article is important for understanding the mechanisms of plasticity during typical and impaired development, and the approach considered, which compares different groups of subjects including, neonates/infants and blind adults, is highly original.

    - Overall, the presented analyses are solid and well detailed, and the results and discussion are convincing.

    Weaknesses

    - While it is informative to compare the "initial" state (close to birth) and the "final" states in blind and sighted adults to study the impact of post-natal and visual experience, this study does not analyze the chronology of this development and when the specialization of functional connections is completed. This would require investigating the evolution of functional connectivity of the visual system as a function of visual experience and thus as a function of age, at least during toddlerhood given the early and intense maturation of the visual system after birth. This could be achieved by analyzing different developmental periods using open databases such as the Baby Connectome Project.

    - The rationale for grouping full-term neonates and preterm infants (scanned at term-equivalent age) is not understandable when seeking to perform comparisons with adults. Even if the study results do not show differences between full-terms and preterms in terms of functional connectivity differences between regions and of connectivity patterns, preterms group had different neurodevelopment and post-natal (including visual) experiences (even a few weeks might have an impact). And actually they show reduced connectivity strength systematically for all regions compared with full-terms (Sup Fig 7). Considering a more homogeneous group of neonates would have strengthen the study design.

    - The rationale for presenting results on the connectivity of secondary visual cortices before the one of primary cortices (V1) could be clarified.

    - The authors acknowledge the methodological difficulties for defining regions of interest (ROIs) in infants in a similar way as adults. Since the brain development is not homogeneous and synchronous across brain regions (in particular with the frontal and parietal lobes showing a delayed growth), this poses major problems for registration. This raises the question of whether the study findings could be biased by differences in ROI positioning across groups.

    Recommendations for the authors:

    Reviewer #1 (Recommendations for the authors):

    The authors are appropriately cautious in many parts of the discussion and include several helpful control analyses. Nonetheless, additional clarification of key assumptions and potential confounds would strengthen the paper.

    (1) The current framing labels vision as "instructive" and blindness as "reorganizing," but it is unclear why these two experiential factors are characterized differently. Both involve activity-dependent changes to functional architecture from a shared immature scaffold. Labeling them differently risks conflating divergent outcomes with distinct underlying mechanisms. Just because visual and blind adults show different patterns of functional connectivity does not mean they reflect separate processes. While the discussion briefly acknowledges the possibility of shared plasticity mechanisms, much of the framing across the manuscript, including in the abstract and introduction, implies a dichotomy. A clearer articulation of the criteria used to assign these labels, or reconsideration of whether such a distinction is warranted, would improve conceptual clarity. The current framing appears analogous to saying that "heat causes expansion" and "cold causes contraction" as if these were separate mechanisms, when they are actually two directions of change along a single factor: temperature. A more parsimonious framework, such as activity-dependent reweighting of pre-existing connectivity, may better capture the nature of plasticity at play in both sighted and blind development.

    Following the reviewer’s suggestion, we have revised the manuscript to clarify that both vision and blindness can be understood as manifestations of a common framework of experience-driven plasticity. We removed all mention of reorganization and clarify and modified the wording throughout.

    Specifically:

    Abstract: “Are infant visual cortices functionally like those of sighted adults, with blindness leading to functional change? We find that, on the contrary that secondary visual cortices of infants are functionally more like those of blind adults: stronger coupling with PFC than with nonvisual sensory-motor networks, suggesting that visual experience modifies elements of the sighted-adult long-range functional connectivity profile. Infant primary visual cortices are in-between blind and sighted adults i.e., more balanced PFC and sensory-motor connectivity than either adult group. The lateralization of occipital-to-frontal connectivity in infants resembles the sighted adults, consistent with the idea that blindness leads to functional change. These results suggest that both vision and blindness modify functional connectivity through experience-driven (i.e., activity-dependent) plasticity.” (Page 1, Line 13)

    Introduction: We replaced “blindness leads to functional reorganization” with “blindness modifies this functional connectivity” (Page 2, Line 52), and the following sentence has also been modified to: “lifetime visual experience shapes connectivity toward the sighted-adult pattern” (Page 2, Line 54) For the lateralization patterns, we now describe them as “blindness-related modification” rather than “reorganization”, to keep the interpretation descriptive rather than mechanistic. (Page 4, Line 114),

    (2) In interpreting the functional correlation differences, the discussion should more explicitly consider how statistical interdependence between areas could influence the observed results. For example, an increase in shared variance between visual and motor areas, such as might result from visually guided action, could result in a reduction in the apparent strength of visual-prefrontal temporal correlation (at the resolution of fMRI) without any true biological change in communication between visual-prefrontal cortex. This possibility is not ruled out by reporting groupwise patterns of relative connectivity. A more cautious systems-level framing could help clarify the distinction between neural plasticity and statistical redistribution of variance.

    We thank the reviewer for raising this important point. We agree that resting-state fMRI provides a measure of statistical synchrony in BOLD signals rather than direct causal interactions between regions. This a fundamental limitation of resting state fMRI, which we now note in the Discussion section. Such changes in correlation are consistent with a variety of underlying biological mechanisms. Online task is one factor that influences cross-region correlations. In the current study, both blind and sighted groups were measured while blindfolded and were not performing visually guided actions during the resting state fMRI scans. It is possible that past visual-guided action experience changes the resting state correlations of sighted participants. Indeed, this is one interesting hypothesis.

    In the revised Discussion, we now explicitly note this limitation and clarify that differences in FC do not by themselves establish whether or how underlying neurophysiological mechanisms are changed. We also emphasize that future work will need to investigate whether FC changes are accompanied by alterations in structural connectivity and to probe causal interactions and mechanistic underpinnings as follows：

    “Resting-state functional connectivity captures synchrony in BOLD signal fluctuations rather than causal interactions and differences in functional connectivity cannot on their own reveal how underlying neurophysiological mechanisms are modified.” (page 13,line 342)

    “Future studies will be needed to determine whether these functional changes are accompanied by alterations in structural connectivity, and to probe causal interactions and mechanistic underpinnings.” (page 13,line 350)

    (3) The mechanistic interpretation of group differences in visual-motor coupling would benefit from stronger network-level justification. Direct connections between these areas are sparse in primates. If effects reflect indirect polysynaptic interactions or shared thalamic input, as the authors suggest, one might expect corresponding group differences in intermediate regions (e.g., parietal cortex, thalamus) that mediate these interactions. Is there any evidence for this in the data?

    We thank the reviewer for raising this point. We agree and as noted above, resting state fMRI cannot distinguish between direct causal interactions between two regions and ones that a mediating region is involved. This is a fundamental limitation of resting state fMRI. The current study further focused on testing a specific hypothesis motivated by previously observed group differences between blind and sighted adults and our analyses focused on ROI-to-ROI connectivity between occipital, frontal, and sensory-motor cortices, and did not include these additional regions. In prior work, we and others, have looked at effects in parietal cortices (Abboud & Cohen, 2019; Bedny et al., 2009; Deen et al., 2015; Kanjlia et al., 2016, 2021; Sen et al., 2022). In blindness, parietal networks show increased correlations with some visual areas, rather than decreased. Regarding the thalamus, there is less clear evidence and there is some ongoing work trying to address this question. A couple of studies suggest that there is indeed increased connectivity between some parts of the thalamus and visual cortex in blindness. Although the anatomical information is limited, some of the work suggests that this increase is with higher-cognitive nuclei of the thalamus (Bedny et al., 2011; Liu et al., 2007).

    We agree that this is an important direction for future work. To acknowledge this point, we have revised the manuscript to highlight the potential role of cortical and subcortical hub regions in mediating connectivity changes. The text has been modified as follows:

    “Connectivity changes between two areas could be mediated by ‘third-party’ hub regions. For example, posterior parietal cortex serves as a cortical hub for multisensory integration and visuo-motor coordination and could mediate occipital-to-sensory-motor communication (Rolls et al., 2023; Sereno & Huang, 2014). Subcortical structures such as the thalamus could also play a mediating role (Vega-Zuniga et al., 2025).” (page 13,line 345)

    (4) The discussion would benefit from deeper engagement with prior work on experience-dependent plasticity, particularly the longstanding distinction between instructive and permissive roles of experience. While the authors briefly define these concepts and reference their historical use, a more explicit consideration of how their findings relate to this broader literature would help clarify whether such distinctions are necessary or appropriate.

    We thank the reviewer for this thoughtful suggestion to engage more explicitly with the longstanding literature on instructive versus permissive roles of experience. However, most of this literature comes from animal models, where experimental manipulations of the anatomical structure, of experience itself (e.g., controlled rearing studies) and sometimes of neural activity patterns allow clear tests of these mechanisms. Such manipulations are not feasible in humans. The terminology in the animal literature does not directly map onto the methods and data available in the present study or in other work with humans. For this reason, the current data does not allow us to fully engage with the debates in the animal literature and doing risks overinterpreting our findings.

    Nevertheless, we agree that once the instructive/permissive framework has been introduced, it is important to clarify how our results relate to it, rather than only providing definitions. We have therefore added the following text to the discussion:

    “In humans, such manipulations are not feasible, leaving us to study only the consequences of the presence or absence of vision. Under an instructive account, visual and multisensory experience could strengthen coupling between visual and other non-visual sensory-motor cortices through coordinated activity, thereby establishing the sighted-adult connectivity pattern. In the absence of visual input, by contrast, the lack of such coordinated activity may prevent these couplings from being established. Alternatively, vision may act permissively, indirectly enabling maturational processes that shift connectivity toward the sighted-adult configuration.” (page 14,line 362)

    (5) The revised discussion acknowledges the divergence between resting-state and task-based findings, but does not fully frame the theoretical implications of this discrepancy. Although this study cannot resolve the issue with its own data, a more integrative discussion could help clarify whether these measures reflect distinct functional states, developmental trajectories, or mechanisms of plasticity. Without such framing, readers are left without clear guidance on how to reconcile the present results with prior work on cross-modal recruitment in blindness.

    We thank the reviewer for this thoughtful comment. We agree that know how resting-state evidence relates to task-based evidence is a fundamentally important issue. We now discuss this more in the Introduction as well as in the Discussion.

    There is a sizable literature of both task-based and resting state studies. Some of prior studies have measured resting state and task-based data within the same participants and found relationships (Kanjlia et al., 2016, 2021; Lane et al., 2015). We now clarify this in the introduction. These studies find that within visual cortices of blind people, the task-based profile of a cortical area is related to its resting state connectivity pattern (Abboud & Cohen, 2019; Deen et al., 2015; Kanjlia et al., 2016, 2021). This suggests that these two measures are related. However, the timecourse of this relationship, the developmental trajectory and mechanism of plasticity is not known. We note this now in the introduction on page 2. Primarily this is because there is very little relevant developmental evidence. For example, in the current study we find that the resting state profile of secondary visual networks in infants is similar to that of blind adults. However, we do not know whether the visual cortices of infants show task-based cross modal responses. To our knowledge nobody has tested this question. We agree with the reviewer that raising this question in the paper is better than not commenting on the relationship at all.

    To address the reviewer’s comment, we have expanded the discussion to situate our results within a developmental framework, highlighting how early intrinsic connectivity may scaffold alternative trajectories shaped by either visual experience or blindness. The revised text now reads as follows:

    “Conversely, for people who remain blind throughout life, visual-PFC connectivity could enable recruitment of visual cortices for higher-order non-visual functions, such as language and executive control (Bedny et al., 2011; Kanjlia et al., 2021). Our results suggest that blind adults may build on connectivity patterns already present in infancy: like blind adults, sighted infants show stronger occipital–PFC than occipital–sensory–motor coupling. Repeated engagement of occipital networks during higher cognitive tasks in early development could intern enhance connectivity and specialization of visual networks for non-visual higher-order functions.

    Some prior studies have measured resting-state and task-based functional profiles in the same participants. These studies find that within visual cortices of blind people, the task-based profile of a cortical area is related to its resting state connectivity pattern (citations.) This suggests that these two measures are related. However, the timecourse of this relationship, the developmental trajectory and mechanism of plasticity is not known. Primarily this is because there is very little relevant developmental evidence. For example, in the current study we find that the resting state profile of secondary visual networks in infants is similar to that of blind adults. However, we do not know whether the visual cortices of infants show enhanced task-based cross modal responses, relative to sighted adults and how this compares to responses observed in blind adults. Future work with infants and children would be able to address this question.

    In the current study, the clearest evidence for functional change driven by blindness was observed for laterality. Connectivity lateralization in sighted infants resembles that of sighted adults, in both V1 and secondary visual cortices. Relative to both sighted infants and sighted adults, blind adults show more lateralized connectivity patterns between occipital and prefrontal cortices. Previous studies suggest that in people born blind occipital and non-occipital language responses are co-lateralized (Lane et al., 2017; Tian et al., 2023). We speculate that habitual activation of visual cortices by higher-cognitive tasks, such as language, which are themselves highly lateralized, contributes to this biased connectivity pattern of occipital cortex in blindness. Taken together, these results suggest a developmental framework in which intrinsic connectivity present in infancy provides a scaffold that is subsequently shaped and reinforced by experience-dependent recruitment, through either visual experience or the lifelong absence of vision in blindness. Longitudinal work across successive developmental stages will be crucial to test how the alternative trajectories shaped by visual experience versus blindness unfold over development.” (page 14-15)

    (6) The split-half reliability analysis is a valuable control. Additional details would clarify what these noise ceilings reflect. Were the rsFC patterns for each ROI calculated only for the ROIs included in the current study or was a broader assessment across the whole brain performed? It also would be helpful to report whether reliability differed for individual ROIs within and between groups. Even if global reliability is matched, selective differences could influence group comparisons. Several infants in the dhcp dataset were scanned twice. Were any second scans included in the current analyses? Comparing first versus second scans directly could strengthen the claim that several weeks of visual experience are insufficient to shift connectivity toward a sighted adult profile.

    Thanks to the reviewer’s comments on the reliability of the current study.

    In the present study, the noise ceiling was computed from the reliability of the ROI-wise FC profiles used across all analyses. Reliability was estimated using a split-half procedure: each rs-fMRI time series was divided into two equal halves, FC among all ROIs included in the study was computed separately for each half, and the noise ceiling for each ROI was defined as the Pearson correlation between its two FC profiles. Then we averaged these ROI-wise noise ceilings to evaluate group-level reliability, which exceeded 0.70 in all three groups and found no significant difference across groups. This provides an estimate of the upper bound on explainable variance for the exact FC features subjected to statistical testing (Lage-Castellanos et al., 2019). A brief description has been added to the manuscript (page 19, line 518).

    Regarding the reviewer’s question about the scope of rsFC features used in the noise-ceiling analysis: we computed noise ceilings only for the ROIs included in the present study, because all analyses in this work were conducted at the ROI–ROI level and did not involve voxelwise whole-brain FC. Thus, the noise-ceiling estimates correspond directly to the full set of FC features on which all statistical comparisons were based.

    As suggested by the reviewer, we examined noise ceilings for each ROI separately. All ROIs showed high absolute reliability (noise ceiling > 0.80) across the three groups, indicating that the ROI-wise FC estimates are generally robust across participants. Although many ROIs exhibited statistically significant group differences in noise ceiling (one-way ANOVA, p < 0.05), the effect sizes were small to moderate (partial η2 < 0.14). These differences indicate that reliability may vary modestly across groups at the ROI level, and we cannot fully determine whether such variability contributes to the observed different FC patterns across groups. We have included this point in the revised manuscript (page 19, line 525), along with the full statistical results for the ROI-wise noise ceilings in the Supplementary Table S2.

    Last, we fully agree that longitudinal comparisons across multiple time points can provide important insights into how early visual experience shapes connectivity. At the same time, in the present dataset, the first scan occurred at a preterm age and the second at term-equivalent age. The differences between the first and second scans would reflect not only additional weeks of visual input, but also differences in prematurity status and overall neurodevelopmental maturity, which would make the interpretation of such comparisons difficult in the context of our current aims. We have clarified in the revised manuscript that only term-equivalent (second) scans were included. We see careful longitudinal work as an important avenue for addressing this question more directly.

    (7) The signal dropout assessment in the infant dataset is a valuable quality control step. Applying the same metric to the adult datasets would help harmonize preprocessing across groups and increase confidence in group-level comparisons.

    Thank you for this valuable suggestion. Following your comment, we applied the same signal dropout assessment to the adult datasets. One participant in the sighted adult group and two participants in the blind adult group showed signal dropout in one ROI each. The corresponding results are now included in the Supplementary Materials (Figure S13). The findings remain unchanged after this additional control analysis. We also add the relevant content in the Method part as follows:

    “The same signal dropout assessment was also applied to the blind and sighted adults to ensure consistent quality control across groups. One participant in the sighted adult group and two participants in the blind adult group exhibited signal dropout in one ROI each. Excluding these participants did not alter the group-level results (see Figure S13).” (page 16, line 449)

    Minor:

    (8) The authors added accurate anatomical descriptions to the methods but a less precise characterization remains in the introduction: "Anatomically, these regions correspond roughly to the location of areas such as motion area V5/MT+, the lateral occipital complex (LO), V3a and V4v in sighted people."

    We thank the reviewer for this helpful comment. We have revised the Introduction to provide a fuller anatomical description, consistent with the Methods. The text now reads:

    “Anatomically, these regions in sighted people approximately correspond to the locations of motion-sensitive V5/MT+ and the lateral occipital complex (LO), as well as ventral portions of occipito-temporal cortex including V4v and dorsal portions including V3a. The occipital ROI also extends ventrally into the middle portion of the ventral temporal lobe and dorsally into the intraparietal sulcus and superior parietal lobule.” (page 3, line 88)

    (9)Typo: "lager effect" should be "larger effect."

    Secondary visual cortices showed a significant within > between difference in both groups, with a lager effect in the blind group (post-hoc tests, Bonferroni-corrected paired: t-test: sighted adults within hemisphere > between hemisphere: t (49) = 7.441, p = 0.012; blind adults within hemisphere > between hemisphere: t (29) = 10.735, p < 0.001; V1: F(1, 78) =87.211, p < 0.001).

    We thank the reviewer for catching this typo. We have corrected “lager effect” to “larger effect” in the revised manuscript. (page 9, line 214)

    Reviewer #2 (Recommendations for the authors):

    All of my other concerns were adequately addressed.

    We thank the reviewer for their positive evaluation, and we are glad that our revisions have addressed their concerns.

    Reviewer #3 (Recommendations for the authors):

    In my view, qualifying infants as "sighted" is confusing and unnecessary: why not simplifying and homogenizing the wording along the manuscript and figures?

    We thank the reviewer for this suggestion. We agree and have revised the manuscript to use consistent wording, avoiding the qualification of infants as “sighted.”

    l188, I don't understand the sentence "By contrast, in sighted adults, this cross-hemisphere difference is weak or absent."

    We thank the reviewer for noting that this sentence was unclear. We have revised the text to provide a more precise explanation. The text now reads:

    “By contrast, in sighted adults this lateralized pattern is weaker: visual areas in each hemisphere show only a modest preference for ipsilateral prefrontal cortices, and connectivity with the contralateral PFC remains comparatively strong.” (page 8, line 207)

    l193: "Secondary visual cortices showed a significant within > between difference in both groups, with a lager effect in the blind group": providing effect sizes for the 2 groups would strengthen this result (+ note the typo laRger).
    - Figure S7, S11: Please add titles of y-axes.

    Thank you for this helpful suggestion. We have corrected the typo and added the effect sizes for both groups in the revised text. The revised sentence now reads as follows:

    “Secondary visual cortices showed a significant within > between difference in both groups, with a larger effect in the blind group (post-hoc tests, Bonferroni-corrected paired: t-test: sighted adults within hemisphere > between hemisphere: t (49) = 7.441, p = 0.012, cohen’d = 0.817; blind adults within hemisphere > between hemisphere: t (29) = 10.735, p < 0.001, cohen’d = 1.96).” (page 9, line 214)

    Titles of the y-axes have also been added to Figures S7 and S11.

  8. Version published to 10.7554/elife.93067.2 on eLife
  9. eLife

    eLife Assessment

    This important study provides evidence supporting the idea that postnatal experience plays an instructive role in shaping the patterns of functional connectivity between extrastriate visual cortex and frontal regions during development, by comparing neonates, blind and sighted adults. The evidence supporting the authors' claim is solid. Nevertheless, substantial weaknesses remain in mechanistic interpretation and alignment with relevant developmental frameworks. This study will be of significant interest to neuroscientists and neuroimaging researchers focused on vision, plasticity and development.

  10. eLife

    Reviewer #1 (Public review):

    Summary:

    The present study evaluates the role of visual experience in shaping functional correlations between human extrastriate visual cortex and frontal regions. The authors used fMRI to assess "resting-state" temporal correlations in three groups: sighted adults, congenitally blind adults, and neonates. Previous research has already demonstrated differences in functional correlations between visual and frontal regions in sighted compared to early blind individuals. The novel contribution of the current study lies in the inclusion of an infant dataset, which allows for an assessment of the developmental origins of these differences.

    The main results of the study reveal that correlations between prefrontal and visual regions are more prominent in the blind and infant groups, with the blind group exhibiting greater lateralization. Conversely, correlations between visual and somato-motor cortices are more prominent in sighted adults. Based on these data, the authors conclude that visual experience plays an instructive role in shaping these cortical networks. This study provides valuable insights into the impact of visual experience on the development of functional connectivity in the brain.

    Strengths:

    The dissociations in functional correlations observed among the sighted adult, congenitally blind, and neonate groups provide strong support for the main conclusion regarding postnatal experience-driven shaping of visual-frontal connectivity.

    The inclusion of neonates offers a unique and valuable developmental anchor for interpreting divergence between blind and sighted adults. This is a major advance over prior studies limited to adult comparisons.

    Convergence with prior findings in the blind and sighted adult groups reinforces the reliability and external validity of the present results.

    The split-half reliability analysis in the infant data increases confidence in the robustness of the reported group differences.

    Weaknesses:

    The manuscript risks overstating a mechanistic distinction between sighted and blind development by framing visual experience as "instructive" and blindness as "reorganizing." Similarly, the binary framing of visual experience and blindness as independent may oversimplify shared plasticity mechanisms.

    The interpretation of changes in temporal correlations as altered neural communication does not adequately consider how shifts in shared variance across networks may influence these measures without reflecting true biological reorganization.

    The discussion does not substantively engage with the longstanding debate over whether sensory experience plays an instructive or permissive role in cortical development.

    The relationship between resting-state and task-based findings in blindness remains unclear.

  11. eLife

    Reviewer #2 (Public review):

    Summary:

    Tian et al. explore the developmental origins of cortical reorganization in blindness. Previous work has found that a set of regions in the occipital cortex show different functional responses and patterns of functional correlations in blind vs. sighted adults. Here, Tian et al. explore how this organization arises over development. Is the "starting state" more like the blind pattern, or more like the adult pattern? Their analyses reveal that the answer depends on the particular networks investigated. Some functional connections in infants look more like blind than sighted adults; other functional connections look more like sighted than blind adults; and others fall somewhere in the middle, or show an altogether different pattern in infants compared with both sighted and blind adults.

    Strengths:

    The paper addresses very important questions about the starting state in the developing visual cortex, and how cortical networks are shaped by experience. Another clear strength lies in the unequivocal nature of many results. Many results have very large effect sizes, critical interactions between regions and groups are tested and found, and infant analyses are replicated in split halves of the data.

    Weaknesses:

    While potential roles of experience (e.g., visual, cross-modal) are discussed in detail, little consideration is given to the role of experience-independent maturation. The infants scanned are extremely young, only 2 weeks old. It is possible then that the sighted adult pattern may still emerge later in infancy or childhood, regardless of infant visual experience. If so, the blind adult pattern may depend on blindness-related experience only (which may or may not reflect "visual" experience per se). In short, it is not clear that birth, or the first couple weeks of life, are a clear cut "starting point" for development, after which all change can be attributed to experience.

  12. eLife

    Reviewer #3 (Public review):

    Summary

    This study aimed to investigate whether the differences observed in the organization of visual brain networks between blind and sighted adults result from a reorganization of an early functional architecture due to blindness, or whether the early architecture is immature at birth and requires visual experience to develop functional connections. This question was investigated through the comparison of 3 groups of subjects with resting-state functional MRI (rs-fMRI). Based on convincing analyses, the study suggests that: 1) secondary visual cortices showed higher connectivity to prefrontal cortical regions (PFC) than to non-visual sensory areas (S1/M1 and A1) in infants like in blind adults, in contrast to sighted adults; 2) the V1 connectivity pattern of infants lies between that of sighted adults (showing stronger functional connectivity with non-visual sensory areas than with PFC) and that of blind adults (showing stronger functional connectivity with PFC than with non-visual sensory areas); 3) the laterality of the connectivity patterns of infants resembled those of sighted adults more than those of blind adults, but infants showed a less differentiated fronto-occipital connectivity pattern than adults.

    Strengths

    The question investigated in this article is important for understanding the mechanisms of plasticity during typical and impaired development, and the approach considered, which compares different groups of subjects including, neonates/infants and blind adults, is highly original.

    Overall, the presented analyses are solid and well detailed, and the results and discussion are convincing.

    Weaknesses

    While it is informative to compare the "initial" state (close to birth) and the "final" states in blind and sighted adults to study the impact of post-natal and visual experience, this study does not analyze the chronology of this development and when the specialization of functional connections is completed. This would require investigating the evolution of functional connectivity of the visual system as a function of visual experience and thus as a function of age, at least during toddlerhood given the early and intense maturation of the visual system after birth. This could be achieved by analyzing different developmental periods using open databases such as the Baby Connectome Project.

    The rationale for grouping full-term neonates and preterm infants (scanned at term-equivalent age) is not understandable when seeking to perform comparisons with adults. Even if the study results do not show differences between full-terms and preterms in terms of functional connectivity differences between regions and of connectivity patterns, preterms group had different neurodevelopment and post-natal (including visual) experiences (even a few weeks might have an impact). And actually they show reduced connectivity strength systematically for all regions compared with full-terms (Sup Fig 7). Considering a more homogeneous group of neonates would have strengthen the study design.

    The rationale for presenting results on the connectivity of secondary visual cortices before the one of primary cortices (V1) could be clarified.

    The authors acknowledge the methodological difficulties for defining regions of interest (ROIs) in infants in a similar way as adults. Since the brain development is not homogeneous and synchronous across brain regions (in particular with the frontal and parietal lobes showing a delayed growth), this poses major problems for registration. This raises the question of whether the study findings could be biased by differences in ROI positioning across groups.

  13. eLife

    Author response:

    Reviewer #1 (Public Review):

    Summary:

    The present study evaluates the role of visual experience in shaping functional correlations between extrastriate visual cortex and frontal regions. The authors used fMRI to assess "resting-state" temporal correlations in three groups: sighted adults, congenitally blind adults, and neonates. Previous research has already demonstrated differences in functional correlations between visual and frontal regions in sighted compared to early blind individuals. The novel contribution of the current study lies in the inclusion of an infant dataset, which allows for an assessment of the developmental origins of these differences.

    The main results of the study reveal that correlations between prefrontal and visual regions are more prominent in the blind and infant groups, with the blind group exhibiting greater lateralization. Conversely, correlations between visual and somato-motor cortices are more prominent in sighted adults. Based on these data, the authors conclude that visual experience plays an instructive role in shaping these cortical networks. This study provides valuable insights into the impact of visual experience on the development of functional connectivity in the brain.

    Strengths:

    The dissociations in functional correlations observed among the sighted adult, congenitally blind, and neonate groups provide strong support for the study's main conclusion regarding experience-driven changes in functional connectivity profiles between visual and frontal regions.

    In general, the findings in sighted adult and congenitally blind groups replicate previous studies and enhance the confidence in the reliability and robustness of the current results.

    Split-half analysis provides a good measure of robustness in the infant data.

    Weaknesses:

    There is some ambiguity in determining which aspects of these networks are shaped by experience.

    This uncertainty is compounded by notable differences in data acquisition and preprocessing methods, which could result in varying signal quality across groups. Variations in signal quality may, in turn, have an impact on the observed correlation patterns.

    The study's findings could benefit from being situated within a broader debate surrounding the instructive versus permissive roles of experience in the development of visual circuits.

    Reviewer #2 (Public Review):

    Summary:

    Tian et al. explore the developmental organs of cortical reorganization in blindness. Previous work has found that a set of regions in the occipital cortex show different functional responses and patterns of functional correlations in blind vs. sighted adults. In this paper, Tian et al. ask: how does this organization arise over development? Is the "starting state" more like the blind pattern, or more like the adult pattern? Their analyses reveal that the answer depends on the particular networks investigated; some functional connections in infants look more like blind than sighted adults; other functional connections look more like sighted than blind adults; and others fall somewhere in the middle, or show an altogether different pattern in infants compared with both sighted and blind adults.

    Strengths:

    The question raised in this paper is extremely important: what is the starting state in development for visual cortical regions, and how is this organization shaped by experience? This paper is among the first to examine this question, particularly by comparing infants not only with sighted adults but also blind adults, which sheds new light on the role of visual (and cross-modal) experience. Another clear strength lies in the unequivocal nature of many results. Many results have very large effect sizes, critical interactions between regions and groups are tested and found, and infant analyses are replicated in split halves of the data.

    Weaknesses:

    A central claim is that "infant secondary visual cortices functionally resemble those of blind more than sighted adults" (abstract, last paragraph of intro). I see two potential issues with this claim. First, a minor change: given the approaches used here, no claims should be made about the "function" of these regions, but rather their "functional correlations". Second (and more importantly), the claim that the secondary visual cortex in general resembles blind more than sighted adults is still not fully supported by the data. In fact, this claim is only true for one aspect of secondary visual area functional correlations (i.e., their connectivity to A1/M1/S1 vs. PFC). In other analyses, the infant secondary visual cortex looks more like sighted adults than blind adults (i.e., in within vs. across hemisphere correlations), or shows a different pattern from both sighted and blind adults (i.e., in occipito-frontal subregion functional connectivity). It is not clear from the manuscript why the comparison to PFC vs. non-visual sensory cortex is more theoretically important than hemispheric changes or within-PFC correlations (in fact, if anything, the within-PFC correlations strike me as the most important for understanding the development and reorganization of these secondary visual regions). It seems then that a more accurate conclusion is that the secondary visual cortex shows a mix of instructive effects of vision and reorganizing effects of blindness, albeit to a different extent than the primary visual cortex.

    Relatedly, group differences in overall secondary visual cortex connectivity are particularly striking as visualized in the connectivity matrices shown in Figure S1. In the results (lines 105-112), it is noted that while the infant FC matrix is strongly correlated with both adult groups, the infant group is nonetheless more strongly correlated with the blind than sighted adults. I am concerned that these results might be at least partially explained by distance (i.e., local spread of the bold signal), since a huge portion of the variance in these FC matrices is driven by stronger correlations between regions within the same system (e.g., secondary-secondary visual cortex, frontal-frontal cortex), which are inherently closer together, relative to those between different systems (e.g., visual to frontal cortex). How do results change if only comparisons between secondary visual regions and non-visual regions are included (i.e., just the pairs of regions within the bold black rectangle on the figure), which limits the analysis to long-rang connections only? Indeed, looking at the off-diagonal comparisons, it seems that in fact there are three altogether different patterns here in the three groups. Even if the correlation between the infant pattern and blind adult pattern survives, it might be more accurate to claim that infants are different from both adult groups, suggesting both instructive effects of vision and reorganizing effects of blindness. It might help to show the correlation between each group and itself (across independent sets of subjects) to better contextualize the relative strength of correlations between the groups.

    It is not clear that differences between groups should be attributed to visual experience only. For example, despite the title of the paper, the authors note elsewhere that cross-modal experience might also drive changes between groups. Another factor, which I do not see discussed, is possible ongoing experience-independent maturation. The infants scanned are extremely young, only 2 weeks old. Although no effects of age are detected, it is possible that cortex is still undergoing experience-independent maturation at this very early stage of development. For example, consider Figure 2; perhaps V1 connectivity is not established at 2 weeks, but eventually achieves the adult pattern later in infancy or childhood. Further, consider the possibility that this same developmental progression would be found in infants and children born blind. In that case, the blind adult pattern may depend on blindness-related experience only (which may or may not reflect "visual" experience per se). To deal with these issues, the authors should add a discussion of the role of maturation vs. experience and temper claims about the role of visual experience specifically (particularly in the title).

    The authors measure functional correlations in three very different groups of participants and find three different patterns of functional correlations. Although these three groups differ in critical, theoretically interesting ways (i.e., in age and visual/cross-modal experience), they also differ in many uninteresting ways, including at least the following: sampling rate (TR), scan duration, multi-band acceleration, denoising procedures (CompCor vs. ICA), head motion, ROI registration accuracy, and wakefulness (I assume the infants are asleep).

    Addressing all of these issues is beyond the scope of this paper, but I do feel the authors should acknowledge these confounds and discuss the extent to which they are likely (or not) to explain their results. The authors would strengthen their conclusions with analyses directly comparing data quality between groups (e.g., measures of head motion and split-half reliability would be particularly effective).

    Response #1: We appreciate the reviewer’s comments. In response, we have revised the paper to provide a more balanced summary of the data and clarified in the introduction which signatures the paper focuses on and why. Additionally, we have included several control analyses to account for other plausible explanations for the observed group differences. Specifically, we randomly split the infant dataset into two halves and performed split-half cross-validation. Across all comparisons, the results from the two halves were highly similar, suggesting that the effects are robust (see Supplementary Figures S3 and S4).

    Furthermore, we compared the split-half noise ceiling across the groups (infants, sighted adults, and blind adults) and found no significant differences between them (details in response #6). Finally, we repeated our analysis after excluding infants with a radiology score of 4 or 5, and the results remained consistent, indicating that our findings are not confounded by potential brain anomalies (details in response #2).

    We hope these control analyses help strengthen our conclusions.

    Reviewer #3 (Public Review):

    Summary:

    This study aimed to investigate whether the differences observed in the organization of visual brain networks between blind and sighted adults result from a reorganization of an early functional architecture due to blindness, or whether the early architecture is immature at birth and requires visual experience to develop functional connections. This question was investigated through the comparison of 3 groups of subjects with resting-state functional MRI (rs-fMRI). Based on convincing analyses, the study suggests that: 1) secondary visual cortices showed higher connectivity to prefrontal cortical regions (PFC) than to non-visual sensory areas (S1/M1 and A1) in sighted infants like in blind adults, in contrast to sighted adults; 2) the V1 connectivity pattern of sighted infants lies between that of sighted adults (stronger functional connectivity with non-visual sensory areas than with PFC) and that of blind adults (stronger functional connectivity with PFC than with non-visual sensory areas); 3) the laterality of the connectivity patterns of sighted infants resembled those of sighted adults more than those of blind adults, but sighted infants showed a less differentiated fronto-occipital connectivity pattern than adults.

    Strengths:

    The question investigated in this article is important for understanding the mechanisms of plasticity during typical and impaired development, and the approach considered, which compares different groups of subjects including, neonates/infants and blind adults, is highly original.

    -Overall, the analyses considered are solid and well-detailed. The results are quite convincing, even if the interpretation might need to be revised downwards, as factors other than visual experience may play a role in the development of functional connections with the visual system.

    Weaknesses:

    While it is informative to compare the "initial" state (close to birth) and the "final" states in blind and sighted adults to study the impact of post-natal and visual experience, this study does not analyze the chronology of this development and when the specialization of functional connections is completed. This would require investigating when experience-dependent mechanisms are important for the setting- establishment of multiple functional connections within the visual system. This could be achieved by analyzing different developmental periods in the same way, using open databases such as the Baby Connectome Project. Given the early, "condensed" maturation of the visual system after birth, we might expect sighted infants to show connectivity patterns similar to those of adults a few months after birth.

    The rationale for mixing full-term neonates and preterm infants (scanned at term-equivalent age) from the dHCP 3rd release is not understandable since preterms might have a very different development related to prematurity and to post-natal (including visual) experience. Although the authors show that the difference between the connectivity of visual and other sensory regions, and the one of visual and PFC regions, do not depend on age at birth, they do not show that each connectivity pattern is not influenced by prematurity. Simply not considering the preterm infants would have made the analysis much more robust, and the full-term group in itself is already quite large compared with the two adult groups. The current study setting and the analyses performed do not seem to be an adequate and sufficient model to ascertain that "a few weeks of vision after birth is ... insufficient to influence connectivity".

    In a similar way, excluding the few infants with detected brain anomalies (radiological scores higher or equal to 4) would strengthen the group homogeneity by focusing on infants supposed to have a rather typical neurodevelopment. The authors quote all infants as "sighted" but this is not guaranteed as no follow-up is provided.

    Response #2: We appreciate the reviewer’s suggestion. We re-analyzed the infant cohort after excluding all cases with radiological scores ≥4 (n =39 infants excluded). The revised analysis confirmed that the connectivity patterns reported in the main text remain statistically unchanged (see Supplementary Fig. S11). This demonstrates the robustness of our findings to potential confounding effects from potential brain anomalies. We have explicitly clarified this in the revised Methods section (page 14, line 391in the manuscript).

    In our dataset, newborns (average age at scan = 2.79 weeks) have very limited and immature vision. We agree with the reviewer that long-term visual outcomes cannot be guaranteed without follow-up data. The term "sighted infants" was used operationally to distinguish this cohort from congenitally blind populations.

    The post-menstrual age (PMA) at scan of the infants is also not described. The methods indicate that all were scanned at "term-equivalent age" but does this mean that there is some PMA variability between 37 and 41 weeks? Connectivity measures might be influenced by such inter-individual variability in PMA, and this could be evaluated.

    The rationale for presenting results on the connectivity of secondary visual cortices before one of the primary cortices (V1) was not clear to understand. Also, it might be relevant to better justify why only the connectivity of visual regions to non-visual sensory regions (S1-M1, A1) and prefrontal cortex (PFC) was considered in the analyses, and not the ones to other brain regions.

    In relation to the question explored, it might be informative to reposition the study in relation to what others have shown about the developmental chronology of structural and functional long-distance and short-distance connections during pregnancy and the first postnatal months.

    The authors acknowledge the methodological difficulties in defining regions of interest (ROIs) in infants in a similar way as adults. The reliability and the comparability of the ROIs positioning in infants is definitely an issue. Given that brain development is not homogeneous and synchronous across brain regions (in particular with the frontal and parietal lobes showing delayed growth), the newborn brain is not homothetic to the adult brain, which poses major problems for registration. The functional specialization of cortical regions is incomplete at birth. This raises the question of whether the findings of this study would be stable/robust if slightly larger or displaced regions had been considered, to cover with greater certainty the same areas as those considered in adults. And have other cortical parcellation approaches been considered to assess the ROIs robustness (e.g. MCRIB-S for full-terms)?

    Recommendations for the Authors:

    Reviewer #1(Recommendations for the authors):

    Further consideration should be given to the underlying changes in network architecture that may account for differences in functional correlations across groups. An increase (or decrease) in correlation between two regions could signify an increase (decrease) in connection or communication between those regions. Alternatively, it might reflect an increase in communication or connection with a third region, while the physical connections/interactions between the two original regions remain unchanged. These possibilities lead to distinct mechanistic interpretations. For example, there are substantial changes in connectivity during early visual (e.g. Burkhalter A. 1993, Cerebral Cortex) and visuo-motor development (e.g., Csibra et al. 2000 Neuroreport). It's not clear whether increases in communication within the visual network and improvements in visuo-motor behavior (e.g., Yizhar et al. 2023 Frontiers in Neuroscience) wouldn't produce a qualitatively similar pattern of results.

    Relatedly, the within-network correlation patterns between visual ROIs and frontal ROIs appear markedly different between sighted adults and infants (Supplementary Figure S1). To what extent do the differences in long-range correlations between visual and frontal regions reflect these within-network differences in functional organization?

    Response #3: The reviewer is raising some interesting questions about possible mechanisms and network changes. Resting state studies are indeed always subject to possibility that some effects are mediated by a third, unobserved region. Prior whole-cortex connectivity analyses have observed primarily changes in occipito-frontal connectivity in blindness, so there is not a clear cortical ‘third region’ candidate (Deen et al., 2015). However, some thalamic affects have also been observed and could contribute to the phenomenon (Bedny et al., 2011). Resting state changes in correlation between two areas do not imply changes in strength of long-range anatomical connectivity. Indeed, in the current case they may well reflect differential functional coupling, rather than strengthening or weakening of anatomical connections. We now discuss this in the Discussion section on page 12, line 301 as follows:

    “Despite these insights, many questions remain regarding the neurobiological mechanisms underlying experience-based functional connectivity changes and their relationship to anatomical development. Long-range anatomical connections between brain regions are already present in infants—even prenatally—though they remain immature (Huang et al., 2009; Kostović et al., 2019, 2021; Takahashi et al., 2012; Vasung, 2017). Functional connectivity changes may stem from local synaptic modifications within these stable structural pathways, consistent with findings that functional connectivity can vary independently of structural connection strength (Fotiadis et al., 2024). Moreover, functional connectivity has been shown to outperform structural connectivity in predicting individual behavioral differences, suggesting that experience-based functional changes may reflect finer-scale synaptic or network-level modulations not captured by macrostructural measures (Ooi et al., 2022). Prior studies also suggest that, even in adults, coordinated sensory-motor experience can lead to enhancement of functional connectivity across sensory-motor systems, indicating that large-scale changes in functional connectivity do not necessarily require corresponding changes in anatomical connectivity (Guerra-Carrillo et al., 2014; Li et al., 2018).”

    It is not clear how changes in correlation patterns among visual areas would produce the connectivity between visual areas and prefrontal areas reported in the current study. Activity in visual areas drives correlations both among visual areas and between visual and prefrontal areas and the same is true of prefrontal corticies.

    The findings from this study should be more closely linked to the extensive literature surrounding the debate on whether experience plays an instructive or permissive role in visual development (e.g., Crair 1999 Current Opin Neurobiol; Sur et al. 1999 J Neurobiol; Kiorpes 2016 J Neurosci; Stellwagen & Shatz 2002 Neuron; Roy et al. 2020 Nature Communications).

    Response #4: The instructive role suggests that specific experiences or patterns of neural activity directly shape and organize neural circuitry, while the permissive role indicates that such experiences or activity merely enable other factors, such as molecular signals, to influence neural circuit formation(Crair, 1999; Sur et al., 1999). To distinguish whether experience plays an instructive or permissive role, it is essential to manipulate the pattern or information content of neural activity while maintaining a constant overall activity level (Crair, 1999; Roy et al., 2020; Stellwagen & Shatz, 2002). However, both the sighted and blind adult groups have had extensive experience and neural activity in the visual cortices. For the sighted group, activity in the visual cortex is partly driven by bottom-up input from the external environment, through the retina, LGN, and ultimately to the cortex. In contrast, the blind group’s visual cortex activity is partially driven by top-down input from non-visual networks. The precise role of this activity in shaping the observed connectivity patterns remains unclear. Although our study cannot speak to this issue directly, we now link to the relevant literature on page 12,line 320 of the manuscript in the Discussion section as follows:

    “The current findings reveal both effects of vision and effects of blindness on the functional connectivity patterns of the visual cortex. A further open question is whether visual experience plays an instructive or permissive role in shaping neural connectivity patterns. An instructive role suggests that specific sensory experiences or patterns of neural activity directly shape and organize neural circuitry. In contrast, a permissive role implies that sensory experience or neural activity merely facilitates the influence of other factors—such as molecular signals—on the formation and organization of neural circuits (Crair, 1999; Sur et al., 1999). Studies with animals that manipulate the pattern or informational content of neural activity while keeping overall activity levels constant could distinguish between these hypotheses (Crair, 1999; Roy et al., 2020; Stellwagen & Shatz, 2002).”

    The assertion that a few weeks of vision after birth is insufficient to influence connectivity is provocative. Though supported by the study's results, it would benefit from integration with research in animal models showing considerable malleability of networks from early experience (e.g., Akerman et al. 2002 Neuron; Li et al. 2006 Nature Neuroscience; Stacy et al. 2023 J Neuroscience).

    Response #5: We thank the reviewer for their suggestion. The present study found that several weeks of postnatal visual experience is insufficient to significantly alter the long-term connectivity patterns of the visual cortices. While animal studies have shown that acute visual experience, or even exposure to visual stimuli through unopened eyelids, can robustly influence visual system development(Akerman et al., 2002; Li et al., 2008; Van Hooser et al., 2012). We think this discrepancy may be attributed to the substantial differences in developmental timelines between species. The human lifespan is much longer, and so is the human critical period, making it unclear how to map duration from one species to another. We briefly touched upon the time course issue in page 11 line 289 in the Discussion section as follows:

    “The present results reveal the effects of experience on development of functional connectivity between infancy and adulthood, but do not speak to the precise time course of these effects. Infants in the current sample had between 0 and 20 weeks of visual experience. Comparisons across these infants suggests that several weeks of postnatal visual experience is insufficient to produce a sighted-adult connectivity profile. The time course of development could be anywhere between a few months and years and could be tested by examining data from children of different ages.”

    Substantial differences between the groups are evident in several key aspects of the study, including the number of subjects, brain sizes, imaging parameters, and data preprocessing, all of which are likely to have an impact on the overall signal quality. To clarify how these differences might have impacted correlation differences between groups, it would be essential to include information on the noise ceilings for each correlation analysis within each group.

    Response #6: We thank the reviewer for their suggestion. We now report the split-half noise ceiling for adult and infant groups. For each participant, we first split the rs-fMRI time series into two halves, then calculated the ROI-wise rsFC pattern from the two splits. The split-half noise ceiling was estimated according to Lage-Castellanos et al (2019). The noise ceilings of the three groups (infants: 0.90 ± 0.056,blind adults: 0.88 ± 0.041, sighted adults: 0.90 ± 0.055) showed no significant difference (One-way ANOVA, F(2,552) = 2.348, p = 0.097). Therefore, we believe that overall signal quality is unlikely to impact our results. We also add the relevant context in the Method section in page 16 Line 447 as follows:

    “Substantial differences between the groups exist in this study, including the number of subjects, brain sizes, imaging parameters, and data preprocessing, all of which are likely to have an impact on the overall signal quality. To address this concern, we compared the split-half noise ceiling across the groups (infants, sighted adults, and blind adults). For each participant, we first split the rs-fMRI time series into two halves, then calculated the ROI-wise rsFC pattern from the two splits. The split-half noise ceiling was estimated according to Lage-Castellanos et al (Lage-Castellanos et al., 2019). The noise ceilings of the three groups (infants: 0.90 ± 0.056, blind adults: 0.88 ± 0.041, sighted adults: 0.90 ± 0.055) showed no significant difference (One-way ANOVA, F (2,552) = 2.348, p = 0.097). Therefore, overall signal quality is unlikely to impact our results.”

    In general, it appears that the infant correlations are stronger compared to the other groups. While this could reflect increased coherence or lack of differentiation, it is also possible that it is simply due to the presence of a non-neuronal global signal. Such a signal has the potential to substantially limit the effective range of functional correlations and comparisons with adults. To address this, it is advisable to conduct control analyses aimed at assessing and potentially removing global signals.

    Response #7: We agree with the reviewer that global signal regression (GSR) may help reduce non-neuronal artifacts, such as motion, cardiac, and respiratory signals, which are known to correlate with the global signal. However, the global signal also contains neural signals from gray matter, and removing it can introduce unwanted artifacts, especially for the current study. First, GSR can reduce the physiological accuracy of functional connectivity (FC); second, GSR may have differential effects across groups, potentially introducing additional artifacts in between-group comparisons, as noted by Murphy et al (Murphy & Fox, 2017). The CompCor method (Behzadi et al., 2007; Whitfield-Gabrieli & Nieto-Castanon, 2012) is capble to estimate the global non-neuronal artifacts like the GSR method. Meanwhile as it estimate global non-neuronal artifacts from signals within the white matter (WM) and cerebrospinal fluid (CSF) masks, but not the gray matter (GM), CompCor could introduce minimal unwanted bias to the GM signal.

    Was there a difference in correlations for preterm vs term neonates? Recent research has suggested that preterm births can have an impact on functional networks, particularly in frontal cortices. e.g., Tokariev et al. 2019, Li et al. 2021 elife; Zhang et al. 2022 Fronteirs in Neuroscience.

    Response #8: We have compared preterm and term neonates for all the main results, including the connectivity from the secondary visual cortex/V1 to non-visual sensory cortices versus prefrontal cortices, the laterality of occipito-frontal connectivity, and the specialization across different fronto-occipital networks. This information is reported in Page 6 line 169 and Supplementary Figure S7. The connectivities of full-term infants are generally higher than those of preterm infants. However, the connectivity patterns of term and preterm infants are very similar.

    The consistency between the current results and prior work (e.g., Burton et al. 2014) is notable, particularly in the observed greater correlations in prefrontal regions and weaker correlations in somato-motor regions for early blind individuals compared to sighted. However, almost all visual-frontal correlations in both groups were negative in that prior study. Some discussion on why positive correlations were found in the current study could help to clarify.

    Response #9: Many other papers have reported positive correlations similar to those found in our study (e.g., Deen et al., 2015; Kanjlia et al., 2021). In contrast, Burton's study identified predominantly negative visual-frontal correlations, we think this is likely because the global signal was regressed out during preprocessing. This methodological choice can lead to an increase in negative connections (Murphy & Fox, 2017).

    The term "secondary visual areas" used throughout the paper lacks specificity, and its usage in terms of underlying anatomical and functional areas has been inconsistent in the literature. It would be advisable to adopt a more precise characterization based on functional and/or anatomical criteria.

    Response #10: We specified in the article that Tthe occipital ROIs were defined in the current study are functional areas in people born blind identified in prior studies as regions that respond to three non-visual tasks such as language, math, or executive function, and show functional connectivity changes in blind adults in previous studies (Kanjlia et al., 2016, 2021; Lane et al., 2015). These regions respond to language, math and executivie function in the congenitally blind population (see Figure 1.) The are refered collectively as ‘secondary visual areas’ to destinguish them from V1. Anatomically, these three regions cover the majority of the lateral occipital cortex and part of the ventral occipital cortex, providing a good sample of the connectivity profile of higher-order visual areas. Thus, we are using the term "secondary visual areas" to refer to these regions. In blind individuals, although these regions respond to non-visual tasks, their exact functions are unknown.

    The inclusion of the ventral temporal cortex in the visual ROIs is currently only depicted in Supplementary Figure S7. To enhance the clarity of the areas of interest analyzed, it would be advisable to illustrate the ventral temporal areas in the main text. Were there notable differences in the frontal correlations between the lateral occipital visual areas and ventral temporal areas?

    Response #11: We thank the reviewer for pointing out this issue. We added a statement about the ventral visual cortex in describing the location of the ROI and added the ventral view of ROIs in the Figure 1. The language-responsive and math -responsive ROIs covers both the lateral and ventral visual cortex, whereas executive function (response-conflict) regions cover only the lateral visual cortex. We compared the connectivity patterns of these three regions and found no differences (see supplementary Fig S2).

    The blind group results are characterized as reflecting a reorganization in comparison to sighted adults while the results for sighted adults compared to infants are discussed more as a maturation ("adult pattern isn't default but requires experience to establish"). Both the sighted and blind adult groups showed differences from the infant group, and these differences are attributed to the role of experience. Why use "reorganization" for one result and maturation for another?

    Response #12: We agree with the reviewer that both of the adult groups should be thought of as equal in relation to the infants. In other words, the brain develops under one set of experiential conditions or another. We do not think that the adult sighted pattern reflects maturation. Rather, the sighted adult pattern reflects the combined influence of maturation and visual experience. The adult blind pattern reflects the combined influence of maturation and blindness. We use the term ‘reorganization’ to label differences in the blind adults relative to sighted infants. We do so for the purpose of clarity and to remain consistent with terminology in prior liaterature. However, we agree with the reviewer that the blind group does not reflect ‘reorganization’ intrinsically any more than the sighted adult group.

    The statement that "visual experience is required to set up long-range functional connectivity" is unclear, especially since the infant and blind groups showed stronger long-range functional correlations with PFC.

    Response #13: We revised this sentence to specifically as “visual experience establishes elements of the sighted-adult long-range connectivity” in tha Abstract line 17.

    The statement that the visual ROIS roughly correspond to "the anatomical location of areas such as V5/MT+, LO, V3a, and V4v" appears imprecise. From Supplementary Figure S7, these areas cover anterior portions of ventral temporal cortex (do these span the anatomical location of putative category-selective areas?) and into the intraparietal sulcus.

    Response #14: Thanks to the reviewer for the clarification. The ventral ROIs cover the middle and part of the anterior portion of the ventral temporal lobe, including the putative category-selective areas. Additionally, the dorsal ROIs extend beyond the occipital lobe to the intraparietal sulcus and superior parietal lobule. We have added a more detailed description of the anatomical location of the ROI in the Methods section Page 17 line 489 as follows:

    “Each functional ROI spans multiple anatomical regions and together the secondary visual ROIs tile large portions of lateral occipital, occipito-temporal, dorsal occipital and occipito-parietal cortices. In sighted people, the secondary visual occipital ROIs include the anatomical locations of functional regions such as motion area V5/MT+, the lateral occipital complex (LO), category specific ventral occipitotemporal cortices and dorsally, V3a and V4v. The occipital ROI also covers the middle of the ventral temporal lobe. Dorsally, it extended to the intraparietal sulcus and superior parietal lobule.”

    The motivation for assessing correlations with motor and frontal regions was briefly discussed in the introduction. It would be helpful to reiterate this motivation when first introducing the analyses in the results.

    Response #15: Thank you for the thoughtful suggestion. Upon reflection, we chose to substantially revise the Introduction to more clearly and comprehensively explain the rationale for examining the couplings with motor and frontal regions, rather than reiterating it in the Results section. We believe this revised framing provides a stronger foundation for the analyses that follow, while avoiding redundancy across sections. We hope this addresses the reviewer’s concern.

    Reviewer #2 (Recommendations for the authors):

    Congratulations on a well-written paper and an interesting set of results.

    Reviewer #3 (Recommendations for the authors):

    Abstract:

    Mentioning "sighted infants" does not seem adequate.

    Response #16: In our dataset, newborns (average age at scan = 2.79 weeks) have very limited and immature vision. We agree with the reviewer that long-term visual outcomes cannot be guaranteed without follow-up data. The term "sighted infants" was used operationally to distinguish this cohort from congenitally blind populations.

    In sentences after "Specifically...", it was not clear whether the authors referred to V1 connectivity.

    Response #17: We thank the reviewer for this comment. In the revised abstract, we have removed the original "Specifically..." phrasing and clarified the results.

    Introduction

    Talking about the "instructive effects" of vision might be confusing or misleading. Visual experiences like exposure to oral language are part of the normal/spontaneous environment that allows the infant behavioral acquisitions (contrarily with learnings that occur later during development with instruction like for reading).

    Response #18: We appreciate the reviewer’s concern and would like to clarify that the term “instructive effect” is used here derived from neurodevelopmental studies (Crair, 1999; Sur et al., 1999). In this context, “instructive” refers to activity-dependent mechanisms where patterns of neural activity actively guide the organization of synaptic connectivity, emphasizing that spontaneous or sensory-driven activity (e.g., retinal waves, visual experience) can directly shape circuit refinement, as seen in ocular dominance column formation. In the context of our study, we emphasize that vision plays an instructive role in setting up the balance of connectivity between occipital cortex and non-visual networks.

    For references on the development of connectivity, I would advise citing MRI studies but also studies based on histological approaches (see for example the detailed review by Kostovic et al, NeuroImage 2019).

    Response #19: We thank the reviewer for this suggestion. We have incorporated a discussion on the long-range anatomical connections that emerge as early as infancy, referencing studies that employed diffusion MR imaging and histological methods, as detailed below.

    “Many long-range anatomical connections between brain regions are already established in infants, even before birth, although they are not yet mature (Huang et al., 2009; Kostović et al., 2019, 2021; Takahashi et al., 2012; Vasung, 2017).” (Page 12, line 303 in the manuscript)

    Results

    P7 l170: It might be helpful to be precise that this is "compared with inter-hemispheric connectivity".

    Response #20: We thank the reviewer for this suggestion. To align with our established terminology, we have revised the statement to explicitly contrast within-hemisphere connectivity with between-hemisphere connectivity. The modified text now reads (page 7, line 183 in the manuscript):

    “Compared to sighted adults, blind adults exhibited a stronger dominance of within-hemisphere connectivity over between-hemisphere connectivity. That is, in people born blind, left visual networks are more strongly connected to left PFC, whereas right visual networks are more strongly connected to right PFC.

    L176-181: It was not clear to me what was the difference between "across" and "between hemisphere connectivity". Would it be informative to test the difference between blind and sighted adults?

    Response #21: We clarify that there is no distinction between the terms “across” and “between hemisphere connectivity”—they refer to the same concept. To ensure consistency, we have revised the text to exclusively use “between hemisphere connectivity” throughout the manuscript. Regarding the comparison between blind and sighted adults, we conducted statistical comparisons between these groups in our analysis, and the results have been incorporated into the revised version (Page 7, line 187 in the manuscript).

    Adding statistics on Figure 3, but also on Figures 1 and 2 might help the reading.

    Response #22: We have added the statistics in Figure 1-4.

    Adding the third comparison in Figure 4 would be possible in my view.

    Response #23: We explored integrating the response-conflict region into Figure 4, but this would require a 3x3 bar chart with pairwise statistical significance markers, which introduced excessive visual complexity that hindered readers’ ability to grasp our intended message. To ensure clarity, we retained the original Figure 4 while providing the complete three-region analysis (including all statistical comparisons) in Supplementary Figure S8 to ensure completeness.

    Methods

    The authors might have to specify ages at birth, and ages at scan (median + range?).

    Response #24: We have added that information in the Methods section as follows:

    “The average age from birth at scan = 2.79 weeks (SD = 3.77, median = 1.57, range = 0 – 19.71); average gestational age at scan = 41.23 weeks (SD = 1.77, median = 41.29, range = 37 – 45.14); average gestational age at birth = 38.43 weeks (SD = 3.73, median = 39.71, range = 23 – 42.71).” (Page 14, line 379 in the manuscript)

    It might be relevant to comment on the range of available fMRI volumes, and the fact that connectivity measures might then be less robust in infants.

    Response #25: We report the range of fMRI volumes in the Methods section (Page 16, Line 449). Adult participants (blind and sighted) underwent 1–4 scanning sessions, each containing 240 volumes (mean scan duration: 710.4 seconds per participant). For infants, all subjects had 2300 fMRI volumes, and we retained a subset of 1600 continuous volumes per subject with the minimum number of motion outliers. While infant connectivity measures may inherently exhibit lower robustness due to developmental and motion-related factors, our infant cohort’s large sample size (n=475) and stringent motion censoring criteria enhance the reliability of group-level inferences. We have integrated this clarification into the Methods section (Page 16, Line 444) as follows:

    "While infant connectivity estimates may be less robust at the individual level compared to adults due to shorter scan durations and higher motion, our cohort’s large sample size (n=475) and rigorous motion censoring mitigate these limitations for group-level analyses. "

    The mention of dHCP 2nd release should be removed from the paragraph on data availability.

    Response #26: We have removed it.

  14. Version published to 10.7554/elife.93067.1 on eLife
  15. eLife

    eLife assessment

    This important study provides evidence supporting the idea that visual experience plays a role in shaping the patterns of functional connectivity between extrastriate visual cortex and prefrontal regions during development, by comparing neonates, blind and sighted adults. The evidence supporting the authors' claim is solid, although control analyses could strengthen the conclusions and possibly offer additional mechanistic insights. This study will be of significant interest to neuroscientists and neuroimaging researchers working on vision, plasticity, and development.

  16. eLife

    Reviewer #1 (Public Review):

    Summary:
    The present study evaluates the role of visual experience in shaping functional correlations between extrastriate visual cortex and frontal regions. The authors used fMRI to assess "resting-state" temporal correlations in three groups: sighted adults, congenitally blind adults, and neonates. Previous research has already demonstrated differences in functional correlations between visual and frontal regions in sighted compared to early blind individuals. The novel contribution of the current study lies in the inclusion of an infant dataset, which allows for an assessment of the developmental origins of these differences.

    The main results of the study reveal that correlations between prefrontal and visual regions are more prominent in the blind and infant groups, with the blind group exhibiting greater lateralization. Conversely, correlations between visual and somato-motor cortices are more prominent in sighted adults. Based on these data, the authors conclude that visual experience plays an instructive role in shaping these cortical networks. This study provides valuable insights into the impact of visual experience on the development of functional connectivity in the brain.

    Strengths:
    The dissociations in functional correlations observed among the sighted adult, congenitally blind, and neonate groups provide strong support for the study's main conclusion regarding experience-driven changes in functional connectivity profiles between visual and frontal regions.

    In general, the findings in sighted adult and congenitally blind groups replicate previous studies and enhance the confidence in the reliability and robustness of the current results.

    Split-half analysis provides a good measure of robustness in the infant data.

    Weaknesses:
    There is some ambiguity in determining which aspects of these networks are shaped by experience.

    This uncertainty is compounded by notable differences in data acquisition and preprocessing methods, which could result in varying signal quality across groups. Variations in signal quality may, in turn, have an impact on the observed correlation patterns.

    The study's findings could benefit from being situated within a broader debate surrounding the instructive versus permissive roles of experience in the development of visual circuits.

  17. eLife

    Reviewer #2 (Public Review):

    Summary:
    Tian et al. explore the developmental organs of cortical reorganization in blindness. Previous work has found that a set of regions in the occipital cortex show different functional responses and patterns of functional correlations in blind vs. sighted adults. In this paper, Tian et al. ask: how does this organization arise over development? Is the "starting state" more like the blind pattern, or more like the adult pattern? Their analyses reveal that the answer depends on the particular networks investigated; some functional connections in infants look more like blind than sighted adults; other functional connections look more like sighted than blind adults; and others fall somewhere in the middle, or show an altogether different pattern in infants compared with both sighted and blind adults.

    Strengths:
    The question raised in this paper is extremely important: what is the starting state in development for visual cortical regions, and how is this organization shaped by experience? This paper is among the first to examine this question, particularly by comparing infants not only with sighted adults but also blind adults, which sheds new light on the role of visual (and cross-modal) experience. Another clear strength lies in the unequivocal nature of many results. Many results have very large effect sizes, critical interactions between regions and groups are tested and found, and infant analyses are replicated in split halves of the data.

    Weaknesses:
    A central claim is that "infant secondary visual cortices functionally resemble those of blind more than sighted adults" (abstract, last paragraph of intro). I see two potential issues with this claim. First, a minor change: given the approaches used here, no claims should be made about the "function" of these regions, but rather their "functional correlations". Second (and more importantly), the claim that the secondary visual cortex in general resembles blind more than sighted adults is still not fully supported by the data. In fact, this claim is only true for one aspect of secondary visual area functional correlations (i.e., their connectivity to A1/M1/S1 vs. PFC). In other analyses, the infant secondary visual cortex looks more like sighted adults than blind adults (i.e., in within vs. across hemisphere correlations), or shows a different pattern from both sighted and blind adults (i.e., in occipito-frontal subregion functional connectivity). It is not clear from the manuscript why the comparison to PFC vs. non-visual sensory cortex is more theoretically important than hemispheric changes or within-PFC correlations (in fact, if anything, the within-PFC correlations strike me as the most important for understanding the development and reorganization of these secondary visual regions). It seems then that a more accurate conclusion is that the secondary visual cortex shows a mix of instructive effects of vision and reorganizing effects of blindness, albeit to a different extent than the primary visual cortex.

    Relatedly, group differences in overall secondary visual cortex connectivity are particularly striking as visualized in the connectivity matrices shown in Figure S1. In the results (lines 105-112), it is noted that while the infant FC matrix is strongly correlated with both adult groups, the infant group is nonetheless more strongly correlated with the blind than sighted adults. I am concerned that these results might be at least partially explained by distance (i.e., local spread of the bold signal), since a huge portion of the variance in these FC matrices is driven by stronger correlations between regions within the same system (e.g., secondary-secondary visual cortex, frontal-frontal cortex), which are inherently closer together, relative to those between different systems (e.g., visual to frontal cortex). How do results change if only comparisons between secondary visual regions and non-visual regions are included (i.e., just the pairs of regions within the bold black rectangle on the figure), which limits the analysis to long-rang connections only? Indeed, looking at the off-diagonal comparisons, it seems that in fact there are three altogether different patterns here in the three groups. Even if the correlation between the infant pattern and blind adult pattern survives, it might be more accurate to claim that infants are different from both adult groups, suggesting both instructive effects of vision and reorganizing effects of blindness. It might help to show the correlation between each group and itself (across independent sets of subjects) to better contextualize the relative strength of correlations between the groups.

    It is not clear that differences between groups should be attributed to visual experience only. For example, despite the title of the paper, the authors note elsewhere that cross-modal experience might also drive changes between groups. Another factor, which I do not see discussed, is possible ongoing experience-independent maturation. The infants scanned are extremely young, only 2 weeks old. Although no effects of age are detected, it is possible that cortex is still undergoing experience-independent maturation at this very early stage of development. For example, consider Figure 2; perhaps V1 connectivity is not established at 2 weeks, but eventually achieves the adult pattern later in infancy or childhood. Further, consider the possibility that this same developmental progression would be found in infants and children born blind. In that case, the blind adult pattern may depend on blindness-related experience only (which may or may not reflect "visual" experience per se). To deal with these issues, the authors should add a discussion of the role of maturation vs. experience and temper claims about the role of visual experience specifically (particularly in the title).

    The authors measure functional correlations in three very different groups of participants and find three different patterns of functional correlations. Although these three groups differ in critical, theoretically interesting ways (i.e., in age and visual/cross-modal experience), they also differ in many uninteresting ways, including at least the following: sampling rate (TR), scan duration, multi-band acceleration, denoising procedures (CompCor vs. ICA), head motion, ROI registration accuracy, and wakefulness (I assume the infants are asleep).

    Addressing all of these issues is beyond the scope of this paper, but I do feel the authors should acknowledge these confounds and discuss the extent to which they are likely (or not) to explain their results. The authors would strengthen their conclusions with analyses directly comparing data quality between groups (e.g., measures of head motion and split-half reliability would be particularly effective).

  18. eLife

    Reviewer #3 (Public Review):

    Summary:
    This study aimed to investigate whether the differences observed in the organization of visual brain networks between blind and sighted adults result from a reorganization of an early functional architecture due to blindness, or whether the early architecture is immature at birth and requires visual experience to develop functional connections. This question was investigated through the comparison of 3 groups of subjects with resting-state functional MRI (rs-fMRI). Based on convincing analyses, the study suggests that: 1) secondary visual cortices showed higher connectivity to prefrontal cortical regions (PFC) than to non-visual sensory areas (S1/M1 and A1) in sighted infants like in blind adults, in contrast to sighted adults; 2) the V1 connectivity pattern of sighted infants lies between that of sighted adults (stronger functional connectivity with non-visual sensory areas than with PFC) and that of blind adults (stronger functional connectivity with PFC than with non-visual sensory areas); 3) the laterality of the connectivity patterns of sighted infants resembled those of sighted adults more than those of blind adults, but sighted infants showed a less differentiated fronto-occipital connectivity pattern than adults.

    Strengths:
    - The question investigated in this article is important for understanding the mechanisms of plasticity during typical and impaired development, and the approach considered, which compares different groups of subjects including, neonates/infants and blind adults, is highly original.

    - Overall, the analyses considered are solid and well-detailed. The results are quite convincing, even if the interpretation might need to be revised downwards, as factors other than visual experience may play a role in the development of functional connections with the visual system.

    Weaknesses:
    - While it is informative to compare the "initial" state (close to birth) and the "final" states in blind and sighted adults to study the impact of post-natal and visual experience, this study does not analyze the chronology of this development and when the specialization of functional connections is completed. This would require investigating when experience-dependent mechanisms are important for the setting- establishment of multiple functional connections within the visual system. This could be achieved by analyzing different developmental periods in the same way, using open databases such as the Baby Connectome Project. Given the early, "condensed" maturation of the visual system after birth, we might expect sighted infants to show connectivity patterns similar to those of adults a few months after birth.

    - The rationale for mixing full-term neonates and preterm infants (scanned at term-equivalent age) from the dHCP 3rd release is not understandable since preterms might have a very different development related to prematurity and to post-natal (including visual) experience. Although the authors show that the difference between the connectivity of visual and other sensory regions, and the one of visual and PFC regions, do not depend on age at birth, they do not show that each connectivity pattern is not influenced by prematurity. Simply not considering the preterm infants would have made the analysis much more robust, and the full-term group in itself is already quite large compared with the two adult groups. The current study setting and the analyses performed do not seem to be an adequate and sufficient model to ascertain that "a few weeks of vision after birth is ... insufficient to influence connectivity".

    In a similar way, excluding the few infants with detected brain anomalies (radiological scores higher or equal to 4) would strengthen the group homogeneity by focusing on infants supposed to have a rather typical neurodevelopment. The authors quote all infants as "sighted" but this is not guaranteed as no follow-up is provided.

    The post-menstrual age (PMA) at scan of the infants is also not described. The methods indicate that all were scanned at "term-equivalent age" but does this mean that there is some PMA variability between 37 and 41 weeks? Connectivity measures might be influenced by such inter-individual variability in PMA, and this could be evaluated.

    - The rationale for presenting results on the connectivity of secondary visual cortices before one of the primary cortices (V1) was not clear to understand. Also, it might be relevant to better justify why only the connectivity of visual regions to non-visual sensory regions (S1-M1, A1) and prefrontal cortex (PFC) was considered in the analyses, and not the ones to other brain regions.

    - In relation to the question explored, it might be informative to reposition the study in relation to what others have shown about the developmental chronology of structural and functional long-distance and short-distance connections during pregnancy and the first postnatal months.

    - The authors acknowledge the methodological difficulties in defining regions of interest (ROIs) in infants in a similar way as adults. The reliability and the comparability of the ROIs positioning in infants is definitely an issue. Given that brain development is not homogeneous and synchronous across brain regions (in particular with the frontal and parietal lobes showing delayed growth), the newborn brain is not homothetic to the adult brain, which poses major problems for registration. The functional specialization of cortical regions is incomplete at birth. This raises the question of whether the findings of this study would be stable/robust if slightly larger or displaced regions had been considered, to cover with greater certainty the same areas as those considered in adults. And have other cortical parcellation approaches been considered to assess the ROIs robustness (e.g. MCRIB-S for full-terms)?

  19. Version published to 10.1101/2023.02.21.528939 on bioRxiv