The role of right and left parietal lobes in the conceptual processing of numbers

(What) can patients with semantic dementia learn?

Semantic Dementia (SD) is a neurodegenerative disease characterised by progressive deterioration of semantic knowledge, resulting in diminished understanding of concepts, whether encountered in verbal or non-verbal form. Over the past three decades, a number of studies employing a range of treatment techniques and learning methods have examined whether patients with SD can relearn previously known concepts or learn and retain new information. In this article, we review this research, addressing two main questions: a) Can aspects of semantic knowledge that are 'lost' due to degeneration be re-acquired? b) How much do other memory systems (working and episodic memory) interact with and depend on semantic memory? Several studies demonstrate successful relearning of previously known words and concepts in SD, particularly after regular, prolonged practice; but this success tends to diminish once practice ceases, and furthermore often fails to generalise to other instances of the same object/concept. This pattern suggests that, with impaired semantic knowledge, learning relies to an abnormal extent on perceptual factors, making it difficult to abstract away from the specific visual or other perceptual format in which a given concept has been trained. Furthermore, the impact of semantic 'status' of a word or object on both working and episodic memory indicates pervasive interaction of these other memory systems with conceptual knowledge.

MRI brain structural and functional networks changes in Parkinson disease with REM sleep behavior disorders

Background

Rapid eye movement sleep behavior disorder (RBD) is common in individuals with Parkinson's disease (PD). In spite of that, the precise mechanism underlying the pathophysiology of RBD among PD remains unclear.

Objective

The aim of the present study was to analyze gray matter volumes (GMVs) as well as the changes of functional connectivity (FC) among PD patients with RBD (PD-RBD) by employing a combination of voxel-based morphometry (VBM) and FC methods.

Methods

A total of 65 PD patients and 21 healthy control (HC) subjects were included in this study. VBM analyses were performed on all subjects. Subsequently, regions with significant different GMVs between PD patients with and without RBD (PD-nRBD) were selected for further analysis of FC. Correlations between altered GMVs and FC values with RBD scores were also investigated. Additionally, receiver operating characteristic (ROC) curves were employed for the evaluation of the predictive value of GMVs and FC in identifying RBD in PD.

Results

PD-RBD patients exhibited lower GMVs in the left middle temporal gyrus (MTG) and bilateral cuneus. Furthermore, we observed higher FC between the left MTG and the right postcentral gyrus (PoCG), as well as lower FC between the bilateral cuneus (CUN) and the right middle frontal gyrus (MFG) among PD-RBD patients in contrast with PD-nRBD patients. Moreover, the GMVs of MTG (extending to the right PoCG) was positively correlated with RBD severity [as measured by REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score]. Conversely, the FC value between the bilateral CUN and the right MTG in PD-RBD patients was negatively correlated with RBDSQ score.

Conclusion

This study revealed the presence replace with GMV and FC changes among PD-RBD patients, which were closely linked to the severity of RBD symptoms. Furthermore, the combination of basic clinical characteristics, GMVs and FC values effectively predicted RBD for individuals with PD.

Correlation between the changes of brain amplitude of low-frequency fluctuation and cognitive impairment in patients with neuropsychiatric lupus

PURPOSE

To explore the relationship between brain function changes and clinical serological indicators and behavioral cognitive assessment in patients with neuropsychiatric systemic lupus erythematosus (NPSLE), and understand the pathogenesis of NPSLE from the perspective of imaging.

METHODS

The resting-state functional imaging data, clinical serological, and behavioral cognitive assessment scores of 28 patients with NPSLE and 22 healthy controls (HC) were prospectively collected. The resting-state amplitude of low-frequency fluctuation (ALFF) values obtained from the analysis and processing were correlated with the serological data and behavioral cognitive assessment scores to determine the relationship between these data.

RESULTS

The average age of the patients of the NPSLE group was older than that of the HC group; significant differences in education level, Auditory Verbal Learning Test Hua Shan Version (AVLT-H), and Trail Making Test scores were observed between the two groups. The NPSLE group demonstrated increased brain activity in the insula, precentral gyrus, and superior temporal gyrus, and decreased brain activity in the superior parietal gyrus. The ALFF value of the insula positively correlated with the Anti-β2gp1 antibody and negatively correlated with the anti-nucleosome antibody and the AVL-recall (RC) score. The ALFF of the precentral gyrus negatively correlated with the AVL-immediate recall (I). The ALFF value of the superior temporal gyrus negatively correlated with the AVL-RC score. The left superior parietal gyrus positively correlated with the c-reactive protein. The right superior parietal gyrus positively correlated with the System Lupus Erythematosus Disease Activity Index and negatively correlated with the AVL-I score.

CONCLUSION

Patients with NPSLE show different brain activity changes in different brain regions, and the abnormal brain regions are correlated with certain lupus antibodies, inflammatory factors, and cognitive assessment, thereby suggesting that the correlation between the three could provide novel insights into the pathogenesis of NPSLE.

Resolving heterogeneity in Alzheimer's disease based on individualized structural covariance network

The heterogeneity of Alzheimer's disease (AD) poses a challenge to precision medicine. We aimed to identify distinct subtypes of AD based on the individualized structural covariance network (IDSCN) analysis and to research the underlying neurobiology mechanisms. In this study, 187 patients with AD (age = 73.57 ± 6.00, 50% female) and 143 matched normal controls (age = 74.30 ± 7.80, 44% female) were recruited from the Alzheimer's Disease Neuroimaging Initiative (ADNI) project database, and T1 images were acquired. We utilized the IDSCN analysis to generate individual-level altered structural covariance network and performed k-means clustering to subtype AD based on structural covariance network. Cognition, disease progression, morphological features, and gene expression profiles were further compared between subtypes, to characterize the heterogeneity in AD. Two distinct AD subtypes were identified in a reproducible manner, and we named the two subtypes as slow progression type (subtype 1, n = 104, age = 76.15 ± 6.44, 42% female) and rapid progression type (subtype 2, n = 83, age = 71.98 ± 8.72, 47% female), separately. Subtype 1 had better baseline visuospatial function than subtype 2 (p < 0.05), whereas subtype 2 had better baseline memory function than subtype 1 (p < 0.05). Subtype 2 showed worse progression in memory (p = 0.003), language (p = 0.003), visuospatial function (p = 0.020), and mental state (p = 0.038) than subtype 1. Subtype 1 often shared increased structural covariance network, mainly in the frontal lobe and temporal lobe regions, whereas subtype 2 often shared increased structural covariance network, mainly in occipital lobe regions and temporal lobe regions. Functional annotation further revealed that all differential structural covariance network between the two AD subtypes were mainly implicated in memory, learning, emotion, and cognition. Additionally, differences in gray matter volume (GMV) between AD subtypes were identified, and genes associated with GMV differences were found to be enriched in the terms potassium ion transport, synapse organization, and histone modification and the pathways viral infection, neurodegeneration-multiple diseases, and long-term depression. The two distinct AD subtypes were identified and characterized with neuroanatomy, cognitive trajectories, and gene expression profiles. These comprehensive results have implications for neurobiology mechanisms and precision medicine.

Human brain representations of internally generated outcomes of approximate calculation revealed by ultra-high-field brain imaging

Much of human culture's advanced technology owes its existence to the ability to mentally manipulate quantities. Neuroscience has described the brain regions overall recruited by numerical tasks and the neuronal codes representing individual quantities during perceptual tasks. Nevertheless, it remains unknown how quantity representations are combined or transformed during mental computations and how specific quantities are coded in the brain when generated as the result of internal computations rather than evoked by a stimulus. Here, we imaged the brains of adult human subjects at 7 Tesla during an approximate calculation task designed to disentangle in- and outputs of the computation from the operation itself. While physically presented sample numerosities were distinguished in activity patterns along the dorsal visual pathway and within frontal and occipito-temporal regions, a representation of the internally generated result was most prominently detected in higher order regions such as angular gyrus and lateral prefrontal cortex. Behavioral precision in the task was related to cross-decoding performance between sample and result representations in medial IPS regions. This suggests the transformation of sample into result may be carried out within dorsal stream sensory-motor integration regions, and resulting outputs maintained for task purposes in higher-level regions in a format possibly detached from sensory-evoked inputs.

Different saccadic profile in bulbar versus spinal-onset amyotrophic lateral sclerosis

Two clinical phenotypes characterize the onset of amyotrophic lateral sclerosis (ALS): the spinal variant, with symptoms beginning in the limbs, and the bulbar variant, affecting firstly speech and swallowing. The two variants show some distinct features in the histopathology, localization and prognosis, but to which extent they really differ clinically and pathologically remains to be clarified. Recent neuropathological and neuroimaging studies have suggested a broader spreading of the neurodegenerative process in ALS, extending beyond the motor areas, toward other cortical and deep grey matter regions, many of which are involved in visual processing and saccadic control. Indeed, a wide range of eye movement deficits have been reported in ALS, but they have never been used to distinguish the two ALS variants. Since quantifying eye movements is a very sensitive and specific method for the study of brain networks, we compared different saccadic and visual search behaviours across spinal ALS patients (n = 12), bulbar ALS patients (n = 6) and healthy control subjects (n = 13), along with cognitive and MRI measures, with the aim to define more accurately the two patients subgroups and possibly clarify a different underlying neural impairment. We found separate profiles of visually-guided saccades between spinal (short saccades) and bulbar (slow saccades) ALS, which could result from the pathologic involvement of different pathways. We suggest an early involvement of the parieto-collicular-cerebellar network in spinal ALS and the fronto-brainstem circuit in bulbar ALS. Overall, our data confirm the diagnostic value of the eye movements analysis in ALS and add new insight on the involved neural networks.

Fronto-parietal cortex activation during walking in patients with Parkinson's disease adopting different postural strategies

Background

Cortical activation patterns in patients with Parkinson's disease (PD) may be influenced by postural strategies, but the underlying neural mechanisms remain unclear. Our aim is to examine the role of the fronto-parietal lobes in patients with PD adopting different postural strategies and the effect of dual task (DT) on fronto-parietal activation.

Methods

Two groups of patients with PD adopting either the posture first strategy (PD-PF) or the posture second strategy (PD-PS) were examined respectively when in the “OFF” state while single-walking task (SW) and DT. Frontal and parietal lobe activity was assessed by functional near infrared spectroscopy (fNIRS) and measuring gait parameters. Linear mixed models were used for analyses.

Results

Patients with PD who adopted PS had greater cortical activation than those who adopted PF, and there was no difference between PF and PS in the behavioral parameters. For oxyhemoglobin levels, the task condition (SW vs. DT) had a main effect in fronto-parietal lobes. Postural strategy (PD-PF vs. PD-PS) a main effect in the left prefrontal cortex (LPFC), left parietal lobe (LPL), and right parietal lobe (RPL) regions. In the task of walking with and without the cognitive task, patients with PD adopting PS had higher activation in the LPL than those adopting PF. In DT, only PD patients who adopted PS had elevated oxyhemoglobin levels in the LPFC, right prefrontal cortex (RPFC), and LPL compared with the SW, whereas patients with PD who adopted PF showed no differences in any region.

Conclusion

Different patterns of fronto-parietal activation exist between PD-PF and PD-PS. This may be because PD-PS require greater cortical functional compensation than those adopting PF.

The complexity of simple counting: ERP findings reveal early perceptual and late numerical processes in different arrangements

The counting process can only be fully understood when taking into account the visual characteristics of the sets counted. Comparing behavioral data as well as event-related brain potentials (ERPs) evoked by different task-irrelevant arrangements of dots during an exact enumeration task, we aimed to investigate the effect of illusory contour detection on the counting process while other grouping cues like proximity were controlled and dot sparsity did not provide a cue to the numerosity of sets. Adult participants (N = 37) enumerated dots (8-12) in irregular and two different types of regular arrangements which differed in the shape of their illusory dot lattices. Enumeration speed was affected by both arrangement and magnitude. The type of arrangement influenced an early ERP negativity peaking at about 270 ms after stimulus onset, whereas numerosity only affected later ERP components (> 300 ms). We also observed that without perceptual cues, magnitude was constructed at a later stage of cognitive processing. We suggest that chunking is a prerequisite for more fluent counting which influences automatic processing (< 300 ms) during enumeration. We conclude that the procedure of exact enumeration depends on the interaction of several perceptual and numerical processes that are influenced by magnitude and arrangement.

Common variants contribute to intrinsic human brain functional networks

The human brain forms functional networks of correlated activity, which have been linked with both cognitive and clinical outcomes. However, the genetic variants affecting brain function are largely unknown. Here, we used resting-state functional magnetic resonance images from 47,276 individuals to discover and validate common genetic variants influencing intrinsic brain activity. We identified 45 new genetic regions associated with brain functional signatures (P < 2.8 × 10^-11), including associations to the central executive, default mode, and salience networks involved in the triple-network model of psychopathology. A number of brain activity-associated loci colocalized with brain disorders (e.g., the APOE ε4 locus with Alzheimer's disease). Variation in brain function was genetically correlated with brain disorders, such as major depressive disorder and schizophrenia. Together, our study provides a step forward in understanding the genetic architecture of brain functional networks and their genetic links to brain-related complex traits and disorders.

Bilateral intraparietal activation for number tasks in studies using an adaptation paradigm: A meta-analysis

Mathematical processing is important for professional successes. The Adaptation Paradigm has been widely used to study the brain underpinnings of mathematical processing. In this study, we aim at shedding light on an important component of mathematical processing, namely numerical cognition. To do so, we performed a meta-analysis using the Activation Likelihood Estimation method on studies that have employed the Adaptation Paradigm for examining numerical cognition. We found a bilateral Intraparietal Sulcus (IPS) activation in studies using both symbolic and non-symbolic stimuli formats. We also found a right lateralized brain activation for the non-symbolic condition and a left lateralized brain activation for the symbolic condition. These results imply that the Adaptation Paradigm likely targets numeric magnitude processing and confirms the potency of this paradigm to activate the Intraparietal Sulcus.

Altered Angular Gyrus Resting State Functional Connectivity Associated with Financial Capacity in Mild Cognitive Impairment

BACKGROUND

Financial capacity (FC) is a complex ability commonly impaired in older individuals with cognitive impairment; however, the underlying neural mechanisms are not well understood.

OBJECTIVE

To assess resting state functional connectivity using functional magnetic resonance imaging (rs-fMRI) in individuals with mild cognitive impairment (MCI) and impaired FC compared to cognitively normal older adults.

METHODS

rs-fMRI scans were obtained from individuals with MCI (N = 17) and normal older adults (N = 15). All participants completed the Financial Capacity Instrument Short Form (FCI-SF) and neuropsychological assessments. Based on previous findings, the left angular gyrus (lAG) was used as the seed region. Connectivity correlation coefficients were calculated for each seed-based connection that showed significantly altered connectivity. A Pearson's correlation was calculated between the connectivity correlation values from relevant regions and FC and other cognitive measures.

RESULTS

A total of 26 brain regions showed significantly increased functional connectivity with the lAG. Of these regions, 14 were identified as relevant to higher-level cognitive function for analysis. Pearson's correlations showed a significant negative correlation between the FCI-SF total score and increased connectivity between the IAG and the right temporal fusiform cortex (rTFC) (r = -0.455, p = 0.009).

CONCLUSION

Results showed a significant correlation between FC and increased functional connectivity between the lAG and the rTFC in cognitively normal older adults compared to participants with MCI. These exploratory findings suggest that cognitive functions play important roles in FC as the functional connectivity between the lAG and rTFC was not associated with other tests of executive or visuospatial cognition.

Intergenerational Transmission of Cortical Sulcal Patterns from Mothers to their Children

Intergenerational effects are described as the genetic, epigenetic, as well as pre- and postnatal environmental influence parents have on their offspring's behavior, cognition, and brain. During fetal brain development, the primary cortical sulci emerge with a distinctive folding pattern that are under strong genetic influence and show little change of this pattern throughout postnatal brain development. We examined intergenerational transmission of cortical sulcal patterns by comparing primary sulcal patterns between children (N = 16, age 5.5 ± 0.81 years, 8 males) and their biological mothers (N = 15, age 39.72 ± 4.68 years) as well as between children and unrelated adult females. Our graph-based sulcal pattern comparison method detected stronger sulcal pattern similarity for child-mother pairs than child-unrelated pairs, where higher similarity between child-mother pairs was observed mostly for the right lobar regions. Our results also show that child-mother versus child-unrelated pairs differ for daughters and sons with a trend toward significance, particularly for the left hemisphere lobar regions. This is the first study to reveal significant intergenerational transmission of cortical sulcal patterns, and our results have important implications for the study of the heritability of complex behaviors, brain-based disorders, the identification of biomarkers, and targets for interventions.

Prevalence of Mathematical and Visuospatial Learning Disabilities in Patients With Posterior Cortical Atrophy

Importance

Increased prevalence of language-based learning disabilities (LDs) has been previously reported in patients with primary progressive aphasia (PPA). This study hypothesized that patients with focal neurodegenerative syndromes outside the language network, such as posterior cortical atrophy (PCA), would have a higher rate of nonlanguage LDs, congruent with their mainly visuospatial presentation.

Objective

To investigate the prevalence and type of LD (language and/or mathematical and visuospatial) in a large cohort of patients with PCA compared with patients with logopenic variant PPA (lvPPA) and amnestic Alzheimer disease (AD).

Design, Setting, and Participants

This case-control study reviewed 279 medical records from a university-based clinic and research center for patients with neurodegenerative diseases for LD history, including patients with PCA (n = 95), patients with lvPPA (n = 84), and a matched cohort with amnestic AD (n = 100). No records were excluded. The study compared cognitive and neuroimaging features of patients with PCA with and without LDs. A review of the records of patients presenting from March 1, 1999, to August 31, 2014, revealed 95 PCA cases and 84 lvPPA cases. Then 100 patients with amnestic AD from this same period were chosen for comparison, matching against the groups for age, sex, and disease severity. Data analysis was performed from September 8, 2013, to November 6, 2017.

Main Outcomes and Measures

Prevalence of total LD history and prevalence of language and mathematical or visuospatial LD history across all cohorts.

Results

A total of 179 atypical AD cases (95 with PCA and 84 with lvPPA) and 100 disease control cases (amnestic AD) were included in the study. The groups were not statistically different for mean (SD) age at first visit (PCA, 61.9 [7.0] years; lvPPA, 65.1 [8.7] years; amnestic AD, 64.0 [12.6] years; P = .08), mean (SD) age at first symptom (PCA, 57.5 [7.0] years; lvPPA, 61.1 [9.0] years; amnestic AD, 59.6 [13.7] years; P = .06), or sex (PCA, 66.3% female; lvPPA, 56.0% female; amnestic AD, 57.0% female; P = .30) but differed on non-right-hand preference (PCA, 18.3%; lvPPA, 20.2%; amnestic AD, 7.7%; P = .04), race/ethnicity (PCA, 88.3% white; lvPPA, 99.0% white; amnestic AD, 80.0% white; P < .001), and mean (SD) educational level (PCA, 15.7 [3.2] years; lvPPA, 16.2 [3.3] years; amnestic AD, 14.8 [3.5] years; P = .02). A total of 18 of the 95 patients with PCA (18.9%) reported a history of LD, which is greater than the 3 of 100 patients (3.0%) in the amnestic AD cohort (P < .001) and the 10.0% expected rate in the general population (P = .007). In the PCA cohort, 13 of 95 patients (13.7%) had a nonlanguage mathematical and/or visuospatial LD; this rate was greater than that in the amnestic AD (1 of 100 [1.0%]; P < .001) and lvPPA (2 of 84 [2.4%]; P = .006) cohorts and greater than the 6.0% expected general population rate of mathematical LD (P = .003). Compared with the patients with PCA without LDs, the group with LDs had greater preservation of global cognition and a more right-lateralized pattern of atrophy.

Conclusions and Relevance

Nonlanguage mathematical and visuospatial LDs were associated with focal, visuospatial predominant neurodegenerative clinical syndromes. This finding supports the hypothesis that neurodevelopmental differences in specific brain networks are associated with phenotypic manifestation of later-life neurodegenerative disease.

Effects of Second Language Learning on the Plastic Aging Brain: Functional Connectivity, Cognitive Decline, and Reorganization

Learning a new language requires the use of extensive neural networks and can represent a powerful tool to reorganize brain neuroplasticity. In this study, we analyze how a 4 months long second language learning program (16, 2 h sessions) can lead to functional changes in the brain of healthy elderly individuals. A large number of studies point out a decline of brain-skills with age; here it is analyzed how cognition together with functional brain organization can be improved later in life. Twenty-six older adults (59-79 years old) were enrolled in the present study. A complete neuropsychological examination was administered before and after the intervention to measure global cognition levels, short- and long-term memory, attention, language access and executive functions. At the end of the program, in the intervention group, the results showed a significant improvement in global cognition together with an increased functional connectivity in the right inferior frontal gyrus (rIFG), right superior frontal gyrus (rSFG) and left superior parietal lobule (lSPL). These findings can be added to the current neurobiological breakthroughs of reshaping brain networks with a short language learning practice in healthy elderly subjects. Therefore, learning a foreign-language may represent a potentially helpful cognitive intervention for promoting healthy aging.

Processing symbolic and non-symbolic proportions: Domain-specific numerical and domain-general processes in intraparietal cortex

Previous studies on the processing of fractions and proportions focused mainly on the processing of their overall magnitude information in the intraparietal sulcus (IPS). However, the IPS is also associated with domain-general cognitive functions beyond processing overall magnitude, which may nevertheless be involved in operating on magnitude information of proportions. To pursue this issue, the present study aimed at investigating whether there is a shared neural correlate for proportion processing in the intraparietal cortex beyond overall magnitude processing and how part-whole relations are processed on the neural level. Across four presentation formats (i.e., fractions, decimals, dot patterns, and pie charts) we observed a shared neural substrate in bilateral inferior parietal cortex, slightly anterior and inferior to IPS areas recently found for overall magnitude proportion processing. Nevertheless, when evaluating the neural correlates of part-whole processing (i.e., contrasting fractions, dot patterns, and pie charts vs. decimals), we found wide-spread activation in fronto-parietal brain areas. These results indicate involvement of domain-general cognitive processes in part-whole processing beyond processing the overall magnitude of proportions. The dissociation between proportions involving part-whole relations and decimals was further substantiated by a representational similarity analysis, which revealed common neural processing for fractions, pie charts, and dot patterns, possibly representing their bipartite part-whole structure. In contrast, decimals seemed to be processed differently on the neural level, possibly reflecting missing processes of actual proportion calculation in decimals.

Lateralized spontaneous exploratory behavior in maturing rats induced by new geometrically differentiated environments after administration with trace elements

Functional laterality is known as an intrinsic property of the brain. Since several studies have shown the presence of laterality in many species other than humans, it has been suggested that this is an adaptive mechanism to aid survival. Previous studies have shown that lateralized behavior observed during exposure to different environmental stimuli is not constant in normal animals, depending on the geometrical form of the exploratory field. In these exploratory fields, animals showed right- or left-biased exploratory behavior, according to the nature of the geometrical properties of the environment. Previously, it was found that tellurium (Te) was able to block spontaneous left-biased exploration in one defined geometrical environment. In the present work, the influence of Te and selenium (Se) in animals exposed to novel geometrically different environments were studied. Three geometrically different testing fields (square, rectangle, and T-shaped) were presented to Se- and Te-treated groups of rats. The results show that in the square field, only the Se treatment was able to block spontaneous right-biased exploratory responses; in the rectangular field, both Se and Te treatments blocked right-biased exploratory responses, and in the T-shaped field, only Te was able to block spontaneous left-biased exploratory responses. Data suggest that trace elements modify lateralized behavioral responses independently of the form of the novel exploratory field, suggesting the presence of a specific action in the brain.

Tracking Economic Value of Products in Natural Settings: A Wireless EEG Study

Economic decision making refers to the process of individuals translating their preference into subjective value (SV). Little is known about the dynamics of the neural processes that underpin this form of value-based decision making and no studies have investigated these processes outside of controlled laboratory settings. The current study investigated the spatio-temporal dynamics that accompany economic valuation of products using mobile electroencephalography (EEG) and eye tracking techniques. Participants viewed and rated images of household products in a gallery setting while EEG and eye tracking data were collected wirelessly. A Becker-DeGroot-Marschak (BDM) auction task was subsequently used to quantify the individual's willingness to pay (WTP) for each product. WTP was used to classify products into low, low medium, high medium and high economic value conditions. Eye movement related potentials (EMRP) were examined, and independent component analysis (ICA) was used to separate sources of activity from grand averaged EEG data. Four independent components (ICs) of EMRPs were modulated by WTP (i.e., SV) in the latency range of 150-250 ms. Of the four value-sensitive ICs, one IC displayed enhanced amplitude for all value conditions excluding low value, and another IC presented enhanced amplitude for low value products only. The remaining two value-sensitive ICs resolved inter-mediate levels of SV. Our study quantified, for the first time, the neural processes involved in economic value based decisions in a natural setting. Results suggest that multiple spatio-temporal brain activation patterns mediate the attention and aversion of products which could reflect an early valuation system. The EMRP parietal P200 component could reflect an attention allocation mechanism that separates the lowest-value products (IC7) from products of all other value (IC4), suggesting that low-value items are categorized early on as being aversive. While none of the ICs showed linear amplitude changes that parallel SV's of products, results suggest that a combination of multiple components may sub-serve a fine-grained resolution of the SV of products.

Prediction of Human Performance Using Electroencephalography under Different Indoor Room Temperatures

Varying indoor environmental conditions is known to affect office worker&rsquo;s performance; wherein past research studies have reported the effects of unfavorable indoor temperature and air quality causing sick building syndrome (SBS) among office workers. Thus, investigating factors that can predict performance in changing indoor environments have become a highly important research topic bearing significant impact in our society. While past research studies have attempted to determine predictors for performance, they do not provide satisfactory prediction ability. Therefore, in this preliminary study, we attempt to predict performance during office-work tasks triggered by different indoor room temperatures (22.2 &deg;C and 30 &deg;C) from human brain signals recorded using electroencephalography (EEG). Seven participants were recruited, from whom EEG, skin temperature, heart rate and thermal survey questionnaires were collected. Regression analyses were carried out to investigate the effectiveness of using EEG power spectral densities (PSD) as predictors of performance. Our results indicate EEG PSDs as predictors provide the highest R² (> 0.70), that is 17 times higher than using other physiological signals as predictors and is more robust. Finally, the paper provides insight on the selected predictors based on brain activity patterns for low- and high-performance levels under different indoor-temperatures.

Probing culture in the head: the neural correlates of relational models

Relational Models Theory or RMT proposes that there are four universal ways in which socio-economic relations can be organized. According to the RMT, each of its four relational models (Communal Sharing, Authority Ranking, Equality Matching, and Market Pricing) is associated with a distinct cognitive representation, with a cumulative pattern in which each relational model is a superset of the next lower model. This report for the first time uses a combination of cognitive and the social neuroscience to put this model to the test. RMT proposes that members of every culture use all four relational models, just in different proportions. It should therefore be possible to study their neural correlates in a mono-cultural sample. In this study, thirty-nine European-American students were imaged in a 3T Siemens Trio with a 24-channel head coil while rating the extent to which each relational model organized relationships with each of thirty-two acquaintances/friend/relatives in a boxcar design. FreeSurfer Functional Analysis Stream (FS-FAST) analyses revealed distinct patterns of activation for each of the relational models. The activations did not follow a cumulative hierarchical pattern, suggestive that this aspect of the RMT model should be revised.

Evaluation of the Triple Code Model of numerical processing-Reviewing past neuroimaging and clinical findings

This review reconciles past findings on numerical processing with key assumptions of the most predominant model of arithmetic in the literature, the Triple Code Model (TCM). This is implemented by reporting diverse findings in the literature ranging from behavioral studies on basic arithmetic operations over neuroimaging studies on numerical processing to developmental studies concerned with arithmetic acquisition, with a special focus on developmental dyscalculia (DD). We evaluate whether these studies corroborate the model and discuss possible reasons for contradictory findings. A separate section is dedicated to the transfer of TCM to arithmetic development and to alternative accounts focusing on developmental questions of numerical processing. We conclude with recommendations for future directions of arithmetic research, raising questions that require answers in models of healthy as well as abnormal mathematical development.

WHAT THIS PAPER ADDS

This review assesses the leading model in the field of arithmetic processing (Triple Code Model) by presenting knowledge from interdisciplinary research. It assesses the observed contradictory findings and integrates the resulting opposing viewpoints. The focus is on the development of arithmetic expertise as well as abnormal mathematical development. The original aspect of this article is that it points to a gap in research on these topics and provides possible solutions for future models.

Gyri of the human parietal lobe: Volumes, spatial extents, automatic labelling, and probabilistic atlases

Accurately describing the anatomy of individual brains enables interlaboratory communication of functional and developmental studies and is crucial for possible surgical interventions. The human parietal lobe participates in multimodal sensory integration including language processing and also contains the primary somatosensory area. We describe detailed protocols to subdivide the parietal lobe, analyze morphological and volumetric characteristics, and create probabilistic atlases in MNI152 stereotaxic space. The parietal lobe was manually delineated on 3D T1 MR images of 30 healthy subjects and divided into four regions: supramarginal gyrus (SMG), angular gyrus (AG), superior parietal lobe (supPL) and postcentral gyrus (postCG). There was the expected correlation of male gender with larger brain and intracranial volume. We examined a wide range of anatomical features of the gyri and the sulci separating them. At least a rudimentary primary intermediate sulcus of Jensen (PISJ) separating SMG and AG was identified in nearly all (59/60) hemispheres. Presence of additional gyri in SMG and AG was related to sulcal features and volumetric characteristics. The parietal lobe was slightly (2%) larger on the left, driven by leftward asymmetries of the postCG and SMG. Intersubject variability was highest for SMG and AG, and lowest for postCG. Overall the morphological characteristics tended to be symmetrical, and volumes also tended to covary between hemispheres. This may reflect developmental as well as maturation factors. To assess the accuracy with which the labels can be used to segment newly acquired (unlabelled) T1-weighted brain images, we applied multi-atlas label propagation software (MAPER) in a leave-one-out experiment and compared the resulting automatic labels with the manually prepared ones. The results showed strong agreement (mean Jaccard index 0.69, corresponding to a mean Dice index of 0.82, average mean volume error of 0.6%). Stereotaxic probabilistic atlases of each subregion were obtained. They illustrate the physiological brain torque, with structures in the right hemisphere positioned more anteriorly than in the left, and right/left positional differences of up to 10 mm. They also allow an assessment of sulcal variability, e.g. low variability for parietooccipital fissure and cingulate sulcus. Illustrated protocols, individual label sets, probabilistic atlases, and a maximum-probability atlas which takes into account surrounding structures are available for free download under academic licences.

Resilience in mathematics after early brain injury: The roles of parental input and early plasticity

Children with early focal unilateral brain injury show remarkable plasticity in language development. However, little is known about how early brain injury influences mathematical learning. Here, we examine early number understanding, comparing cardinal number knowledge of typically developing children (TD) and children with pre- and perinatal lesions (BI) between 42 and 50 months of age. We also examine how this knowledge relates to the number words children hear from their primary caregivers early in life. We find that children with BI, are, on average, slightly behind TD children in both cardinal number knowledge and later mathematical performance, and show slightly slower learning rates than TD children in cardinal number knowledge during the preschool years. We also find that parents’ “number talk” to their toddlers predicts later mathematical ability for both TD children and children with BI. These findings suggest a relatively optimistic story in which neural plasticity is at play in children’s mathematical development following early brain injury. Further, the effects of early number input suggest that intervening to enrich the number talk that children with BI hear during the preschool years could narrow the math achievement gap.

Angular default mode network connectivity across working memory load

Initially identified during no-task, baseline conditions, it has now been suggested that the default mode network (DMN) engages during a variety of working memory paradigms through its flexible interactions with other large-scale brain networks. Nevertheless, its contribution to whole-brain connectivity dynamics across increasing working memory load has not been explicitly assessed. The aim of our study was to determine which DMN hubs relate to working memory task performance during an fMRI-based n-back paradigm with parametric increases in difficulty. Using a voxel-wise metric, termed the intrinsic connectivity contrast (ICC), we found that the bilateral angular gyri (core DMN hubs) displayed the greatest change in global connectivity across three levels of n-back task load. Subsequent seed-based functional connectivity analysis revealed that the angular DMN regions robustly interact with other large-scale brain networks, suggesting a potential involvement in the global integration of information. Further support for this hypothesis comes from the significant correlations we found between angular gyri connectivity and reaction times to correct responses. The implication from our study is that the DMN is actively involved during the n-back task and thus plays an important role related to working memory, with its core angular regions contributing to the changes in global brain connectivity in response to increasing environmental demands. Hum Brain Mapp 38:41-52, 2017. © 2016 Wiley Periodicals, Inc.

Neuronal foundations of human numerical representations

The human species has developed complex mathematical skills which likely emerge from a combination of multiple foundational abilities. One of them seems to be a preverbal capacity to extract and manipulate the numerosity of sets of objects which is shared with other species and in humans is thought to be integrated with symbolic knowledge to result in a more abstract representation of numerical concepts. For what concerns the functional neuroanatomy of this capacity, neuropsychology and functional imaging have localized key substrates of numerical processing in parietal and frontal cortex. However, traditional fMRI mapping relying on a simple subtraction approach to compare numerical and nonnumerical conditions is limited to tackle with sufficient precision and detail the issue of the underlying code for number, a question which more easily lends itself to investigation by methods with higher spatial resolution, such as neurophysiology. In recent years, progress has been made through the introduction of approaches sensitive to within-category discrimination in combination with fMRI (adaptation and multivariate pattern recognition), and the present review summarizes what these have revealed so far about the neural coding of individual numbers in the human brain, the format of these representations and parallels between human and monkey neurophysiology findings.

Conceptual size representation in ventral visual cortex

Recent findings suggest that visual objects may be mapped along the ventral occipitotemporal cortex according to their real-world size (Konkle and Oliva, 2012). It has been argued that such mapping does not reflect an abstract, conceptual size representation, but rather the visual or functional properties associated with small versus big real-world objects. To determine whether a more abstract conceptual size representation may affect visual cortical activation we used meaningless geometrical shapes, devoid of semantic or functional associations, which were associated with specific size representations by virtue of extensive training. Following training, participants underwent functional magnetic resonance imaging (fMRI) scanning while performing a conceptual size comparison task on the geometrical shapes. In addition, a size comparison task was conducted for numeral digits denoting small and big numbers. A region-of-interest analysis revealed larger blood oxygenation level dependent (BOLD) responses for conceptually 'big' than for conceptually 'small' shapes, as well as for big versus small numbers, within medial (parahippocampal place area, PPA) and lateral (occipital place area, OPA) place-selective regions. Processing of the 'big' visual shapes further elicited enhanced activation in early visual cortex, possibly reflecting top-down projections from PPA. By using arbitrary shapes and numbers we minimized visual, categorical, or functional influences on fMRI measurement, providing evidence for a possible neural mechanism underlying the representation of abstract conceptual size within the ventral visual stream.

'How many' and 'how much' dissociate in the parietal lobe

We investigated whether two features that are fundamental for quantity processing, namely numerosity and continuous quantity - or 'how many' versus 'how much' - may dissociate in the parietal lobe. Fourteen mathematically-normal participants performed a well-established numerosity discrimination task after receiving continuous theta burst transcranial magnetic stimulation (TBS) over the left or right intraparietal sulcus (IPS) or the Vertex. We performed a detailed analysis of accuracy (based on the Weber Fraction, wf), which distinguished between trials in which numerosity was anti-correlated or 'incongruent' to other continuous measures of quantity, and trials in which numerosity and other continuous features were 'congruent'. Congruent trials can be processed by integrating numerosity or continuous quantity features like cumulative area since they correlate. Instead incongruent trials can only be processed based on numerosity and requires inhibiting cumulative area or other continuous quantity features like dot size and would lead to incorrect judgment if these features are used as a proxy for numerosity. We found an increase of wf, i.e., weakened numerosity processing in incongruent but not congruent trials following left IPS-TBS, which suggests that numerosity processing was impaired while continuous quantity processing remained unchanged. Moreover, wf increased in congruent but not in incongruent trials following right IPS stimulation. We concluded that left and right parietal are respectively critical for numerosity discrimination, i.e., 'how many' or alternatively for response selection, and for integrating numerosity and continuous quantity features.

Numbers are not like words: Different pathways for literacy and numeracy

Literacy and numeracy are two fundamental cognitive skills that require mastering culturally-invented symbolic systems for representing spoken language and quantities. How numbers and words are processed in the human brain and their temporal dynamics remain unclear. Using MEG (magnetoencephalography), we find brain activation differences for literacy and numeracy from early stages of processing in the temporal-occipital and temporal-parietal regions. Native speakers of Spanish were exposed to visually presented words, pseudowords, strings of numbers, strings of letters and strings of symbols while engaged in a go/no-go task. Results showed more evoked neuromagnetic activity for words and pseudowords compared to symbols at ~120-130ms in the left occipito-temporal and temporal-parietal cortices (angular gyrus and intra-parietal sulcus) and at ~200ms in the left inferior frontal gyrus and left temporal areas. In contrast, numbers showed more activation than symbols at similar time windows in homologous regions of the right hemisphere: occipito-temporal and superior and middle temporal cortices at ~100-130ms. A direct comparison between the responses to words and numbers confirmed this distinct lateralization for the two stimulus types. These results suggest that literacy and numeracy follow distinct processing streams through the left and right hemispheres, respectively, and that the temporal-parietal and occipito-temporal regions may interact during processing alphanumeric stimuli.

Converging evidence from fMRI and aphasia that the left temporoparietal cortex has an essential role in representing abstract semantic knowledge

While the neural underpinnings of concrete semantic knowledge have been studied extensively, abstract conceptual knowledge remains enigmatic. We present two experiments that provide converging evidence for the involvement of key regions in the temporoparietal cortex (TPC) in abstract semantic representations. First, we carried out a neuroimaging study in which participants thought deeply about abstract and concrete words. A functional connectivity analysis revealed a cortical network, including portions of the TPC, that showed coordinated activity specific to abstract word processing. In a second experiment, we tested participants with lesions involving the left TPC on a spoken-to-written word matching task using abstract and concrete target words presented in arrays of related or unrelated distractors. The results revealed an interaction between concreteness and relatedness: participants with TPC lesions were significantly less accurate for abstract words presented in related arrays than in unrelated arrays, but exhibited no effect of relatedness for concrete words. These results confirm that the TPC plays an important role in abstract concept representation and that it is part of a larger network of functionally cooperative regions needed for abstract word processing.

Dissociation between arithmetic relatedness and distance effects is modulated by task properties: an ERP study comparing explicit vs. implicit arithmetic processing

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ERPs were recorded while performing number matching and arithmetic verification tasks.

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Access to the arithmetic facts lexicon is modulated by task properties.

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Arithmetic relatedness and distance effects are sensitive to task properties.

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Matching tasks involve semantic processes.

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Verification tasks involve semantic and detection of mismatch processes.

Event-related potential (ERP) studies have detected several characteristic consecutive amplitude modulations in both implicit and explicit mental arithmetic tasks. Implicit tasks typically focused on the arithmetic relatedness effect (in which performance is affected by semantic associations between numbers) while explicit tasks focused on the distance effect (in which performance is affected by the numerical difference of to-be-compared numbers). Both task types elicit morphologically similar ERP waves which were explained in functionally similar terms. However, to date, the relationship between these tasks has not been investigated explicitly and systematically. In order to fill this gap, here we examined whether ERP effects and their underlying cognitive processes in implicit and explicit mental arithmetic tasks differ from each other. The same group of participants performed both an implicit number-matching task (in which arithmetic knowledge is task-irrelevant) and an explicit arithmetic-verification task (in which arithmetic knowledge is task-relevant). 129-channel ERP data differed substantially between tasks. In the number-matching task, the arithmetic relatedness effect appeared as a negativity over left-frontal electrodes whereas the distance effect was more prominent over right centro-parietal electrodes. In the verification task, all probe types elicited similar N2b waves over right fronto-central electrodes and typical centro-parietal N400 effects over central electrodes. The distance effect appeared as an early-rising, long-lasting left parietal negativity. We suggest that ERP effects in the implicit task reflect access to semantic memory networks and to magnitude discrimination, respectively. In contrast, effects of expectation violation are more prominent in explicit tasks and may mask more delicate cognitive processes.

Commonalities for Numerical and Continuous Quantity Skills at Temporo-parietal Junction

How do our abilities to process number and other continuous quantities such as time and space relate to each other? Recent evidence suggests that these abilities share common magnitude processing and neural resources, although other findings also highlight the role of dimension-specific processes. To further characterize the relation between number, time, and space, we first examined them in a population with a developmental numerical dysfunction (developmental dyscalculia) and then assessed the extent to which these abilities correlated both behaviorally and anatomically in numerically normal participants. We found that (1) participants with dyscalculia showed preserved continuous quantity processing and (2) in numerically normal adults, numerical and continuous quantity abilities were at least partially dissociated both behaviorally and anatomically. Specifically, gray matter volume correlated with both measures of numerical and continuous quantity processing in the right TPJ; in contrast, individual differences in number proficiency were associated with gray matter volume in number-specific cortical regions in the right parietal lobe. Together, our new converging evidence of selective numerical impairment and of number-specific brain areas at least partially distinct from common magnitude areas suggests that the human brain is equipped with different ways of quantifying the outside world.

Format-dependent representations of symbolic and non-symbolic numbers in the human cortex as revealed by multi-voxel pattern analyses

Neuroimaging studies in the last 20 years have tried to unravel the neural correlates of number processing across formats in humans and non-human primates. Results point to the intraparietal sulcus as the core area for an abstract representation of numerical quantity. On the other hand, there exist a variety of behavioral and neuroimaging data that are difficult to reconcile with the existence of such an abstract representation. In this study, we addressed this issue by applying multi-voxel pattern analysis (MVPA) to functional Magnetic Resonance Imaging (fMRI) data to unravel the neural representations of symbolic (digits) and non-symbolic (dots) numbers and their possible overlap on three different spatial scales (entire lobules, smaller regions of interest and a searchlight analysis with 2-voxel radius). Results showed that numbers in both formats are decodable in occipital, frontal, temporal and parietal regions. However, there were no overlapping representations between dots and digits on any of the spatial scales. These data suggest that the human brain does not contain an abstract representation of numerical magnitude.

Residual number processing in dyscalculia

Developmental dyscalculia – a congenital learning disability in understanding numerical concepts – is typically associated with parietal lobe abnormality. However, people with dyscalculia often retain some residual numerical abilities, reported in studies that otherwise focused on abnormalities in the dyscalculic brain. Here we took a different perspective by focusing on brain regions that support residual number processing in dyscalculia. All participants accurately performed semantic and categorical colour-decision tasks with numerical and non-numerical stimuli, with adults with dyscalculia performing slower than controls in the number semantic tasks only. Structural imaging showed less grey-matter volume in the right parietal cortex in people with dyscalculia relative to controls. Functional MRI showed that accurate number semantic judgements were maintained by parietal and inferior frontal activations that were common to adults with dyscalculia and controls, with higher activation for participants with dyscalculia than controls in the right superior frontal cortex and the left inferior frontal sulcus. Enhanced activation in these frontal areas was driven by people with dyscalculia who made faster rather than slower numerical decisions; however, activation could not be accounted for by response times per se, because it was greater for fast relative to slow dyscalculics but not greater for fast controls relative to slow dyscalculics. In conclusion, our results reveal two frontal brain regions that support efficient number processing in dyscalculia.

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Dyscalculics (DD) show congenital number impairment due to parietal abnormalities.

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However DD often show residual number skills which have not been studied before.

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We studied the brain networks supporting residual skills and individual differences

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DD: reduced parietal grey-matter, accurate but slower than controls in number tasks

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Faster DD responses over-activated two frontal areas

Prenatal tobacco exposure predicts differential brain function during working memory in early adolescence: a preliminary investigation

Children prenatally exposed to tobacco exhibit higher rates of learning and emotional-behavioral problems related to worse working memory performance. Brain function, however, among tobacco exposed children while performing a working memory task has not previously been examined. This study compared the brain function of tobacco-exposed (n = 7) and unexposed (n = 11) 12-year-olds during a number N-back working memory task using an event-related functional magnetic resonance imaging (fMRI) design. Prenatal alcohol exposure, neonatal medical problems, environmental risk, and sex were statistically controlled. Tobacco-exposed children showed greater activation in inferior parietal regions, whereas unexposed children showed greater activation in inferior frontal regions. These differences were observed in the context of correct responses, suggesting that exposed and unexposed children use different brain regions and approaches to succeed in working memory tasks. Implications for future research and intervention are discussed.

Comparing the neural distance effect derived from the non-symbolic comparison and the same-different task

As a result of the representation of numerosities, more accurate and faster discrimination between two numerosities is observed when the distance between them increases. In previous studies, the comparison and same-different task were most frequently used to investigate this distance effect. Recently, it was questioned whether the non-symbolic distance effects derived from these tasks originate at the same level. In the current study, we examined the behavioral and neural distance effects of the comparison and same-different task to assess potential differences between both tasks. Participants were first year university students. Each participant completed both tasks, while their reaction time, accuracy and brain activity on predefined components was measured. The early N1-P2p transition and the P2p component on temporo-occipital (TO) and inferior parietal (IP) electrode groups were considered, as well as the late P3 component on a central (C) electrode group. The results showed that the behavioral distance effects from both tasks were comparable, although participants' performance was worse on the same-different task. The neural results revealed similar effects of distance on the mean amplitudes for the early components for both tasks (all p′s < 0.02) and an additional effect of task difficulty on the mean amplitudes of these components. Similar as in previous studies, we found a (marginally) significant increase in mean amplitude of the later P3 component with increasing distance for the comparison (p = 0.07), but not for the same-different task. Apparently, the initial stages of number processing are comparable for both tasks, but an additional later stage is only present for the comparison task. The P3 effect would be indicative of this decisional stage, which was previously proposed to underlie the comparison distance effect (CDE).

An electrophysiological investigation of non-symbolic magnitude processing: numerical distance effects in children with and without mathematical learning disabilities

INTRODUCTION

The aim of the present study was to probe electrophysiological effects of non-symbolic numerical processing in 20 children with mathematical learning disabilities (mean age = 99.2 months) compared to a group of 20 typically developing matched controls (mean age = 98.4 months).

METHODS

EEG data were obtained while children were tested with a standard non-symbolic numerical comparison paradigm that allowed us to investigate the effects of numerical distance manipulations for different set sizes, i.e., the classical subitizing, counting and estimation ranges. Effects of numerical distance manipulations on event-related potential (ERP) amplitudes as well as activation patterns of underlying current sources were analyzed.

RESULTS

In typically developing children, the amplitudes of a late parietal positive-going ERP component showed systematic numerical distance effects that did not depend on set size. For the group of children with mathematical learning disabilities, ERP distance effects were found only for stimuli within the subitizing range. Current source density analysis of distance-related group effects suggested that areas in right inferior parietal regions are involved in the generation of the parietal ERP amplitude differences.

CONCLUSION

Our results suggest that right inferior parietal regions are recruited differentially by controls compared to children with mathematical learning disabilities in response to non-symbolic numerical magnitude processing tasks, but only for stimuli with set sizes that exceed the subitizing range.

The angular gyrus: multiple functions and multiple subdivisions

There is considerable interest in the structural and functional properties of the angular gyrus (AG). Located in the posterior part of the inferior parietal lobule, the AG has been shown in numerous meta-analysis reviews to be consistently activated in a variety of tasks. This review discusses the involvement of the AG in semantic processing, word reading and comprehension, number processing, default mode network, memory retrieval, attention and spatial cognition, reasoning, and social cognition. This large functional neuroimaging literature depicts a major role for the AG in processing concepts rather than percepts when interfacing perception-to-recognition-to-action. More specifically, the AG emerges as a cross-modal hub where converging multisensory information is combined and integrated to comprehend and give sense to events, manipulate mental representations, solve familiar problems, and reorient attention to relevant information. In addition, this review discusses recent findings that point to the existence of multiple subdivisions in the AG. This spatial parcellation can serve as a framework for reporting AG activations with greater definition. This review also acknowledges that the role of the AG cannot comprehensibly be identified in isolation but needs to be understood in parallel with the influence from other regions. Several interesting questions that warrant further investigations are finally emphasized.

Triadic (ecological, neural, cognitive) niche construction: a scenario of human brain evolution extrapolating tool use and language from the control of reaching actions

Hominin evolution has involved a continuous process of addition of new kinds of cognitive capacity, including those relating to manufacture and use of tools and to the establishment of linguistic faculties. The dramatic expansion of the brain that accompanied additions of new functional areas would have supported such continuous evolution. Extended brain functions would have driven rapid and drastic changes in the hominin ecological niche, which in turn demanded further brain resources to adapt to it. In this way, humans have constructed a novel niche in each of the ecological, cognitive and neural domains, whose interactions accelerated their individual evolution through a process of triadic niche construction. Human higher cognitive activity can therefore be viewed holistically as one component in a terrestrial ecosystem. The brain's functional characteristics seem to play a key role in this triadic interaction. We advance a speculative argument about the origins of its neurobiological mechanisms, as an extension (with wider scope) of the evolutionary principles of adaptive function in the animal nervous system. The brain mechanisms that subserve tool use may bridge the gap between gesture and language—the site of such integration seems to be the parietal and extending opercular cortices.

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.