title: Affective blindsight: intact fear conditioning to a visual cue in a cortically blind patient.
abstract: Blindsight refers to remarkable residual visual abilities of patients with damage to the primary visual cortex (V1). Recent studies revealed that such residual abilities do not apply only to relatively simple object discriminations, but that these patients can also differentially categorize and respond to emotionally salient stimuli. The current study reports on a case of intact fear conditioning to a visual cue in a male patient with complete bilateral cortical blindness. The patient was admitted to the stroke unit of the neurological department because of complete loss of vision. Both CT and structural MRI scans confirmed lesions in both territories of the posterior cerebral artery. No visual evoked potentials could be detected confirming complete cortical blindness. During fear conditioning, a visual cue predicted the occurrence of an aversive electric shock. Acoustic startle probes were presented during and between the conditioned stimuli. Relative to the control condition, startle reflexes were substantially potentiated when elicited in the presence of the conditioned stimuli. No such potentiation was observed prior to conditioning. These data suggest that fear learning to visual cues does not require a cortical representation of the conditioned stimulus in the primary sensory cortex and that subcortical pathways are sufficient to activate the fear module in humans.
authors.affiliation: Department of Psychology, Ernst-Moritz-Arndt-University of Greifswald, Germany. hamm@uni-greifswald.de
authors.forename: Alfons O
authors.initials: AO
authors.lastname: Hamm
authors.forename: Almut I
authors.initials: AI
authors.lastname: Weike
authors.forename: Harald T
authors.initials: HT
authors.lastname: Schupp
authors.forename: Thomas
authors.initials: T
authors.lastname: Treig
authors.forename: Alexander
authors.initials: A
authors.lastname: Dressel
authors.forename: Christof
authors.initials: C
authors.lastname: Kessler
mesh_terms: D000368:Aged; D019575:Blindness, Cortical / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology*; D003214:Conditioning, Classical; D003463:Cues; D004558:Electric Stimulation; D005074:Evoked Potentials, Visual; D005239:Fear; D005712:Galvanic Skin Response; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010775:Photic Stimulation / Q000379:methods; D013216:Reflex, Startle; D014057:Tomography, X-Ray Computed; D014793:Visual Cortex / Q000473:pathology / Q000503:physiopathology