The influence of reading ability on subsequent changes in verbal IQ in the teenage years

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Reading ability predicts subsequent changes in verbal IQ (VIQ) in teenagers.

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The effect of reading was observed on all VIQ subtests, except arithmetic.

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VIQ changes were larger when there was a discrepancy between VIQ and reading.

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The effect of reading on VIQ changes was validated by structural brain changes.

Intelligence Quotient (IQ) is regularly used in both education and employment as a measure of cognitive ability. Although an individual's IQ is generally assumed to stay constant across the lifespan, a few studies have suggested that there may be substantial variation at the individual level. Motivated by previous reports that reading quality/quantity has a positive influence on vocabulary acquisition, we hypothesised that reading ability in the early teenage years might contribute to changes in verbal IQ (VIQ) over the next few years. We found that good readers were more likely to experience relative improvements in VIQ over time, with the reverse true for poor readers. These effects were largest when there was a discrepancy between Time 1 reading ability and Time 1 VIQ. In other words, VIQ increases tended to be greatest when reading ability was high relative to VIQ. Additional analyses supported these findings by showing that variance in VIQ change associated with Time 1 behaviour was also associated with independent measurements of brain structure. Our finding that reading in the early teenage years can predict a significant proportion of the variance in subsequent VIQ change has implications for targeted education in both home and school environments.

Current themes in neuroimaging studies of reading

This editorial provides a summary of the highlights from 11 new papers that have been published in a special issue of Brain and Language on the neurobiology of reading. The topics investigate reading mechanisms in both adults and children. Several of the findings illustrate how responses in the left ventral occipito-temporal cortex, and other reading areas, change with learning, expertise and the task: In the early stages of reading acquisition, learning/expertise increases activation in reading areas as well as in an attentionally-controlled, learning circuit. In later stages, expertise and efficiency decrease activation within the reading network and increase anatomical connectivity. Special interest is given to a white matter tract (the vertical occipital fasciculus) that projects dorsally from the left occipito-temporal cortex to the posterior parietal lobe. This observation fits with a magnetoencephalography study showing how activity in the angular gyrus is influenced by early occipito-temporal activity; with angular gyrus activity contributing to inferior frontal activity. Overall, the papers within the special issue illustrate the wide range of different techniques that can be used to reveal the functional anatomy of reading and the time course of activity within the different reading pathways.

Increased Facilitatory Connectivity from the Pre-SMA to the Left Dorsal Premotor Cortex during Pseudoword Repetition

Previous studies have demonstrated that the repetition of pseudowords engages a network of premotor areas for articulatory planning and articulation. However, it remains unclear how these premotor areas interact and drive one another during speech production. We used fMRI with dynamic causal modeling to investigate effective connectivity between premotor areas during overt repetition of words and pseudowords presented in both the auditory and visual modalities. Regions involved in phonological aspects of language production were identified as those where regional increases in the BOLD signal were common to repetition in both modalities. We thus obtained three seed regions: the bilateral pre-SMA, left dorsal premotor cortex (PMd), and left ventral premotor cortex that were used to test 63 different models of effective connectivity in the premotor network for pseudoword relative to word repetition. The optimal model was identified with Bayesian model selection and reflected a network with driving input to pre-SMA and an increase in facilitatory drive from pre-SMA to PMd during repetition of pseudowords. The task-specific increase in effective connectivity from pre-SMA to left PMd suggests that the pre-SMA plays a supervisory role in the generation and subsequent sequencing of motor plans. Diffusion tensor imaging-based fiber tracking in another group of healthy volunteers showed that the functional connection between both regions is underpinned by a direct cortico-cortical anatomical connection.

Predicting IQ change from brain structure: a cross-validation study

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We quantify how well IQ changes in teenagers can be predicted from brain scans.

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We compare different ways to cross-validate predictions from neuroimaging.

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We demonstrate the advantage of using Leave-One-Out cross-validation.

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We illustrate the limitations of using IQ as a measure of cognitive potential.

Procedures that can predict cognitive abilities from brain imaging data are potentially relevant to educational assessments and studies of functional anatomy in the developing brain. Our aim in this work was to quantify the degree to which IQ change in the teenage years could be predicted from structural brain changes. Two well-known k-fold cross-validation analyses were applied to data acquired from 33 healthy teenagers – each tested at Time 1 and Time 2 with a 3.5 year interval. One approach, a Leave-One-Out procedure, predicted IQ change for each subject on the basis of structural change in a brain region that was identified from all other subjects (i.e., independent data). This approach predicted 53% of verbal IQ change and 14% of performance IQ change. The other approach used half the sample, to identify regions for predicting IQ change in the other half (i.e., a Split half approach); however – unlike the Leave-One-Out procedure – regions identified using half the sample were not significant. We discuss how these out-of-sample estimates compare to in-sample estimates; and draw some recommendations for k-fold cross-validation procedures when dealing with small datasets that are typical in the neuroimaging literature.

Inter- and intrahemispheric connectivity differences when reading Japanese Kanji and Hiragana

Unlike most languages that are written using a single script, Japanese uses multiple scripts including morphographic Kanji and syllabographic Hiragana and Katakana. Here, we used functional magnetic resonance imaging with dynamic causal modeling to investigate competing theories regarding the neural processing of Kanji and Hiragana during a visual lexical decision task. First, a bilateral model investigated interhemispheric connectivity between ventral occipito–temporal (vOT) cortex and Broca's area (“pars opercularis”). We found that Kanji significantly increased the connection strength from right-to-left vOT. This is interpreted in terms of increased right vOT activity for visually complex Kanji being integrated into the left (i.e. language dominant) hemisphere. Secondly, we used a unilateral left hemisphere model to test whether Kanji and Hiragana rely preferentially on ventral and dorsal paths, respectively, that is, they have different intrahemispheric functional connectivity profiles. Consistent with this hypothesis, we found that Kanji increased connectivity within the ventral path (V1 ↔ vOT ↔ Broca's area), and that Hiragana increased connectivity within the dorsal path (V1 ↔ supramarginal gyrus ↔ Broca's area). Overall, the results illustrate how the differential processing demands of Kanji and Hiragana influence both inter- and intrahemispheric interactions.

Reading front to back: MEG evidence for early feedback effects during word recognition

Magnetoencephalography studies in humans have shown word-selective activity in the left inferior frontal gyrus (IFG) approximately 130 ms after word presentation ( Pammer et al. 2004; Cornelissen et al. 2009; Wheat et al. 2010). The role of this early frontal response is currently not known. We tested the hypothesis that the IFG provides top-down constraints on word recognition using dynamic causal modeling of magnetoencephalography data collected, while subjects viewed written words and false font stimuli. Subject-specific dipoles in left and right occipital, ventral occipitotemporal and frontal cortices were identified using Variational Bayesian Equivalent Current Dipole source reconstruction. A connectivity analysis tested how words and false font stimuli differentially modulated activity between these regions within the first 300 ms after stimulus presentation. We found that left inferior frontal activity showed stronger sensitivity to words than false font and a stronger feedback connection onto the left ventral occipitotemporal cortex (vOT) in the first 200 ms. Subsequently, the effect of words relative to false font was observed on feedforward connections from left occipital to ventral occipitotemporal and frontal regions. These findings demonstrate that left inferior frontal activity modulates vOT in the early stages of word processing and provides a mechanistic account of top-down effects during word recognition.

The effect of aging on the neural correlates of phonological word retrieval

Age has a differential effect on cognition, with word retrieval being one of the cognitive domains most affected by aging. This study examined the functional and structural neural correlates of phonological word retrieval in younger and older adults using word and picture rhyme judgment tasks. Although the behavioral performance in the fMRI task was similar for the two age groups, the older adults had increased activation in the right pars triangularis across tasks and in the right pars orbitalis for the word task only. Increased activation together with preserved performance in the older participants would suggest that increased activation was related to compensatory processing. We validated this hypothesis by showing that right pars triangularis activation during correct rhyme judgments was highest in participants who made overall more errors, therefore being most error-prone. Our findings demonstrate that the effect of aging differ in adjacent but distinct right inferior frontal regions. The differential effect of age on word and picture tasks also provides new clues to the level of processing that is most affected by age in speech production tasks. Specifically, we suggest that right inferior frontal activation in older participants is needed to inhibit errors.

Functional ontologies for cognition: The systematic definition of structure and function

Cognitive scientists have traditionally specified the functional components of cognitive skills on the basis of behavioural studies of normal and neurologically impaired subjects. The results of functional imaging studies are challenging these classical models because there is a high degree of overlap among the neural systems activated by tasks that share no cognitive components. This suggests that a given neuronal structure can perform multiple functions that depend on the areas with which it interacts. However, there will be a limited range of functions that an area can perform given that its anatomical (intrinsic and extrinsic) connectivity is fixed. Assigning labels that encompass the operations that each area performs should enable a task to be re-described in terms of the functions of the areas activated. In other words, function should predict the structure and conversely structure should predict function. These systematic descriptions are referred to as ontologies. We argue that a systematic ontology for cognition would facilitate the integration of cognitive and anatomical models and organise the cognitive components of diverse tasks into a single framework. These points are illustrated with cognitive and anatomical models of reading and object recognition.

A comparison of VLSM and VBM in a cohort of patients with post-stroke aphasia

Studies attempting to map post-stroke cognitive or motor symptoms to lesion location have been available in the literature for over 150 years. In the last two decades, two computational techniques have been developed to identify the lesion sites associated with behavioural impairments. Voxel Based Morphometry (VBM) has now been used extensively for this purpose in many different patient populations. More recently, Voxel-based Lesion Symptom Mapping (VLSM) was developed specifically for the purpose of identifying lesion–symptom relationships in stroke patients, and has been used extensively to study, among others functions, language, motor abilities and attention. However, no studies have compared the results of these two techniques so far. In this study we compared VLSM and VBM in a cohort of 20 patients with chronic post-stroke aphasia. Comparison of the two techniques showed overlap in regions previously found to be relevant for the tasks used, suggesting that using both techniques and looking for overlaps between them can increase the reliability of the results obtained. However, overall VBM and VLSM provided only partially concordant results and the differences between the two techniques are discussed.

Functional Heterogeneity within the Default Network during Semantic Processing and Speech Production

This fMRI study investigated the functional heterogeneity of the core nodes of the default mode network (DMN) during language processing. The core nodes of the DMN were defined as task-induced deactivations over multiple tasks in 94 healthy subjects. We used a factorial design that manipulated different tasks (semantic matching or speech production) and stimuli (familiar words and objects or unfamiliar stimuli), alternating with periods of fixation/rest. Our findings revealed several consistent effects in the DMN, namely less deactivations in the left inferior parietal lobule during semantic than perceptual matching in parallel with greater deactivations during semantic matching in anterior subdivisions of the posterior cingulate cortex (PCC) and the ventromedial prefrontal cortex (MPFC). This suggests that, when the brain is engaged in effortful semantic tasks, a part of the DMN in the left angular gyrus was less deactivated as five other nodes of the DMN were more deactivated. These five DMN areas, where deactivation was greater for semantic than perceptual matching, were further differentiated because deactivation was greater in (i) posterior ventral MPFC for speech production relative to semantic matching, (ii) posterior precuneus and PCC for perceptual processing relative to speech production, and (iii) right inferior parietal cortex for pictures of objects relative to written words during both naming and semantic decisions. Our results thus highlight that task difficulty alone cannot fully explain the functional variability in task-induced deactivations. Together these results emphasize that core nodes within the DMN are functionally heterogeneous and differentially sensitive to the type of language processing.

A review and synthesis of the first 20 years of PET and fMRI studies of heard speech, spoken language and reading

The anatomy of language has been investigated with PET or fMRI for more than 20 years. Here I attempt to provide an overview of the brain areas associated with heard speech, speech production and reading. The conclusions of many hundreds of studies were considered, grouped according to the type of processing, and reported in the order that they were published. Many findings have been replicated time and time again leading to some consistent and undisputable conclusions. These are summarised in an anatomical model that indicates the location of the language areas and the most consistent functions that have been assigned to them. The implications for cognitive models of language processing are also considered. In particular, a distinction can be made between processes that are localized to specific structures (e.g. sensory and motor processing) and processes where specialisation arises in the distributed pattern of activation over many different areas that each participate in multiple functions. For example, phonological processing of heard speech is supported by the functional integration of auditory processing and articulation; and orthographic processing is supported by the functional integration of visual processing, articulation and semantics. Future studies will undoubtedly be able to improve the spatial precision with which functional regions can be dissociated but the greatest challenge will be to understand how different brain regions interact with one another in their attempts to comprehend and produce language.

Structural correlates for lexical efficiency and number of languages in non-native speakers of English

We used structural magnetic resonance imaging (MRI) and voxel based morphometry (VBM) to investigate whether the efficiency of word processing in the non-native language (lexical efficiency) and the number of non-native languages spoken (2+ versus 1) were related to local differences in the brain structure of bilingual and multilingual speakers. We dissociate two different correlates for non-native language processing. Firstly, multilinguals who spoke 2 or more non-native languages had higher grey matter density in the right posterior supramarginal gyrus compared to bilinguals who only spoke one non-native language. This is interpreted in relation to previous studies that have shown that grey matter density in this region is related to the number of words learnt in bilinguals relative to monolinguals and in monolingual adolescents with high versus low vocabulary. Our second result was that, in bilinguals, grey matter density in the left pars opercularis was positively related to lexical efficiency in second language use, as measured by the speed and accuracy of lexical decisions and the number of words produced in a timed verbal fluency task. Grey matter in the same region was also negatively related to the age at which the second language was acquired. This is interpreted in terms of previous findings that associated the left pars opercularis with phonetic expertise in the native language.

How number processing survives left occipito-temporal damage

We investigated the neural systems that support number processing in a patient (JL) who had damage to the left ventral occipito-temporal cortex (LvOT). JL had severely impaired written word recognition but he was remarkably accurate in number tasks, albeit slower than normal. This suggests LvOT activation is necessary for efficient but not for accurate number decisions. Here we investigated how JL made accurate number decisions using fMRI; we compared JL's brain activation to that in healthy controls and in two patients with frontal lobe damage who, like JL, made slow but accurate responses in number tasks. For semantic relative to perceptual decisions on numbers, JL did not activate the left occipito-temporal area that was involved in all other subjects. However, JL had significantly increased activation in a left posterior middle temporal region. In addition, during semantic and perceptual decisions on numbers, JL showed increased activation in: (1) the right occipito-temporal cortex, (2) right caudate, and (3) bilateral frontal regions. These effects were unique to JL and cannot be explained in terms of abnormally long response times because they were not observed in the other patients who made slow but accurate number decisions. Together these results show that although the LvOT usually contributes to efficient number processing, activation in this region is not essential for accurate performance because (i) perceptual processing of numbers can be supported by right occipital, right caudate, and bilateral frontal activation and (ii) semantic processing of numbers can be supported by increased left posterior middle temporal activation associated with hand actions.

How doctors generate diagnostic hypotheses: a study of radiological diagnosis with functional magnetic resonance imaging

BACKGROUND

In medical practice, diagnostic hypotheses are often made by physicians in the first moments of contact with patients; sometimes even before they report their symptoms. We propose that generation of diagnostic hypotheses in this context is the result of cognitive processes subserved by brain mechanisms that are similar to those involved in naming objects or concepts in everyday life.

METHODOLOGY AND PRINCIPAL FINDINGS

To test this proposal we developed an experimental paradigm with functional magnetic resonance imaging (fMRI) using radiological diagnosis as a model. Twenty-five radiologists diagnosed lesions in chest X-ray images and named non-medical targets (animals) embedded in chest X-ray images while being scanned in a fMRI session. Images were presented for 1.5 seconds; response times (RTs) and the ensuing cortical activations were assessed. The mean response time for diagnosing lesions was 1.33 (SD ±0.14) seconds and 1.23 (SD ±0.13) seconds for naming animals. 72% of the radiologists reported cogitating differential diagnoses during trials (3.5 seconds). The overall pattern of cortical activations was remarkably similar for both types of targets. However, within the neural systems shared by both stimuli, activation was significantly greater in left inferior frontal sulcus and posterior cingulate cortex for lesions relative to animals.

CONCLUSIONS

Generation of diagnostic hypotheses and differential diagnoses made through the immediate visual recognition of clinical signs can be a fast and automatic process. The co-localization of significant brain activation for lesions and animals suggests that generating diagnostic hypotheses for lesions and naming animals are served by the same neuronal systems. Nevertheless, diagnosing lesions was cognitively more demanding and associated with more activation in higher order cortical areas. These results support the hypothesis that medical diagnoses based on prompt visual recognition of clinical signs and naming in everyday life are supported by similar brain systems.

Auditory short-term memory capacity correlates with gray matter density in the left posterior STS in cognitively normal and dyslexic adults

A central feature of auditory STM is its item-limited processing capacity. We investigated whether auditory STM capacity correlated with regional gray and white matter in the structural MRI images from 74 healthy adults, 40 of whom had a prior diagnosis of developmental dyslexia whereas 34 had no history of any cognitive impairment. Using whole-brain statistics, we identified a region in the left posterior STS where gray matter density was positively correlated with forward digit span, backward digit span, and performance on a "spoonerisms" task that required both auditory STM and phoneme manipulation. Across tasks and participant groups, the correlation was highly significant even when variance related to reading and auditory nonword repetition was factored out. Although the dyslexics had poorer phonological skills, the effect of auditory STM capacity in the left STS was the same as in the cognitively normal group. We also illustrate that the anatomical location of this effect is in proximity to a lesion site recently associated with reduced auditory STM capacity in patients with stroke damage. This result, therefore, indicates that gray matter density in the posterior STS predicts auditory STM capacity in the healthy and damaged brain. In conclusion, we suggest that our present findings are consistent with the view that there is an overlap between the mechanisms that support language processing and auditory STM.

Verbal and non-verbal intelligence changes in the teenage brain

Intelligence quotient (IQ) is a standardized measure of human intellectual capacity that takes into account a wide range of cognitive skills. IQ is generally considered to be stable across the lifespan, with scores at one time point used to predict educational achievement and employment prospects in later years. Neuroimaging allows us to test whether unexpected longitudinal fluctuations in measured IQ are related to brain development. Here we show that verbal and non-verbal IQ can rise or fall in the teenage years, with these changes in performance validated by their close correlation with changes in local brain structure. A combination of structural and functional imaging showed that verbal IQ changed with grey matter in a region that was activated by speech, whereas non-verbal IQ changed with grey matter in a region that was activated by finger movements. By using longitudinal assessments of the same individuals, we obviated the many sources of variation in brain structure that confound cross-sectional studies. This allowed us to dissociate neural markers for the two types of IQ and to show that general verbal and non-verbal abilities are closely linked to the sensorimotor skills involved in learning. More generally, our results emphasize the possibility that an individual's intellectual capacity relative to their peers can decrease or increase in the teenage years. This would be encouraging to those whose intellectual potential may improve, and would be a warning that early achievers may not maintain their potential.

The neural correlates of inner speech defined by voxel-based lesion-symptom mapping

The neural correlates of inner speech have been investigated previously using functional imaging. However, methodological and other limitations have so far precluded a clear description of the neural anatomy of inner speech and its relation to overt speech. Specifically, studies that examine only inner speech often fail to control for subjects' behaviour in the scanner and therefore cannot determine the relation between inner and overt speech. Functional imaging studies comparing inner and overt speech have not produced replicable results and some have similar methodological caveats as studies looking only at inner speech. Lesion analysis can avoid the methodological pitfalls associated with using inner and overt speech in functional imaging studies, while at the same time providing important data about the neural correlates essential for the specific function. Despite its advantages, a study of the neural correlates of inner speech using lesion analysis has not been carried out before. In this study, 17 patients with chronic post-stroke aphasia performed inner speech tasks (rhyme and homophone judgements), and overt speech tasks (reading aloud). The relationship between brain structure and language ability was studied using voxel-based lesion-symptom mapping. This showed that inner speech abilities were affected by lesions to the left pars opercularis in the inferior frontal gyrus and to the white matter adjacent to the left supramarginal gyrus, over and above overt speech production and working memory. These results suggest that inner speech cannot be assumed to be simply overt speech without a motor component. It also suggests that the use of overt speech to understand inner speech and vice versa might result in misleading conclusions, both in imaging studies and clinical practice.

A Generative Model of Speech Production in Broca's and Wernicke's Areas

Speech production involves the generation of an auditory signal from the articulators and vocal tract. When the intended auditory signal does not match the produced sounds, subsequent articulatory commands can be adjusted to reduce the difference between the intended and produced sounds. This requires an internal model of the intended speech output that can be compared to the produced speech. The aim of this functional imaging study was to identify brain activation related to the internal model of speech production after activation related to vocalization, auditory feedback, and movement in the articulators had been controlled. There were four conditions: silent articulation of speech, non-speech mouth movements, finger tapping, and visual fixation. In the speech conditions, participants produced the mouth movements associated with the words “one” and “three.” We eliminated auditory feedback from the spoken output by instructing participants to articulate these words without producing any sound. The non-speech mouth movement conditions involved lip pursing and tongue protrusions to control for movement in the articulators. The main difference between our speech and non-speech mouth movement conditions is that prior experience producing speech sounds leads to the automatic and covert generation of auditory and phonological associations that may play a role in predicting auditory feedback. We found that, relative to non-speech mouth movements, silent speech activated Broca’s area in the left dorsal pars opercularis and Wernicke’s area in the left posterior superior temporal sulcus. We discuss these results in the context of a generative model of speech production and propose that Broca’s and Wernicke’s areas may be involved in predicting the speech output that follows articulation. These predictions could provide a mechanism by which rapid movement of the articulators is precisely matched to the intended speech outputs during future articulations.

Speech facilitation by left inferior frontal cortex stimulation

Electrophysiological studies in humans and animals suggest that noninvasive neurostimulation methods such as transcranial direct current stimulation (tDCS) can elicit long-lasting [1], polarity-dependent [2] changes in neocortical excitability. Application of tDCS can have significant and selective behavioral consequences that are associated with the cortical location of the stimulation electrodes and the task engaged during stimulation [3–8]. However, the mechanism by which tDCS affects human behavior is unclear. Recently, functional magnetic resonance imaging (fMRI) has been used to determine the spatial topography of tDCS effects [9–13], but no behavioral data were collected during stimulation. The present study is unique in this regard, in that both neural and behavioral responses were recorded using a novel combination of left frontal anodal tDCS during an overt picture-naming fMRI study. We found that tDCS had significant behavioral and regionally specific neural facilitation effects. Furthermore, faster naming responses correlated with decreased blood oxygen level-dependent (BOLD) signal in Broca's area. Our data support the importance of Broca's area within the normal naming network and as such indicate that Broca's area may be a suitable candidate site for tDCS in neurorehabilitation of anomic patients, whose brain damage spares this region.

Specialization in the human brain: the case of numbers

How numerical representation is encoded in the adult human brain is important for a basic understanding of human brain organization, its typical and atypical development, its evolutionary precursors, cognitive architectures, education, and rehabilitation. Previous studies have shown that numerical processing activates the same intraparietal regions irrespective of the presentation format (e.g., symbolic digits or non-symbolic dot arrays). This has led to claims that there is a single format-independent, numerical representation. In the current study we used a functional magnetic resonance adaptation paradigm, and effective connectivity analysis to re-examine whether numerical processing in the intraparietal sulci is dependent or independent on the format of the stimuli. We obtained two novel results. First, the whole brain analysis revealed that format change (e.g., from dots to digits), in the absence of a change in magnitude, activated the same intraparietal regions as magnitude change, but to a greater degree. Second, using dynamic causal modeling as a tool to disentangle neuronal specialization across regions that are commonly activated, we found that the connectivity between the left and right intraparietal sulci is format-dependent. Together, this line of results supports the idea that numerical representation is subserved by multiple mechanisms within the same parietal regions.

Where, when and why brain activation differs for bilinguals and monolinguals during picture naming and reading aloud

Using functional magnetic resonance imaging, we found that when bilinguals named pictures or read words aloud, in their native or nonnative language, activation was higher relative to monolinguals in 5 left hemisphere regions: dorsal precentral gyrus, pars triangularis, pars opercularis, superior temporal gyrus, and planum temporale. We further demonstrate that these areas are sensitive to increasing demands on speech production in monolinguals. This suggests that the advantage of being bilingual comes at the expense of increased work in brain areas that support monolingual word processing. By comparing the effect of bilingualism across a range of tasks, we argue that activation is higher in bilinguals compared with monolinguals because word retrieval is more demanding; articulation of each word is less rehearsed; and speech output needs careful monitoring to avoid errors when competition for word selection occurs between, as well as within, language.

Modules and brain mapping

This review highlights the key role of modularity and the additive factors method in functional neuroimaging. Our focus is on structure–function mappings in the human brain and how these are disclosed by brain mapping. We describe how modularity of processing (and possibly processes) was a key point of reference for establishing functional segregation as a principle of brain organization. Furthermore, modularity plays a crucial role when trying to characterize distributed brain responses in terms of functional integration or coupling among brain areas. We consider additive factors logic and how it helped to shape the design and interpretation of studies at the inception of brain mapping, with a special focus on factorial designs. We look at factorial designs in activation experiments and in the context of lesion–deficit mapping. In both cases, the presence or absence of interactions among various experimental factors has proven essential in understanding the context-sensitive nature of distributed but modular processing and discerning the nature of (potentially degenerate) structure–function relationships in cognitive neuroscience.

Parallel recovery in a trilingual speaker: the use of the Bilingual Aphasia Test as a diagnostic complement to the Comprehensive Aphasia Test

We illustrate the value of the Bilingual Aphasia Test in the diagnostic assessment of a trilingual speaker post-stroke living in England for whom English was a non-native language. The Comprehensive Aphasia Test is routinely used to assess patients in English, but only in combination with the Bilingual Aphasia Test is it possible and practical to provide a full picture of the language impairment. We describe our test selection and the assessment it allows us to make.

The interactive account of ventral occipitotemporal contributions to reading

The ventral occipitotemporal cortex (vOT) is involved in the perception of visually presented objects and written words. The Interactive Account of vOT function is based on the premise that perception involves the synthesis of bottom-up sensory input with top-down predictions that are generated automatically from prior experience. We propose that vOT integrates visuospatial features abstracted from sensory inputs with higher level associations such as speech sounds, actions and meanings. In this context, specialization for orthography emerges from regional interactions without assuming that vOT is selectively tuned to orthographic features. We discuss how the Interactive Account explains left vOT responses during normal reading and developmental dyslexia; and how it accounts for the behavioural consequences of left vOT damage.