Le sens du goût chez l'aveugle congénital

Vision is crucial for seeking and identifying food. Not only does it trigger the cephalic digestion reflex but, when combined with the experience of eating, it helps to refine expectations about foods. In a single eye blink, sight informs us about the availability, identity, palatability, flavours, textures as well as nutritional, caloric and toxic contents of foods surrounding us. Given the importance of sight in the gustatory experience, one may therefore ask the following question: What happens to gustation without vision? This thesis answers this question by studying this modality in congenitally blind subjects using psychophysical and brain imaging techniques. Additionally, the gustatory consequences of blindness are compared to those following the loss of another important modality involved in the appreciation of food, i.e. the sense of smell (anosmia). Behavioural results first show that the absence of vision from birth reduces the gustatory sensitivity, as reflected by higher detection and identification thresholds of the five basic tastes (sweet, salty, acid, bitter, umami). Second, although congenitally blind subjects are better at identifying palatable odorant stimuli through their nostrils (orthonasal olfactory route), they lose this advantage over sighted people when identifying these stimuli placed on their tongue (retronasal olfactory route). Neuroimaging results also reveal that congenitally blind subjects activate the primary gustatory cortex (insula/operculum) and the hypothalamus less compared to blindfolded sighted participants. Moreover, the absence of occipital (“visual”) cortex activity in the blind points towards the lack of crossmodal plasticity in gustation. In congenitally anosmics, on the other hand, not only does the absence of smell lower the ability to recognize tastes but it also lowers the strength of the signal in olfactory areas (e.g. medial orbitofrontal cortex) during a gustatory task. The results in the blind greatly contrast with previous studies highlighting the enhancement of their exteroceptive senses such as audition, (orthonasal) olfaction and touch, all of which involve crossmodal plasticity. Moreover, data in the anosmic group are consistent with previous literature describing similar decrease of trigeminal chemosensation that is also associated with a weakening of the flavour neural network. This suggests that the sense of taste is not useful to the visually impaired to perceive their exterior environment and compensate for their lack of vision. Furthermore, although olfaction contributes to the appreciation of foods in the mouth, the lack of this modality does not drive sensory compensation in anosmic subjects. Taken together, these data indicate different adaptation mechanisms following blindness and anosmia. They also support the view according to which the unified perception of tastes and flavours includes not only the chemical senses (taste, smell and trigeminal chemosensation) and touch but also vision. Given the importance of taste and eating experience in quality of life, these results encourage society as well as rehabilitation professionals to facilitate access to foods and culinary lessons in sensory deprived subjects.

Keyphrases: Gustation, Vision, Gustation, Vision, Blindness, Smell, Anosmia, Crossmodal plasticity