Alexia due to ischemic stroke of the visual word form area

Music literacy improves reading skills via bilateral orthographic development

Considerable evidence suggests that musical education induces structural and functional neuroplasticity in the brain. This study aimed to explore the potential impact of such changes on word-reading proficiency. We investigated whether musical training promotes the development of uncharted orthographic regions in the right hemisphere leading to better reading abilities. A total of 60 healthy, right-handed culturally matched professional musicians and controls took part in this research. They were categorised as normo-typical readers based on their reading speed (syl/sec) and subdivided into two groups of relatively good and poor readers. High density EEG/ERPs were recorded while participants engaged in a note or letter detection task. Musicians were more fluent in word, non-word and text reading tests, and faster in detecting both notes and words. They also exhibited greater N170 and P300 responses, and target-non target differences for words than controls. Similarly, good readers showed larger N170 and P300 responses than poor readers. Increased reading skills were associated to a bilateral activation of the occipito/temporal cortex, during music and word reading. Source reconstruction also showed a reduced activation of the left fusiform gyrus, and of areas devoted to attentional/ocular shifting in poor vs. good readers, and in controls vs. musicians. Data suggest that music literacy acquired early in time can shape reading circuits by promoting the specialization of a right-sided reading area, whose activity was here associated with enhanced reading proficiency. In conclusion, music literacy induces measurable neuroplastic changes in the left and right OT cortex responsible for improved word reading ability.

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.

Acquired reading impairment following brain injury

This large-scale patient study investigated the rate, unique signatures associated with acquired reading impairments, its neurocognitive correlates, and long-term outcome in 731 acute stroke patients using the sentence and non-word reading subtests of Birmingham Cognitive Screen (BCoS). The objectives for the study were to explore the (i) potentially different error patterns among adult patients, (ii) associative relationship between the different subclasses of reading impairment and performance in other cognitive domains, and (iii) recovery rates in patients nine months post-lesion compared with their initial performance. The study revealed distinctive reading impairment profiles in patients with left hemisphere (LH) and right hemisphere (RH) lesions. Some interesting associations between reading disorder and other cognitive functions were observed. Nine months post-lesion, both groups showed some recovery in reading performance compared with their baseline performance, but the rate of improvement was higher for the LH group. The study reveals unique reading profiles and impairment patterns among left and right hemisphere lesions. The findings of the study provide a deeper understanding of reading deficits that will inform clinical practice, planning of rehabilitative interventions of brain injured patients, and the scientific community.

General object-based features account for letter perception

After years of experience, humans become experts at perceiving letters. Is this visual capacity attained by learning specialized letter features, or by reusing general visual features previously learned in service of object categorization? To explore this question, we first measured the perceptual similarity of letters in two behavioral tasks, visual search and letter categorization. Then, we trained deep convolutional neural networks on either 26-way letter categorization or 1000-way object categorization, as a way to operationalize possible specialized letter features and general object-based features, respectively. We found that the general object-based features more robustly correlated with the perceptual similarity of letters. We then operationalized additional forms of experience-dependent letter specialization by altering object-trained networks with varied forms of letter training; however, none of these forms of letter specialization improved the match to human behavior. Thus, our findings reveal that it is not necessary to appeal to specialized letter representations to account for perceptual similarity of letters. Instead, we argue that it is more likely that the perception of letters depends on domain-general visual features.

For over a century, scientists have conducted behavioral experiments to investigate how the visual system recognizes letters, but it has proven difficult to propose a model of the feature space underlying this capacity. Here we leveraged recent advances in machine learning to model a wide variety of features ranging from specialized letter features to general object-based features. Across two large-scale behavioral experiments we find that general object-based features account well for letter perception, and that adding letter specialization did not improve the correspondence to human behavior. It is plausible that the ability to recognize letters largely relies on general visual features unaltered by letter learning.

Controversy over the temporal cortical terminations of the left arcuate fasciculus: a reappraisal

The arcuate fasciculus has been considered a major dorsal fronto-temporal white matter pathway linking frontal language production regions with auditory perception in the superior temporal gyrus, the so-called Wernicke's area. In line with this tradition, both historical and contemporary models of language function have assigned primacy to superior temporal projections of the arcuate fasciculus. However, classical anatomical descriptions and emerging behavioural data are at odds with this assumption. On one hand, fronto-temporal projections to Wernicke's area may not be unique to the arcuate fasciculus. On the other hand, dorsal stream language deficits have been reported also for damage to middle, inferior and basal temporal gyri which may be linked to arcuate disconnection. These findings point to a reappraisal of arcuate projections in the temporal lobe. Here, we review anatomical and functional evidence regarding the temporal cortical terminations of the left arcuate fasciculus by incorporating dissection and tractography findings with stimulation data using cortico-cortical evoked potentials and direct electrical stimulation mapping in awake patients. Firstly, we discuss the fibers of the arcuate fasciculus projecting to the superior temporal gyrus and the functional rostro-caudal gradient in this region where both phonological encoding and auditory-motor transformation may be performed. Caudal regions within the temporoparietal junction may be involved in articulation and associated with temporoparietal projections of the third branch of the superior longitudinal fasciculus, while more rostral regions may support encoding of acoustic phonetic features, supported by arcuate fibres. We then move to examine clinical data showing that multimodal phonological encoding is facilitated by projections of the arcuate fasciculus to superior, but also middle, inferior and basal temporal regions. Hence, we discuss how projections of the arcuate fasciculus may contribute to acoustic (middle-posterior superior and middle temporal gyri), visual (posterior inferior temporal/fusiform gyri comprising the visual word form area) and lexical (anterior-middle inferior temporal/fusiform gyri in the basal temporal language area) information in the temporal lobe to be processed, encoded and translated into a dorsal phonological route to the frontal lobe. Finally, we point out surgical implications for this model in terms of the prediction and avoidance of neurological deficit.

From Schools to Scans: A Neuroeducational Approach to Comorbid Math and Reading Disabilities

We bridge two analogous concepts of comorbidity, dyslexia-dyscalculia and reading-mathematical disabilities, in neuroscience and education, respectively. We assessed the cognitive profiles of 360 individuals (mean age 25.79 ± 13.65) with disability in reading alone (RD group), mathematics alone (MD group) and both (comorbidity: MDRD group), with tests widely used in both psychoeducational and neuropsychological batteries. As expected, the MDRD group exhibited reading deficits like those shown by the RD group. The former group also exhibited deficits in quantitative reasoning like those shown by the MD group. However, other deficits related to verbal working memory and semantic memory were exclusive to the MDRD group. These findings were independent of gender, age, or socioeconomic and demographic factors. Through a systematic exhaustive review of clinical neuroimaging literature, we mapped the resulting cognitive profiles to correspondingly plausible neuroanatomical substrates of dyslexia and dyscalculia. In our resulting "probing" model, the complex set of domain-specific and domain-general impairments shown in the comorbidity of reading and mathematical disabilities are hypothesized as being related to atypical development of the left angular gyrus. The present neuroeducational approach bridges a long-standing transdisciplinary divide and contributes a step further toward improved early prediction, teaching and interventions for children and adults with combined reading and math disabilities.

Examining the function of the visual word form area with stereo EEG electrical stimulation: A case report of pure alexia

Functional imaging studies have implicated an area in the left lateral fusiform gyrus, known as the visual word form area (VWFA), in pre-lexical orthographic processing. There are very few studies that have examined the functional specificity of this area in patients with discrete lesions limited to this region. Here we describe a rare opportunity to examine the functional specificity of the VWFA in a patient with stereo EEG (sEEG) electrodes implanted for localization of seizures prior to epilepsy surgery. sEEG offers the opportunity to create a transient and highly localized electrophysiological lesion to examine brain behavior correlates during functional mapping. In this case, word reading and writing as well as a variety of non-orthographic language functions (e.g., picture and face naming, auditory naming, and non-word repetition), were tested during electrical stimulation at a series of different electrode contact sites in the ventral temporal region. Pure alexia resulted from stimulation of the lateral fusiform gyrus at coordinates nearly identical to those published for the VWFA in the functional imaging literature.

Functional Anatomy of the Inferior Longitudinal Fasciculus: From Historical Reports to Current Hypotheses

The inferior longitudinal fasciculus (ILF) is a long-range, associative white matter pathway that connects the occipital and temporal-occipital areas of the brain to the anterior temporal areas. In view of the ILF's anatomic connections, it has been suggested that this pathway has a major role in a relatively large array of brain functions. Until recently, however, the literature data on these potential functions were scarce. Here, we review the key findings of recent anatomic, neuromodulation, and neuropsychological studies. We also summarize reports on how this tract is disrupted in a wide range of brain disorders, including psychopathologic, neurodevelopmental, and neurologic diseases. Our review reveals that the ILF is a multilayered, bidirectional tract involved in processing and modulating visual cues and thus in visually guided decisions and behaviors. Accordingly, sudden disruption of the ILF by neurologic insult is mainly associated with neuropsychological impairments of visual cognition (e.g., visual agnosia, prosopagnosia, and alexia). Furthermore, disruption of the ILF may constitute the pathophysiologic basis for visual hallucinations and socio-emotional impairments in schizophrenia, as well as emotional difficulties in autism spectrum disorder. Degeneration of the ILF in neurodegenerative diseases affecting the temporal lobe may explain (at least in part) the gradual onset of semantic and lexical access difficulties. Although some of the functions mediated by the ILF appear to be relatively lateralized, observations from neurosurgery suggest that disruption of the tract's anterior portion can be dynamically compensated for by the contralateral portion. This might explain why bilateral disruption of the ILF in either acute or progressive disease is highly detrimental in neuropsychological terms.

Face and Word Recognition Can Be Selectively Affected by Brain Injury or Developmental Disorders

Face and word recognition have traditionally been thought to rely on highly specialised and relatively independent cognitive processes. Some of the strongest evidence for this has come from patients with seemingly category-specific visual perceptual deficits such as pure prosopagnosia, a selective face recognition deficit, and pure alexia, a selective word recognition deficit. Together, the patterns of impaired reading with preserved face recognition and impaired face recognition with preserved reading constitute a double dissociation. The existence of these selective deficits has been questioned over the past decade. It has been suggested that studies describing patients with these pure deficits have failed to measure the supposedly preserved functions using sensitive enough measures, and that if tested using sensitive measurements, all patients with deficits in one visual category would also have deficits in the other. The implications of this would be immense, with most textbooks in cognitive neuropsychology requiring drastic revisions. In order to evaluate the evidence for dissociations, we review studies that specifically investigate whether face or word recognition can be selectively affected by acquired brain injury or developmental disorders. We only include studies published since 2004, as comprehensive reviews of earlier studies are available. Most of the studies assess the supposedly preserved functions using sensitive measurements. We found convincing evidence that reading can be preserved in acquired and developmental prosopagnosia and also evidence (though weaker) that face recognition can be preserved in acquired or developmental dyslexia, suggesting that face and word recognition are at least in part supported by independent processes.

Lexical is as lexical does: computational approaches to lexical representation

In much of neuroimaging and neuropsychology, regions of the brain have been associated with 'lexical representation', with little consideration as to what this cognitive construct actually denotes. Within current computational models of word recognition, there are a number of different approaches to the representation of lexical knowledge. Structural lexical representations, found in original theories of word recognition, have been instantiated in modern localist models. However, such a representational scheme lacks neural plausibility in terms of economy and flexibility. Connectionist models have therefore adopted distributed representations of form and meaning. Semantic representations in connectionist models necessarily encode lexical knowledge. Yet when equipped with recurrent connections, connectionist models can also develop attractors for familiar forms that function as lexical representations. Current behavioural, neuropsychological and neuroimaging evidence shows a clear role for semantic information, but also suggests some modality- and task-specific lexical representations. A variety of connectionist architectures could implement these distributed functional representations, and further experimental and simulation work is required to discriminate between these alternatives. Future conceptualisations of lexical representations will therefore emerge from a synergy between modelling and neuroscience.

Task dependent lexicality effects support interactive models of reading: a meta-analytic neuroimaging review

Models of reading must explain how orthographic input activates a phonological representation, and elicits the retrieval of word meaning from semantic memory. Comparisons between tasks that theoretically differ with respect to the degree to which they rely on connections between orthographic, phonological and semantic systems during reading can thus provide valuable insight into models of reading, but such direct comparisons are not well-represented in the literature. An ALE meta-analysis explored lexicality effects directly contrasting words and pseudowords using the lexical decision task and overt or covert naming, which we assume rely most on the semantic and phonological systems, respectively. Interactions between task and lexicality effects demonstrate that different demands of the lexical decision and naming tasks lead to different manifestations of lexicality effects.

The visual pathway--functional anatomy and pathology

Visual failure of any kind is a common clinical presentation and indication for neuroimaging. Monocular deficits should concentrate the search to the anterior (prechiasmatic) visual pathway. Bitemporal hemianopia suggests a chiasmatic cause, whereas retrochiasmatic lesions characteristically cause homonymous hemianopic defects. Quadrantanopias usually arise from lesions in the optic radiations. Disorders of visual perception can be broadly divided into "where" and "what" problems caused by lesions in the parietal and temporal lobes, respectively, and their associated white matter tracts. Visualization of the retrochiasmatic visual and visual association pathways is aided by diffusion tensor imaging.

Beyond the visual word form area: the orthography-semantics interface in spelling and reading

Lexical orthographic information provides the basis for recovering the meanings of words in reading and for generating correct word spellings in writing. Research has provided evidence that an area of the left ventral temporal cortex, a subregion of what is often referred to as the visual word form area (VWFA), plays a significant role specifically in lexical orthographic processing. The current investigation goes beyond this previous work by examining the neurotopography of the interface of lexical orthography with semantics. We apply a novel lesion mapping approach with three individuals with acquired dysgraphia and dyslexia who suffered lesions to left ventral temporal cortex. To map cognitive processes to their neural substrates, this lesion mapping approach applies similar logical constraints to those used in cognitive neuropsychological research. Using this approach, this investigation: (a) identifies a region anterior to the VWFA that is important in the interface of orthographic information with semantics for reading and spelling; (b) determines that, within this orthography-semantics interface region (OSIR), access to orthography from semantics (spelling) is topographically distinct from access to semantics from orthography (reading); (c) provides evidence that, within this region, there is modality-specific access to and from lexical semantics for both spoken and written modalities, in both word production and comprehension. Overall, this study contributes to our understanding of the neural architecture at the lexical orthography-semantic-phonological interface within left ventral temporal cortex.