Preserved cortical hierarchy characterizes vision without awareness after visual cortex damage

In a cohort of psychophysically defined blindsight patients after primary visual cortex (V1) damage, blindsight-positive cases retain control-like sensory–association coupling, unlike blindsight-negative cases.

• Why it matters: It remains unclear why some people with similar V1 lesions show vision-guided detection without awareness, while others do not, despite attention to spared bypass pathways.
• What they did: Using resting-state fMRI, regional coupling was quantified as mutual information in age-matched blindsight-positive and blindsight-negative patients and controls, then linked to blind-field stimulus detection.
• The result: Sensory–association coupling differentiation tracked blind-field detection and predicted performance across the patient cohort, and ipsilesional posterior thalamus (pulvinar-consistent) showed group differences tied to contralesional visual and frontal pre-motor coupling.

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