A mesial-to-lateral dissociation for orthographic processing in the visual cortex

Dissociation of reading and naming in ventral occipitotemporal cortex

Lesions in the language-dominant ventral occipitotemporal cortex (vOTC) can result in selective impairment of either reading or naming, resulting in alexia or anomia. Yet, functional imaging studies that show differential activation for naming and reading do not reveal activity exclusively tuned to one of these inputs. To resolve this dissonance in the functional architecture of the vOTC, we used focused stimulation to the vOTC in 49 adult patients during reading and naming, and generated a population-level, probabilistic map to evaluate if reading and naming are clearly dissociable within individuals. Language mapping (50 Hz, 2829 stimulations) was performed during passage reading (216 positive sites) and visual naming (304 positive sites). Within the vOTC, we isolated sites that selectively disrupted reading (24 sites in 11 patients) or naming (27 sites in 12 patients), and those that disrupted both processes (75 sites in 21 patients). The anteromedial vOTC had a higher probability of producing naming disruption, while posterolateral regions resulted in greater reading-specific disruption. Between them lay a multi-modal region where stimulation disrupted both reading and naming. This work provides a comprehensive view of vOTC organization-the existence of a heteromodal cortex critical to both reading and naming, along with a causally dissociable unimodal naming cortex, and a reading-specific visual word form area in the vOTC. Their distinct roles as associative regions may thus relate to their connectivity within the broader language network that is disrupted by stimulation, more than to highly selective tuning properties. Our work also implies that pre-surgical mapping of both reading and naming is essential for patients requiring vOTC resections, as these functions are not co-localized, and such mapping may prevent the occurrence of unexpected deficits.

Subtitled speech: the neural mechanisms of ticker-tape synaesthesia

The acquisition of reading modifies areas of the brain associated with vision and with language, in addition to their connections. These changes enable reciprocal translation between orthography and the sounds and meaning of words. Individual variability in the pre-existing cerebral substrate contributes to the range of eventual reading abilities, extending to atypical developmental patterns, including dyslexia and reading-related synaesthesias. The present study is devoted to the little-studied but highly informative ticker-tape synaesthesia, in which speech perception triggers the vivid and irrepressible perception of words in their written form in the mind's eye. We scanned a group of 17 synaesthetes and 17 matched controls with functional MRI, while they listened to spoken sentences, words, numbers or pseudowords (Experiment 1), viewed images and written words (Experiment 2) or were at rest (Experiment 3). First, we found direct correlates of the ticker-tape synaesthesia phenomenon: during speech perception, as ticker-tape synaesthesia was active, synaesthetes showed over-activation of left perisylvian regions supporting phonology and of the occipitotemporal visual word form area, where orthography is represented. Second, we provided support to the hypothesis that ticker-tape synaesthesia results from atypical relationships between spoken and written language processing: the ticker-tape synaesthesia-related regions overlap closely with cortices activated during reading, and the overlap of speech-related and reading-related areas is larger in synaesthetes than in controls. Furthermore, the regions over-activated in ticker-tape synaesthesia overlap with regions under-activated in dyslexia. Third, during the resting state (i.e. in the absence of current ticker-tape synaesthesia), synaesthetes showed increased functional connectivity between left prefrontal and bilateral occipital regions. This pattern might reflect a lowered threshold for conscious access to visual mental contents and might imply a non-specific predisposition to all synaesthesias with a visual content. These data provide a rich and coherent account of ticker-tape synaesthesia as a non-detrimental developmental condition created by the interaction of reading acquisition with an atypical cerebral substrate.

Linguistic and attentional factors - Not statistical regularities - Contribute to word-selective neural responses with FPVS-oddball paradigms

Studies using frequency-tagging in electroencephalography (EEG) have dramatically increased in the past 10 years, in a variety of domains and populations. Here we used Fast Periodic Visual Stimulation (FPVS) combined with an oddball design to explore visual word recognition. Given the paradigm's high sensitivity, it is crucial for future basic research and clinical application to prove its robustness across variations of designs, stimulus types and tasks. This paradigm uses periodicity of brain responses to measure discrimination between two experimentally defined categories of stimuli presented periodically. EEG was recorded in 22 adults who viewed words inserted every 5 stimuli (at 2 Hz) within base stimuli presented at 10 Hz. Using two discrimination levels (deviant words among nonwords or pseudowords), we assessed the impact of relative frequency of item repetition (set size or item repetition controlled for deviant versus base stimuli), and of the orthogonal task (focused or deployed spatial attention). Word-selective occipito-temporal responses were robust at the individual level (significant in 95% of participants), left-lateralized, larger for the prelexical (nonwords) than lexical (pseudowords) contrast, and stronger with a deployed spatial attention task as compared to the typically used focused task. Importantly, amplitudes were not affected by item repetition. These results help understanding the factors influencing word-selective EEG responses and support the validity of FPVS-EEG oddball paradigms, as they confirm that word-selective responses are linguistic. Second, they show its robustness against design-related factors that could induce statistical (ir)regularities in item rate. They also confirm its high individual sensitivity and demonstrate how it can be optimized, using a deployed rather than focused attention task, to measure implicit word recognition processes in typical and atypical populations.

Visual word processing engages a hierarchical, distributed, and bilateral cortical network

Although the Visual Word Form Area (VWFA) in left temporal cortex is considered the pre-eminent region in visual word processing, other regions are also implicated. We examined the entire text-selective circuit, using functional MRI. Ten regions of interest (ROIs) per hemisphere were defined, which, based on clustering, grouped into early vision, high-level vision, and language clusters. We analyzed the responses of the ROIs and clusters to words, inverted words, and consonant strings using univariate, multivariate, and functional connectivity measures. Bilateral modulation by stimulus condition was evident, with a stronger effect in left hemisphere regions. Last, using graph theory, we observed that the VWFA was equivalently connected with early visual and language clusters in both hemispheres, reflecting its role as a mediator in the circuit. Although the individual ROIs and clusters bilaterally were flexibly altered by the nature of the input, stability held at the level of global circuit connectivity, reflecting the complex hierarchical distributed system serving visual text perception.

The role of the left ventral occipitotemporal cortex in speech processing-The influence of visual deprivation

The role of the left ventral occipitotemporal cortex (vOT) in reading is well-established in both sighted and blind readers. Its role in speech processing remains only partially understood. Here, we test the involvement of the left vOT in phonological processing of spoken language in the blind (N = 50, age: 6.76-60.32) and in the sighted (N = 54, age: 6.79-59.83) by means of whole-brain and region-of-interest (including individually identified) fMRI analyses. We confirm that the left vOT is sensitive to phonological processing (shows greater involvement in rhyming compared to control spoken language task) in both blind and sighted participants. However, in the sighted, the activation was observed only during the rhyming task and in the speech-specific region of the left vOT, pointing to task and modality specificity. In contrast, in the blind group, the left vOT was active during speech processing irrespective of task and in both speech and reading-specific vOT regions. Only in the blind, the left vOT presented a higher degree of sensitivity to phonological processing than other language nodes in the left inferior frontal and superior temporal cortex. Our results suggest a changed development of the left vOT sensitivity to spoken language, resulting from visual deprivation.

The advantage of being a synesthete: The behavioral benefits of ticker-tape synesthesia

As first described by Francis Galton, some persons perceive vividly and automatically in their mind's eye the written form of words that they are hearing. This phenomenon, labeled ticker-tape synesthesia (TTS), is thought to reflect an abnormally strong influence of speech processing in language areas on to orthographic representations in the visual cortex. Considering the relevance of TTS for the study of reading acquisition, we looked for objective behavioral advantages or impairments in 22 synesthetes, as compared to 22 matched control participants. In three auditory tasks relying on orthographic working memory (letters counting, backward spelling, and letter shape decision), we predicted and observed better performance in synesthetes than in controls. In two visual tasks (lexical decision and letter decision) with a concurrent auditory stimulation, we predicted that synesthetes should suffer from a larger interference by irrelevant speech than controls, but eventually found no difference between the groups. Those results, which we discuss in relation to orthographic processing, mental imagery, and working memory, promote TTS from pure subjectivity to an experimentally measurable phenomenon.

Reading Braille by Touch Recruits Posterior Parietal Cortex

Blind readers use a tactile reading system consisting of raised dot arrays: braille/⠃⠗⠇. How do human brains implement reading by touch? The current study looked for signatures of reading-specific orthographic processes in braille, separate from low-level somatosensory responses and semantic processes. Of specific interest were responses in posterior parietal cortices (PPCs), because of their role in high-level tactile perception. Congenitally blind, proficient braille readers read real words and pseudowords by touch while undergoing fMRI. We leveraged the system of contractions in English braille, where one braille cell can represent multiple English print letters (e.g., "ing" ⠬, "one" ⠐⠕), making it possible to separate physical and orthographic word length. All words in the study consisted of four braille cells, but their corresponding Roman letter spellings varied from four to seven letters (e.g., "con-c-er-t" ⠒⠉⠻⠞. contracted: four cells; uncontracted: seven letters). We found that the bilateral supramarginal gyrus in the PPC increased its activity as the uncontracted word length increased. By contrast, in the hand region of primary somatosensory cortex (S1), activity increased as a function of a low-level somatosensory feature: dot-number per word. The PPC also showed greater response to pseudowords than real words and distinguished between real and pseudowords in multivariate-pattern analysis. Parieto-occipital, early visual and ventral occipito-temporal, as well as prefrontal cortices also showed sensitivity to the real-versus-pseudoword distinction. We conclude that PPC is involved in orthographic processing for braille, that is, braille character and word recognition, possibly because of braille's tactile modality.

A single case neuroimaging study of tickertape synesthesia

Reading acquisition is enabled by deep changes in the brain's visual system and language areas, and in the links subtending their collaboration. Disruption of those plastic processes commonly results in developmental dyslexia. However, atypical development of reading mechanisms may occasionally result in ticker-tape synesthesia (TTS), a condition described by Francis Galton in 1883 wherein individuals "see mentally in print every word that is uttered (…) as from a long imaginary strip of paper". While reading is the bottom-up translation of letters into speech, TTS may be viewed as its opposite, the top-down translation of speech into internally visualized letters. In a series of functional MRI experiments, we studied MK, a man with TTS. We showed that a set of left-hemispheric areas were more active in MK than in controls during the perception of normal than reversed speech, including frontoparietal areas involved in speech processing, and the Visual Word Form Area, an occipitotemporal region subtending orthography. Those areas were identical to those involved in reading, supporting the construal of TTS as upended reading. Using dynamic causal modeling, we further showed that, parallel to reading, TTS induced by spoken words and pseudowords relied on top-down flow of information along distinct lexical and phonological routes, involving the middle temporal and supramarginal gyri, respectively. Future studies of TTS should shed new light on the neurodevelopmental mechanisms of reading acquisition, their variability and their disorders.

Lexical and sublexical cortical tuning for print revealed by Steady-State Visual Evoked Potentials (SSVEPs) in early readers

There are multiple levels of processing relevant to reading that vary in their visual, sublexical, and lexical orthographic processing demands. Segregating distinct cortical sources for each of these levels has been challenging in EEG studies of early readers. To address this challenge, we applied recent advances in analyzing high-density EEG using Steady-State Visual Evoked Potentials (SSVEPs) via data-driven Reliable Components Analysis (RCA) in a group of early readers spanning from kindergarten to second grade. Three controlled stimulus contrasts-familiar words versus unfamiliar pseudofonts, familiar words versus pseudowords, and pseudowords versus nonwords-were used to isolate coarse print tuning, lexical processing, and sublexical orthography-related processing, respectively. First, three overlapping yet distinct neural sources-left vOT, dorsal parietal, and primary visual cortex were revealed underlying coarse print tuning. Second, we segregated distinct cortical sources for the other two levels of processing: lexical fine tuning over occipito-temporal/parietal regions; sublexical orthographic fine tuning over left occipital regions. Finally, exploratory group analyses based on children's reading fluency suggested that coarse print tuning emerges early even in children with limited reading knowledge, while sublexical and higher-level lexical processing emerge only in children with sufficient reading knowledge. RESEARCH HIGHLIGHTS: Cognitive processes underlying coarse print tuning, sublexical, and lexical fine tuning were examined in beginning readers. Three overlapping yet distinct neural sources-left ventral occipito-temporal (vOT), left temporo-parietal, and primary visual cortex-were revealed underlying coarse print tuning. Responses to sublexical orthographic fine tuning were found over left occipital regions, while responses to higher-level linguistic fine tuning were found over occipito-temporal/parietal regions. Exploratory group analyses suggested that coarse print tuning emerges in children with limited reading knowledge, while sublexical and higher-level linguistic fine tuning effects emerge in children with sufficient reading knowledge.

Self-regulation of visual word form area activation with real-time fMRI neurofeedback

The Visual Word Form Area (VWFA) is a key region of the brain's reading network and its activation has been shown to be strongly associated with reading skills. Here, for the first time, we investigated whether voluntary regulation of VWFA activation is feasible using real-time fMRI neurofeedback. 40 adults with typical reading skills were instructed to either upregulate (UP group, N = 20) or downregulate (DOWN group, N = 20) their own VWFA activation during six neurofeedback training runs. The VWFA target region was individually defined based on a functional localizer task. Before and after training, also regulation runs without feedback ("no-feedback runs") were performed. When comparing the two groups, we found stronger activation across the reading network for the UP than the DOWN group. Further, activation in the VWFA was significantly stronger in the UP group than the DOWN group. Crucially, we observed a significant interaction of group and time (pre, post) for the no-feedback runs: The two groups did not differ significantly in their VWFA activation before neurofeedback training, but the UP group showed significantly stronger activation than the DOWN group after neurofeedback training. Our results indicate that upregulation of VWFA activation is feasible and that, once learned, successful upregulation can even be performed in the absence of feedback. These results are a crucial first step toward the development of a potential therapeutic support to improve reading skills in individuals with reading impairments.

Engaging in word recognition elicits highly specific modulations in visual cortex

A person's cognitive state determines how their brain responds to visual stimuli. The most common such effect is a response enhancement when stimuli are task relevant and attended rather than ignored. In this fMRI study, we report a surprising twist on such attention effects in the visual word form area (VWFA), a region that plays a key role in reading. We presented participants with strings of letters and visually similar shapes, which were either relevant for a specific task (lexical decision or gap localization) or ignored (during a fixation dot color task). In the VWFA, the enhancement of responses to attended stimuli occurred only for letter strings, whereas non-letter shapes evoked smaller responses when attended than when ignored. The enhancement of VWFA activity was accompanied by strengthened functional connectivity with higher-level language regions. These task-dependent modulations of response magnitude and functional connectivity were specific to the VWFA and absent in the rest of visual cortex. We suggest that language regions send targeted excitatory feedback into the VWFA only when the observer is trying to read. This feedback enables the discrimination of familiar and nonsense words and is distinct from generic effects of visual attention.

Does the visual word form area split in bilingual readers? A millimeter-scale 7-T fMRI study

In expert readers, a brain region known as the visual word form area (VWFA) is highly sensitive to written words, exhibiting a posterior-to-anterior gradient of increasing sensitivity to orthographic stimuli whose statistics match those of real words. Using high-resolution 7-tesla functional magnetic resonance imaging (fMRI), we ask whether, in bilingual readers, distinct cortical patches specialize for different languages. In 21 English-French bilinguals, unsmoothed 1.2-millimeters fMRI revealed that the VWFA is actually composed of several small cortical patches highly selective for reading, with a posterior-to-anterior word-similarity gradient, but with near-complete overlap between the two languages. In 10 English-Chinese bilinguals, however, while most word-specific patches exhibited similar reading specificity and word-similarity gradients for reading in Chinese and English, additional patches responded specifically to Chinese writing and, unexpectedly, to faces. Our results show that the acquisition of multiple writing systems can indeed tune the visual cortex differently in bilinguals, sometimes leading to the emergence of cortical patches specialized for a single language.

Sensory modality and spoken language shape reading network in blind readers of Braille

The neural basis of reading is highly consistent across many languages and scripts. Are there alternative neural routes to reading? How does the sensory modality of symbols (tactile vs. visual) influence their neural representations? We examined these questions by comparing reading of visual print (sighted group, n = 19) and tactile Braille (congenitally blind group, n = 19). Blind and sighted readers were presented with written (words, consonant strings, non-letter shapes) and spoken stimuli (words, backward speech) that varied in word-likeness. Consistent with prior work, the ventral occipitotemporal cortex (vOTC) was active during Braille and visual reading. A posterior/anterior vOTC word-form gradient was observed only in sighted readers with more anterior regions preferring larger orthographic units (words). No such gradient was observed in blind readers. Consistent with connectivity predictions, in blind compared to sighted readers, posterior parietal cortices were recruited to a greater degree and contained word-preferring patches. Lateralization of Braille in blind readers was predicted by laterality of spoken language and reading hand. The effect of spoken language increased along a cortical hierarchy, whereas effect of reading hand waned. These results suggested that the neural basis of reading is influenced by symbol modality and spoken language and support connectivity-based views of cortical function.

Hominoid-specific sulcal variability is related to face perception ability

The relationship among brain structure, brain function, and behavior is of major interest in neuroscience, evolutionary biology, and psychology. This relationship is especially intriguing when considering hominoid-specific brain structures because they cannot be studied in widely examined models in neuroscience such as mice, marmosets, and macaques. The fusiform gyrus (FG) is a hominoid-specific structure critical for face processing that is abnormal in individuals with developmental prosopagnosia (DPs)-individuals who have severe deficits recognizing the faces of familiar people in the absence of brain damage. While previous studies have found anatomical and functional differences in the FG between DPs and NTs, no study has examined the shallow tertiary sulcus (mid-fusiform sulcus, MFS) within the FG that is a microanatomical, macroanatomical, and functional landmark in humans, as well as was recently shown to be present in non-human hominoids. Here, we implemented pre-registered analyses of neuroanatomy and face perception in NTs and DPs. Results show that the MFS was shorter in DPs than NTs. Furthermore, individual differences in MFS length in the right, but not left, hemisphere predicted individual differences in face perception. These results support theories linking brain structure and function to perception, as well as indicate that individual differences in MFS length can predict individual differences in face processing. Finally, these findings add to growing evidence supporting a relationship between morphological variability of late developing, tertiary sulci and individual differences in cognition.

The mechanisms supporting holistic perception of words and faces are not independent

The question of whether word and face recognition rely on overlapping or dissociable neural and cognitive mechanisms received considerable attention in the literature. In the present work, we presented words (aligned or misaligned) superimposed on faces (aligned or misaligned) and tested the interference from the unattended stimulus category on holistic processing of the attended category. In Experiment 1, we found that holistic face processing is reduced when a face was overlaid with an unattended, aligned word (processed holistically). In Experiment 2, we found a similar reduction of holistic processing for words when a word was superimposed on an unattended, aligned face (processed holistically). This reciprocal interference effect indicates a trade-off in holistic processing of the two stimuli, consistent with the idea that word and face recognition may rely on non-independent, overlapping mechanisms.

Patterns of Neural Functional Connectivity in Infants at Familial Risk of Developmental Dyslexia

Importance

Developmental dyslexia is a heritable learning disability affecting 7% to 10% of the general population and can have detrimental impacts on mental health and vocational potential. Individuals with dyslexia show altered functional organization of the language and reading neural networks; however, it remains unknown how early in life these neural network alterations might emerge.

Objective

To determine whether the early emergence of large-scale neural functional connectivity (FC) underlying long-term language and reading development is altered in infants with a familial history of dyslexia (FHD).

Design, Setting, and Participants

This cohort study included infants recruited at Boston Children's Hospital between May 2011 and February 2019. Participants underwent structural and resting-state functional magnetic resonance imaging in the Department of Radiology at Boston Children's Hospital. Infants with FHD were matched with infants without FHD based on age and sex. Data were analyzed from April 2019 to June 2021.

Exposures

FHD was defined as having at least 1 first-degree relative with a dyslexia diagnosis or documented reading difficulties.

Main Outcomes and Measures

Whole-brain FC patterns associated with 20 predefined cerebral regions important for long-term language and reading development were computed for each infant. Multivariate pattern analyses were applied to identify specific FC patterns that differentiated between infants with vs without FHD. For classification performance estimates, 99% CIs were calculated as the classification accuracy minus chance level.

Results

A total of 98 infants (mean [SD] age, 8.5 [2.3] months; 51 [52.0%] girls) were analyzed, including 35 infants with FHD and 63 infants without FHD. Multivariate pattern analyses identified distinct FC patterns between infants with vs without FHD in the left fusiform gyrus (classification accuracy, 0.55 [99% CI, 0.046-0.062]; corrected P < .001; Cohen d = 0.76). Connections linking left fusiform gyrus to regions in the frontal and parietal language and attention networks were among the paths with the highest contributions to the classification performance.

Conclusions and Relevance

These findings suggest that on the group level, FHD was associated with an early onset of atypical FC of regions important for subsequent word form recognition during reading acquisition. Longitudinal studies linking the atypical functional network and school-age reading abilities will be essential to further elucidate the ontogenetic mechanisms underlying the development of dyslexia.

Lifespan developmental changes in neural substrates and functional connectivity for visual semantic processing

Human learning and cognitive functions change with age and experience, with late-developed complex cognitive functions, particularly those served by the prefrontal cortex, showing more age-dependent variance. Reading as a complex process of constructing meaning from print uses the left prefrontal cortex and may show a similar aging pattern. In this study, we delineated the lifespan developmental changes in the neural substrates and functional connectivity for visual semantic processing from childhood (age 6) to late adulthood (age 74). Different from previous studies that reported aging as a form of activation or neuronal changes, we examined additionally how the functional connectivity networks changed with age. A cohort of 122 Chinese participants performed semantic and font-size judgment tasks during functional magnetic resonance imaging. Although a common left-lateralized neural system including the left mid-inferior prefrontal cortex was recruited across all participants, the effect of age, or reading experience, is evident as 2 contrastive developmental patterns: a declining trend in activation strength and extent and an increasing trend in functional connections of the network. This study suggests that visual semantic processing is not prone to cognitive decline, and that continuous reading until old age helps strengthen the functional connections of reading-related brain regions.

A Spatiotemporal Map of Reading Aloud

Reading words aloud is a fundamental aspect of literacy. The rapid rate at which multiple distributed neural substrates are engaged in this process can only be probed via techniques with high spatiotemporal resolution. We probed this with direct intracranial recordings covering most of the left hemisphere in 46 humans (26 male, 20 female) as they read aloud regular, exception and pseudo-words. We used this to create a spatiotemporal map of word processing and to derive how broadband γ activity varies with multiple word attributes critical to reading speed: lexicality, word frequency, and orthographic neighborhood. We found that lexicality is encoded earliest in mid-fusiform (mFus) cortex, and precentral sulcus, and is represented reliably enough to allow single-trial lexicality decoding. Word frequency is first represented in mFus and later in the inferior frontal gyrus (IFG) and inferior parietal sulcus (IPS), while orthographic neighborhood sensitivity resides solely in IPS. We thus isolate the neural correlates of the distributed reading network involving mFus, IFG, IPS, precentral sulcus, and motor cortex and provide direct evidence for parallel processes via the lexical route from mFus to IFG, and the sublexical route from IPS and precentral sulcus to anterior IFG.SIGNIFICANCE STATEMENT Reading aloud depends on multiple complex cerebral computations: mapping from a written letter string on a page to a sequence of spoken sound representations. Here, we used direct intracranial recordings in a large cohort while they read aloud known and novel words, to track, across space and time, the progression of neural representations of behaviorally relevant factors that govern reading speed. We find, concordant with cognitive models of reading, that known and novel words are differentially processed through a lexical route, sensitive to frequency of occurrence of known words in natural language, and a sublexical route, performing letter-by-letter construction of novel words.

The relationships between reading fluency and different measures of holistic word processing

Recently, paradigms in the face recognition literature have been adopted to reveal holistic processing in word recognition. It is unknown, however, whether different measures of holistic word processing share similar underlying mechanisms, and whether fluent word reading relies on holistic word processing. We measured holistic processing effects in three paradigms (composite, configural sensitivity, part-whole) as well as in reading fluency (3DM task: reading aloud high- and low-frequency words and pseudowords). Bin scores were used to combine accuracy and response time variables in the quest for a more comprehensive, reliable, and valid measure of holistic processing. Weak correlations were found between the different holistic processing measures, with only a significant correlation between the configural sensitivity effect and part-whole effect (r = .32) and a trend of a positive correlation between the word composite effect and configural sensitivity effect (r = .21). Of the three holistic processing measures, only one (part-whole effect) correlated with a lexical access measure of 3DM (r = .23). We also performed a principal component analysis (PCA) of performance in the three lists of 3DM, with the second most probably reflecting lexical access processes. There was a tendency for a positive correlation between part-whole bin measure and Component 2 of PCA. We also found a positive correlation between composite aligned in accuracy and Component 2 of PCA.Our results show that different measures of holistic word processing reflect predominantly different mechanisms, and that differences among normal readers in word reading do not seem to depend highly on holistic processing.

Task modulates the orthographic and phonological representations in the bilateral ventral Occipitotemporal cortex

As a key area in word reading, the left ventral occipitotemporal cortex is proposed for abstract orthographic processing, and its middle part has even been labeled as the visual word form area. Because the definition of the VWFA largely varies and the reading task differs across studies, the function of the left ventral occipitotemporal cortex in word reading is continuingly debated on whether this region is specific for orthographic processing or be involved in an interactive framework. By using representational similarity analysis (RSA), this study examined information representation in the VWFA at the individual level and the modulatory effect of reading task. Twenty-four subjects were scanned while performing the explicit (i.e., the naming task) and implicit (i.e., the perceptual task) reading tasks. Activation analysis showed that the naming task elicited greater activation in regions related to phonological processing (e.g., the bilateral prefrontal cortex and temporoparietal cortex), while the perceptual task recruited greater activation in visual cortex and default mode network (e.g., the bilateral middle frontal gyrus, angular gyrus, and the right middle temporal gyrus). More importantly, RSA also showed that task modulated information representation in the bilateral anterior occipitotemporal cortex and VWFA. Specifically, ROI-based RSA revealed enhanced orthographic and phonological representations in the bilateral anterior fusiform cortex and VWFA in the naming task relative to the perceptual task. These results suggest that lexical representation in the VWFA is influenced by the demand of phonological processing, which supports the interactive account of the VWFA.

Emergence of a compositional neural code for written words: Recycling of a convolutional neural network for reading

The visual word form area (VWFA) is a region of human inferotemporal cortex that emerges at a fixed location in the occipitotemporal cortex during reading acquisition and systematically responds to written words in literate individuals. According to the neuronal recycling hypothesis, this region arises through the repurposing, for letter recognition, of a subpart of the ventral visual pathway initially involved in face and object recognition. Furthermore, according to the biased connectivity hypothesis, its reproducible localization is due to preexisting connections from this subregion to areas involved in spoken-language processing. Here, we evaluate those hypotheses in an explicit computational model. We trained a deep convolutional neural network of the ventral visual pathway, first to categorize pictures and then to recognize written words invariantly for case, font, and size. We show that the model can account for many properties of the VWFA, particularly when a subset of units possesses a biased connectivity to word output units. The network develops a sparse, invariant representation of written words, based on a restricted set of reading-selective units. Their activation mimics several properties of the VWFA, and their lesioning causes a reading-specific deficit. The model predicts that, in literate brains, written words are encoded by a compositional neural code with neurons tuned either to individual letters and their ordinal position relative to word start or word ending or to pairs of letters (bigrams).

A Heteromodal Word-Meaning Binding Site in the Visual Word Form Area under Top-Down Frontoparietal Control

The integral capacity of human language together with semantic memory drives the linkage of words and their meaning, which theoretically is subject to cognitive control. However, it remains unknown whether, across different language modalities and input/output formats, there is a shared system in the human brain for word-meaning binding and how this system interacts with cognitive control. Here, we conducted a functional magnetic resonance imaging experiment based on a large cohort of subjects (50 females, 50 males) to comprehensively measure the brain responses evoked by semantic processing in spoken and written word comprehension and production tasks (listening, speaking, reading, and writing). We found that heteromodal word input and output tasks involved distributed brain regions within a frontal-parietal-temporal network and focally coactivated the anterior lateral visual word form area (VWFA), which is located in the basal occipitotemporal area. Directed connectivity analysis revealed that the VWFA was invariably under significant top-down modulation of the frontoparietal control network and interacts with regions related to attention and semantic representation. This study reveals that the VWFA is a key site subserving general semantic processes linking words and meaning, challenging the predominant emphasis on this area's specific role in reading or more general visual processes. Our findings also suggest that the dynamics between semantic memory and cognitive control mechanisms during word processing are largely independent of the modalities of input or output.SIGNIFICANCE STATEMENT Binding words and their meaning into a coherent whole during retrieval requires accessing semantic memory and cognitive control, allowing our thoughts to be expressed and comprehended through mind-external tokens in multiple modalities, such as written or spoken forms. However, it is still unknown whether multimodal language comprehension and production share a common word-meaning binding system in human brains and how this system is connected to a cognitive control mechanism. By systematically measuring brain activity evoked by spoken and written verbal input and output tasks tagging word-meaning binding processes, we demonstrate a general word-meaning binding site within the visual word form area (VWFA) and how this site is modulated by the frontal-parietal control network.

Intracranial recording in patients with aphasia using nanomaterial-based flexible electronics: promises and challenges

In recent years, researchers have studied how nanotechnology could enhance neuroimaging techniques. The application of nanomaterial-based flexible electronics has the potential to advance conventional intracranial electroencephalography (iEEG) by utilising brain-compatible soft nanomaterials. The resultant technique has significantly high spatial and temporal resolution, both of which enhance the localisation of brain functions and the mapping of dynamic language processing. This review presents findings on aphasia, an impairment in language and communication, and discusses how different brain imaging techniques, including positron emission tomography, magnetic resonance imaging, and iEEG, have advanced our understanding of the neural networks underlying language and reading processing. We then outline the strengths and weaknesses of iEEG in studying human cognition and the development of intracranial recordings that use brain-compatible flexible electrodes. We close by discussing the potential advantages and challenges of future investigations adopting nanomaterial-based flexible electronics for intracranial recording in patients with aphasia.

How does inattention affect written and spoken language processing?

The classic cocktail party effect suggests that some, but probably not all levels of language processing can proceed without attention. We used whole-brain functional MRI to investigate how modality-specific and modality-independent language areas are modulated by the withdrawal of attention to another sensory modality (e.g., attending to vision during the presentation of auditory sentences, or vice-versa). We tested the hypotheses that inattention may abolish sentence-level integration and eliminate top-down effects. In both written and spoken modalities, language processing was strongly modulated by the distraction of attention, but this inattention effect varied considerably depending on the area and hierarchical level of language processing. Under inattention, a bottom-up activation remained in early modality-specific areas, particularly in superior temporal spoken-language areas, but the difference between sentences and words lists vanished. Under both attended and unattended conditions, ventral temporal cortices were activated in a top-down manner by spoken language more than by control stimuli, reaching posteriorily the Visual Word Form Area. We conclude that inattention prevents sentence-level syntactic and semantic integration, but preserves some top-down crossmodal processing, plus a large degree of bottom-up modality-specific processing, including a ventral occipito-temporal specialization for letter strings in a known alphabet.

Spatiotemporal dynamics of orthographic and lexical processing in the ventral visual pathway

Reading is a rapid, distributed process that engages multiple components of the ventral visual stream. To understand the neural constituents and their interactions that allow us to identify written words, we performed direct intra-cranial recordings in a large cohort of humans. This allowed us to isolate the spatiotemporal dynamics of visual word recognition across the entire left ventral occipitotemporal cortex. We found that mid-fusiform cortex is the first brain region sensitive to lexicality, preceding the traditional visual word form area. The magnitude and duration of its activation are driven by the statistics of natural language. Information regarding lexicality and word frequency propagates posteriorly from this region to visual word form regions and to earlier visual cortex, which, while active earlier, show sensitivity to words later. Further, direct electrical stimulation of this region results in reading arrest, further illustrating its crucial role in reading. This unique sensitivity of mid-fusiform cortex to sub-lexical and lexical characteristics points to its central role as the orthographic lexicon-the long-term memory representations of visual word forms.

Neural Representation in Visual Word Form Area during Word Reading

The visual word form area (VWFA) has been consistently identified as a crucial structure in visual word processing. Nevertheless, it is controversial whether the VWFA represents external visual information (e.g., case information) of visual words. To address that question, we functionally localized VWFA at the group level (gVWFA) and at the individual level (iVWFA), and used multivariate pattern analysis (MVPA) to explore the information representation in the VWFA during an implicit reading task (i.e., a passive viewing task). Univariate activation analysis revealed that participants showed stronger activations for uppercase English words compared to lowercase ones in the VWFA. MVPA further revealed that the classifier trained based on lowercase words versus letter strings significantly distinguished uppercase words versus letter strings in the iVWFA, while that trained based on lowercase words versus uppercase words distinguished lowercase letter strings versus uppercase letter strings neither in the gVWFA nor in the iVWFA. These results suggest that the VWFA does not represent case information, but represents case-independent linguistic information. Our findings elaborate the function in the VWFA and support the VWFA hypothesis.

Visual word form processing deficits driven by severity of reading impairments in children with developmental dyslexia

The visual word form area (VWFA) in the left ventral occipito-temporal (vOT) cortex is key to fluent reading in children and adults. Diminished VWFA activation during print processing tasks is a common finding in subjects with severe reading problems. Here, we report fMRI data from a multicentre study with 140 children in primary school (7.9-12.2 years; 55 children with dyslexia, 73 typical readers, 12 intermediate readers). All performed a semantic task on visually presented words and a matched control task on symbol strings. With this large group of children, including the entire spectrum from severely impaired to highly fluent readers, we aimed to clarify the association of reading fluency and left vOT activation during visual word processing. The results of this study confirm reduced word-sensitive activation within the left vOT in children with dyslexia. Interestingly, the association of reading skills and left vOT activation was especially strong and spatially extended in children with dyslexia. Thus, deficits in basic visual word form processing increase with the severity of reading disability but seem only weakly associated with fluency within the typical reading range suggesting a linear dependence of reading scores with VFWA activation only in the poorest readers.

Further evidence for a late locus of holistic word processing: Exploring vertex effect in the word composite task

Previous studies have shown a rather late and lexical level for holistic word processing. In the present study, we evaluated whether there are early effects in holistic processing of words, taking into consideration the role of lower-level visual processes that are critical in the hierarchy of visual word recognition: the extraction of viewpoint-invariant line junctions/vertices. We used contour-deleted words in two conditions: preservation of the vertices versus preservation of midsegments and an all-contour condition. We found evidence of a composite effect that was equivalent for all materials. Thus, we found no evidence of an early contribution of holistic processing to word recognition, and confirmed that holistic word processing is related to late lexical orthographic representations.

Taking the sublexical route: brain dynamics of reading in the semantic variant of primary progressive aphasia

Reading aloud requires mapping an orthographic form to a phonological one. The mapping process relies on sublexical statistical regularities (e.g. 'oo' to |uː|) or on learned lexical associations between a specific visual form and a series of sounds (e.g. yacht to/jɑt/). Computational, neuroimaging, and neuropsychological evidence suggest that sublexical, phonological and lexico-semantic processes rely on partially distinct neural substrates: a dorsal (occipito-parietal) and a ventral (occipito-temporal) route, respectively. Here, we investigated the spatiotemporal features of orthography-to-phonology mapping, capitalizing on the time resolution of magnetoencephalography and the unique clinical model offered by patients with semantic variant of primary progressive aphasia (svPPA). Behaviourally, patients with svPPA manifest marked lexico-semantic impairments including difficulties in reading words with exceptional orthographic to phonological correspondence (irregular words). Moreover, they present with focal neurodegeneration in the anterior temporal lobe, affecting primarily the ventral, occipito-temporal, lexical route. Therefore, this clinical population allows for testing of specific hypotheses on the neural implementation of the dual-route model for reading, such as whether damage to one route can be compensated by over-reliance on the other. To this end, we reconstructed and analysed time-resolved whole-brain activity in 12 svPPA patients and 12 healthy age-matched control subjects while reading irregular words (e.g. yacht) and pseudowords (e.g. pook). Consistent with previous findings that the dorsal route is involved in sublexical, phonological processes, in control participants we observed enhanced neural activity over dorsal occipito-parietal cortices for pseudowords, when compared to irregular words. This activation was manifested in the beta-band (12-30 Hz), ramping up slowly over 500 ms after stimulus onset and peaking at ∼800 ms, around response selection and production. Consistent with our prediction, svPPA patients did not exhibit this temporal pattern of neural activity observed in controls this contrast. Furthermore, a direct comparison of neural activity between patients and controls revealed a dorsal spatiotemporal cluster during irregular word reading. These findings suggest that the sublexical/phonological route is involved in processing both irregular and pseudowords in svPPA. Together these results provide further evidence supporting a dual-route model for reading aloud mediated by the interplay between lexico-semantic and sublexical/phonological neurocognitive systems. When the ventral route is damaged, as in the case of neurodegeneration affecting the anterior temporal lobe, partial compensation appears to be possible by over-recruitment of the slower, serial attention-dependent, dorsal one.

A compositional neural code in high-level visual cortex can explain jumbled word reading

We read jubmled wrods effortlessly, but the neural correlates of this remarkable ability remain poorly understood. We hypothesized that viewing a jumbled word activates a visual representation that is compared to known words. To test this hypothesis, we devised a purely visual model in which neurons tuned to letter shape respond to longer strings in a compositional manner by linearly summing letter responses. We found that dissimilarities between letter strings in this model can explain human performance on visual search, and responses to jumbled words in word reading tasks. Brain imaging revealed that viewing a string activates this letter-based code in the lateral occipital (LO) region and that subsequent comparisons to stored words are consistent with activations of the visual word form area (VWFA). Thus, a compositional neural code potentially contributes to efficient reading.

Hemispheric Organization for Visual Object Recognition: A Theoretical Account and Empirical Evidence

Despite the similarity in structure, the hemispheres of the human brain have somewhat different functions. A traditional view of hemispheric organization asserts that there are independent and largely lateralized domain-specific regions in ventral occipitotemporal (VOTC), specialized for the recognition of distinct classes of objects. Here, we offer an alternative account of the organization of the hemispheres, with a specific focus on face and word recognition. This alternative account relies on three computational principles: distributed representations and knowledge, cooperation and competition between representations, and topography and proximity. The crux is that visual recognition results from a network of regions with graded functional specialization that is distributed across both hemispheres. Specifically, the claim is that face recognition, which is acquired relatively early in life, is processed by VOTC regions in both hemispheres. Once literacy is acquired, word recognition, which is co-lateralized with language areas, primarily engages the left VOTC and, consequently, face recognition is primarily, albeit not exclusively, mediated by the right VOTC. We review psychological and neural evidence from a range of studies conducted with normal and brain-damaged adults and children and consider findings which challenge this account. Last, we offer suggestions for future investigations whose findings may further refine this account.

Holistic word processing is correlated with efficiency in visual word recognition

Holistic processing of visual words (i.e., obligatory encoding of/attending to all letters of a word) could be a marker of expert word recognition. In the present study, we thus examined for the first time whether there is a direct relation between the word-composite effect (i.e., all parts of a visual word are fully processed when observers perform a task on a word part) and fast access to the orthographic lexicon by visual word experts (i.e., fluent adult readers). We adopted an individual differences approach and used the word-frequency effect (i.e., faster recognition of high- than low-frequency words) in an independent lexical decision task as a proxy of fast access to lexical orthographic representations. Fluent readers with larger word-composite effect showed smaller word-frequency effect. This correlation was mainly driven by an association between a larger composite effect and faster lexical decision on low-frequency words, probably because these lexical representations are less stable and integrated/unitized, hence allowing differentiating among fluent readers. We thus showed that holistic processing of visual words is indeed related to higher efficiency in visual word recognition by skilled readers.

A mesial-to-lateral dissociation for orthographic processing in the visual cortex

Efficient reading requires a fast conversion of the written word to both phonological and semantic codes. We tested the hypothesis that, within the left occipitotemporal cortical regions involved in visual word recognition, distinct subregions harbor slightly different orthographic codes adapted to those 2 functions. While the lexico-semantic pathway may operate on letter or open-bigram information, the phonological pathway requires the identification of multiletter graphemes such as "ch" or "ou" in order to map them onto phonemes. To evaluate the existence of a specific stage of graphemic encoding, 20 adults performed lexical decision and naming tasks on words and pseudowords during functional MRI. Graphemic encoding was facilitated or disrupted by coloring and spacing the letters either congruently with multiletter graphemes (ch-ai-r) or incongruently with them (c-ha-ir). This manipulation affected behavior, primarily during the naming of pseudowords, and modulated brain activity in the left midfusiform sulcus, at a site medial to the classical visual word form area (VWFA). This putative grapheme-related area (GRA) differed from the VWFA in being preferentially connected functionally to dorsal parietal areas involved in letter-by-letter reading, while the VWFA showed effects of lexicality and spelling-to-sound regularity. Our results suggest a partial dissociation within left occipitotemporal cortex: the midfusiform GRA would encode orthographic information at a sublexical graphemic level, while the lateral occipitotemporal VWFA would contribute primarily to direct lexico-semantic access.