Neurocognitive mechanisms of digit processing and their relationship with mathematics competence

Avatar-based versus conventional patient monitoring with distant vision: a computer-based simulation study

Patient monitoring in the perioperative setting can be challenging, especially when monitoring multiple patients simultaneously or managing dynamic situations that require movement around the operating room. We aimed to evaluate whether avatar-based patient monitoring, which presents vital signs in the form of changing colors, shapes and motion, improves remote vital sign recognition compared to conventional monitoring. We conducted a prospective, single-center, computer-based simulation study to evaluate how anesthesia providers recognize vital signs when using the Philips Visual Patient Avatar at different viewing distances (8 and 16 m) compared to conventional monitoring. The primary outcome was the total number of correctly identified vital signs which were compared for the two distances and the two devices using mixed Poisson regression. We analyzed data from 28 anesthesia providers who participated in 112 simulations. The correct recognition rate using the Visual Patient Avatar compared to conventional monitoring at 8 m was increased by 74% (rate ratio 1.74, 95% CI, 1.42 to 2.14, p < 0.001) and by 51% at 16-meter viewing distance (rate ratio 1.51, 95% CI, 1.23 to 1.87, p < 0.001). We observed scenario-specific superior performance for six vital signs at 8 m. The results provide empirical evidence that avatar-based monitoring can significantly improve the perception of vital signs when using distant vision.

Functional and representational differences between bilateral inferior temporal numeral areas

The processing of numerals as visual objects is supported by an "Inferior Temporal Numeral Area" (ITNA) in the bilateral inferior temporal gyri (ITG). Extant findings suggest some degree of hemispheric asymmetry in how the bilateral ITNAs process numerals. Pollack and Price (2019) reported such a hemispheric asymmetry by which a region in the left ITG was sensitive to digits during a visual search for a digit among letters, and a homologous region in the right ITG that showed greater digit sensitivity in individuals with higher calculation skills. However, the ITG regions were localized with separate analyses without directly contrasting their digit sensitivities and relation to calculation skills. So, the extent of and reasons for these functional asymmetries remain unclear. Here we probe whether the functional and representational properties of the ITNAs are asymmetric by applying both univariate and multivariate region-of-interest analyses to Pollack and Price's (2019) data. Contrary to the implications of the original findings, digit sensitivity did not differ between ITNAs, and digit sensitivity in both left and right ITNAs was associated with calculation skills. Representational similarity analyses revealed that the overall representational geometries of digits in the ITNAs were also correlated, albeit weakly, but the representational contents of the ITNAs were largely inconclusive. Nonetheless, we found a right lateralization in engagement in alphanumeric categorization, and that the right ITNA showed greater discriminability between digits and letters. Greater right lateralization of digit sensitivity and digit discriminability in the left ITNA were also related to higher calculation skills. Our findings thus suggest that the ITNAs may not be functionally identical and should be directly contrasted in future work. Our study also highlights the importance of within-individual comparisons for understanding hemispheric asymmetries, and analyses of individual differences and multivariate features to uncover effects that would otherwise be obscured by averages.

Structural and functional connectivity of the inferior temporal numeral area

A growing body of evidence suggests that in adults, there is a spatially consistent "inferior temporal numeral area" (ITNA) in the occipitotemporal cortex that appears to preferentially process Arabic digits relative to non-numerical symbols and objects. However, very little is known about why the ITNA is spatially segregated from regions that process other orthographic stimuli such as letters, and why it is spatially consistent across individuals. In the present study, we used diffusion-weighted imaging and functional magnetic resonance imaging to contrast structural and functional connectivity between left and right hemisphere ITNAs and a left hemisphere letter-preferring region. We found that the left ITNA had stronger structural and functional connectivity than the letter region to inferior parietal regions involved in numerical magnitude representation and arithmetic. Between hemispheres, the left ITNA showed stronger structural connectivity with the left inferior frontal gyrus (Broca's area), while the right ITNA showed stronger structural connectivity to the ipsilateral inferior parietal cortex and stronger functional coupling with the bilateral IPS. Based on their relative connectivity, our results suggest that the left ITNA may be more readily involved in mapping digits to verbal number representations, while the right ITNA may support the mapping of digits to quantity representations.

Heritability and cross-species comparisons of human cortical functional organization asymmetry

The human cerebral cortex is symmetrically organized along large-scale axes but also presents inter-hemispheric differences in structure and function. The quantified contralateral homologous difference, that is asymmetry, is a key feature of the human brain left-right axis supporting functional processes, such as language. Here, we assessed whether the asymmetry of cortical functional organization is heritable and phylogenetically conserved between humans and macaques. Our findings indicate asymmetric organization along an axis describing a functional trajectory from perceptual/action to abstract cognition. Whereas language network showed leftward asymmetric organization, frontoparietal network showed rightward asymmetric organization in humans. These asymmetries were heritable in humans and showed a similar spatial distribution with macaques, in the case of intra-hemispheric asymmetry of functional hierarchy. This suggests (phylo)genetic conservation. However, both language and frontoparietal networks showed a qualitatively larger asymmetry in humans relative to macaques. Overall, our findings suggest a genetic basis for asymmetry in intrinsic functional organization, linked to higher order cognitive functions uniquely developed in humans.

Visual Occipito-Temporal N1 Sensitivity to Digits Across Elementary School

Number processing abilities are important for academic and personal development. The course of initial specialization of ventral occipito-temporal cortex (vOTC) sensitivity to visual number processing is crucial for the acquisition of numeric and arithmetic skills. We examined the visual N1, the electrophysiological correlate of vOTC activation across five time points in kindergarten (T1, mean age 6.60 years), middle and end of first grade (T2, 7.38 years; T3, 7.68 years), second grade (T4, 8.28 years), and fifth grade (T5, 11.40 years). A combination of cross-sectional and longitudinal EEG data of a total of 62 children (35 female) at varying familial risk for dyslexia were available to form groups of 23, 22, 27, 27, and 42 participants for each of the five time points. The children performed a target detection task which included visual presentation of single digits (DIG), false fonts (FF), and letters (LET) to derive measures for coarse (DIG vs. FF) and fine (DIG vs. LET) digit sensitive processing across development. The N1 amplitude analyses indicated coarse and fine sensitivity characterized by a stronger N1 to digits than false fonts across all five time points, and stronger N1 to digits than letters at all but the second (T2) time point. In addition, lower arithmetic skills were associated with stronger coarse N1 digit sensitivity over the left hemisphere in second grade (T4), possibly reflecting allocation of more attentional resources or stronger reliance on the verbal system in children with poorer arithmetic skills. To summarize, our results show persistent visual N1 sensitivity to digits that is already present early on in pre-school and remains stable until fifth grade. This pattern of digit sensitivity development clearly differs from the relatively sharp rise and fall of the visual N1 sensitivity to words or letters between kindergarten and middle of elementary school and suggests unique developmental trajectories for visual processing of written characters that are relevant to numeracy and literacy.

Neural processing of vision and language in kindergarten is associated with prereading skills and predicts future literacy

The main objective of this longitudinal study was to investigate the neural predictors of reading acquisition. For this purpose, we followed a sample of 54 children from the end of kindergarten to the end of second grade. Preliterate children were tested for visual symbol (checkerboards, houses, faces, written words) and auditory language processing (spoken words) using a passive functional magnetic resonance imaging paradigm. To examine brain-behavior relationships, we also tested cognitive-linguistic prereading skills at kindergarten age and reading performance of 48 of the same children 2 years later. Face-selective response in the bilateral fusiform gyrus was positively associated with rapid automatized naming (RAN). Response to both spoken and written words at preliterate age was negatively associated with RAN in the dorsal temporo-parietal language system. Longitudinally, neural response to faces in the ventral stream predicted future reading fluency. Here, stronger neural activity in inferior and middle temporal gyri at kindergarten age was associated with higher reading performance. Our results suggest that interindividual differences in the neural system of language and reading affect literacy acquisition and thus might serve as a marker for successful reading acquisition in preliterate children.

Network topology of symbolic and nonsymbolic number comparison

Studies of brain activity during number processing suggest symbolic and nonsymbolic numerical stimuli (e.g., Arabic digits and dot arrays) engage both shared and distinct neural mechanisms. However, the extent to which number format influences large-scale functional network organization is unknown. In this study, using 7 Tesla MRI, we adopted a network neuroscience approach to characterize the whole-brain functional architecture supporting symbolic and nonsymbolic number comparison in 33 adults. Results showed the degree of global modularity was similar for both formats. The symbolic format, however, elicited stronger community membership among auditory regions, whereas for nonsymbolic, stronger membership was observed within and between cingulo-opercular/salience network and basal ganglia communities. The right posterior inferior temporal gyrus, left intraparietal sulcus, and two regions in the right ventromedial occipital cortex demonstrated robust differences between formats in terms of their community membership, supporting prior findings that these areas are differentially engaged based on number format. Furthermore, a unified fronto-parietal/dorsal attention community in the nonsymbolic condition was fractionated into two components in the symbolic condition. Taken together, these results reveal a pattern of overlapping and distinct network architectures for symbolic and nonsymbolic number processing.

Shared Numerosity Representations Across Formats and Tasks Revealed with 7 Tesla fMRI: Decoding, Generalization, and Individual Differences in Behavior

Debate continues on whether encoding of symbolic number is grounded in nonsymbolic numerical magnitudes. Nevertheless, fluency of perceiving both number formats, and translating between them, predicts math skills across the life span. Therefore, this study asked if numbers share cortical activation patterns across formats and tasks, and whether neural response to number predicts math-related behaviors. We analyzed patterns of neural activation using 7 Tesla functional magnetic resonance imaging in a sample of 39 healthy adults. Discrimination was successful between numerosities 2, 4, 6, and 8 dots and generalized to activation patterns of the same numerosities represented as Arabic digits in the bilateral parietal lobes and left inferior frontal gyrus (IFG) (and vice versa). This indicates that numerosity-specific neural resources are shared between formats. Generalization was also successful across tasks where participants either identified or compared numerosities in bilateral parietal lobes and IFG. Individual differences in decoding did not relate to performance on a number comparison task completed outside of the scanner, but generalization between formats and across tasks negatively related to math achievement in the parietal lobes. Together, these findings suggest that individual differences in representational specificity within format and task contexts relate to mathematical expertise.

Investigating the visual number form area: a replication study

The influential triple-code model of number representation proposed that there are three distinct brain regions for three different numerical representations: verbal words, visual digits and abstract magnitudes. It was hypothesized that the region for visual digits, known as the number form area, would be in ventral occipitotemporal cortex (vOTC), near other visual category-specific regions, such as the visual word form area. However, neuroimaging investigations searching for a region that responds in a category-specific manner to the visual presentation of number symbols have yielded inconsistent results. Price & Ansari (Price, Ansari 2011 Neuroimage 57, 1205-1211) investigated whether any regions activated more in response to passively viewing digits in contrast with letters and visually similar nonsense symbols and identified a region in the left angular gyrus. By contrast, Grotheer et al. (Grotheer, Herrmann, Kovács 2016 J. Neurosci. 36, 88-97) found bilateral regions in vOTC which were more activated in response to digits than other stimuli categories while performing a one-back task. In the current study, we aimed to replicate the findings reported in Grotheer et al. with Price & Ansari's passive viewing task as this is the most stringent test of bottom-up, sensory-driven, category-specific perception. Moreover, we used the contrasts reported in both papers in order to test whether the discrepancy in findings could be attributed to the difference in analysis.