Bilateral hemispheric processing of words and faces: evidence from word impairments in prosopagnosia and face impairments in pure alexia

Disentangling developmental prosopagnosia: A scoping review of terms, tools and topics

The goal of this preregistered scoping review is to create an overview of the research on developmental prosopagnosia (DP). Through analysis of all empirical studies of DP in adults, we investigate 1) how DP is conceptualized and defined, 2) how individuals are classified with DP and 3) which aspects of DP are investigated in the literature. We reviewed 224 peer-reviewed studies of DP. Our analysis of the literature reveals that while DP is predominantly defined as a lifelong face recognition impairment in the absence of acquired brain injury and intellectual/cognitive problems, there is far from consensus on the specifics of the definition with some studies emphasizing e.g., deficits in face perception, discrimination and/or matching as core characteristics of DP. These differences in DP definitions is further reflected in the vast heterogeneity in classification procedures. Only about half of the included studies explicitly state how they classify individuals with DP, and these studies adopt 40 different assessment tools. The two most frequently studied aspects of DP are the role of holistic processing and the specificity of face processing, and alongside a substantial body of neuroimaging studies of DP, this paints a picture of a research field whose scientific interests and aims are rooted in cognitive neuropsychology and neuroscience. We argue that these roots - alongside the heterogeneity in DP definition and classification - may have limited the scope and interest of DP research unnecessarily, and we point to new avenues of research for the field.

Cortical and Subcortical Mechanisms of Orthographic Word-form Learning

We examined the initial stages of orthographic learning in real time as literate adults learned spellings for spoken pseudowords during fMRI scanning. Participants were required to learn and store orthographic word forms because the pseudoword spellings were not uniquely predictable from sound to letter mappings. With eight learning trials per word form, we observed changes in the brain's response as learning was taking place. Accuracy was evaluated during learning, immediately after scanning, and 1 week later. We found evidence of two distinct learning systems-hippocampal and neocortical-operating during orthographic learning, consistent with the predictions of dual systems theories of learning/memory such as the complementary learning systems framework [McClelland, J. L., McNaughton, B. L., & O'Reilly, R. C. Why there are complementary learning systems in the hippocampus and neocortex: Insights from the successes and failures of connectionist models of learning and memory. Psychological Review, 102, 419-457, 1995]. The bilateral hippocampus and the visual word form area (VWFA) showed significant BOLD response changes over learning, with the former exhibiting a rising pattern and the latter exhibiting a falling pattern. Moreover, greater BOLD signal increase in the hippocampus was associated with better postscan recall. In addition, we identified two distinct bilateral brain networks that mirrored the rising and falling patterns of the hippocampus and VWFA. Functional connectivity analysis revealed that regions within each network were internally synchronized. These novel findings highlight, for the first time, the relevance of multiple learning systems in orthographic learning and provide a paradigm that can be used to address critical gaps in our understanding of the neural bases of orthographic learning in general and orthographic word-form learning specifically.

Functional Resilience of the Neural Visual Recognition System Post-Pediatric Occipitotemporal Resection

In the typically developing (TD) brain, neural representations for visual stimulus categories (e.g., faces, objects, and words) emerge in bilateral occipitotemporal cortex (OTC), albeit with weighted asymmetry; in parallel, recognition behavior continues to be refined. A fundamental question is whether two hemispheres are necessary or redundant for the emergence of neural representations and recognition behavior typically distributed across both hemispheres. The rare population of patients undergoing unilateral OTC resection in childhood offers a unique opportunity to evaluate whether neural computations for visual stimulus individuation suffice for recognition with only a single developing OTC. Here, using functional magnetic resonance imaging, we mapped category selectivity (CS) and neural representations for individual stimulus exemplars using repetition suppression (RS) in the non-resected hemisphere of pediatric OTC resection patients (n = 9) and control patients with resection outside of OTC (n = 12), as well as in both hemispheres of TD controls (n = 21). There were no univariate group differences in the magnitude of CS or RS or any multivariate differences (per representational similarity analysis) in neural activation to faces, objects, or words across groups. Notwithstanding their comparable neural profiles, accuracy of OTC resection patients on face and object recognition, but not word recognition, was statistically inferior to that of controls. The comparable neural signature of the OTC resection patients' preserved hemisphere and the other two groups highlights the resilience of the system following damage to the contralateral homologue. Critically, however, a single OTC does not suffice for normal behavior, and, thereby, implicates the necessity for two hemispheres.

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

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

Holistic processing and face expertise after pediatric resection of occipitotemporal cortex

The nature and extent of hemispheric lateralization and its potential for reorganization continues to be debated, although there is general agreement that there is a right hemisphere (RH) advantage for face processing in human adults. Here, we examined face processing and its lateralization in individuals with a single preserved occipitotemporal cortex (OTC), either in the RH or left hemisphere (LH), following early childhood resection for the management of drug-resistant epilepsy. The matched controls and those with a lesion outside of OTC evinced the standard superiority in processing upright over inverted faces and the reverse sensitivity to a nonface category (bicycles). In contrast, the LH and the RH patient groups were significantly less accurate than the controls and showed mild orientation sensitivities at best (and not always in the predicted directions). For the two patient groups, the accuracies of face and bicycle processing did not differ from each other and were not obviously related to performance on intermediate level global form tasks with, again, poorer thresholds for both patient groups than controls and no difference between the patient groups. These findings shed light on the complexity of hemispheric lateralization and face and nonface object processing in individuals following surgical resection of OTC. Overall, this study highlights the unique dynamics and potential for plasticity in those with childhood cortical resection.

From Perugino to Picasso revisited: Electrophysiological responses to faces in paintings from different art styles

Behavioral research (Ventura, et al., 2023) suggested that pictorial representations of faces varying along a realism-distortion spectrum elicit holistic processing as natural faces. Whether holistic face neural responses are engaged similarly remains, however, underexplored. In the present study, we evaluated the neural correlates of naturalist and artistic face processing, by exploring electrophysiological responses to faces in photographs versus in four major painting styles. The N170 response to faces in photographs was indistinguishable from that elicited by faces in the renaissance art style (depicting the most realistic faces), whilst both categories elicited larger N170 than faces in other art styles (post-impressionism, expressionism, and cubism), with a gradation in brain activity. The present evidence suggest that visual processing may become finer grained the more the realistic nature of the face. Despite behavioral equivalence, the neural mechanisms for holistic processing of natural faces and faces in diverse art styles are not equivalent.

A new approach to diagnosing and researching developmental prosopagnosia: Excluded cases are impaired too

Developmental prosopagnosia is characterized by severe, lifelong difficulties when recognizing facial identity. Unfortunately, the most common diagnostic assessment (Cambridge Face Memory Test) misses 50-65% of individuals who believe that they have this condition. This results in such excluded cases' absence from scientific knowledge, effect sizes of impairment potentially overestimated, treatment efficacy underrated, and may elicit in them a negative experience of research. To estimate their symptomology and group-level impairments in face processing, we recruited a large cohort who believes that they have prosopagnosia. Matching prior reports, 56% did not meet criteria on the Cambridge Face Memory Test. However, the severity of their prosopagnosia symptoms and holistic perception deficits were comparable to those who did meet criteria. Excluded cases also exhibited face perception and memory impairments that were roughly one standard deviation below neurotypical norms, indicating the presence of objective problems. As the prosopagnosia index correctly classified virtually every case, we propose it should be the primary method for providing a diagnosis, prior to subtype categorization. We present researchers with a plan on how they can analyze these excluded prosopagnosia cases in their future work without negatively impacting their traditional findings. We anticipate such inclusion will enhance scientific knowledge, more accurately estimate effect sizes of impairments and treatments, and identify commonalities and distinctions between these different forms of prosopagnosia. Owing to their atypicalities in visual perception, we recommend that the prosopagnosia index should be used to screen out potential prosopagnosia cases from broader vision research.

Faces, English words and Chinese characters: a study of dual-task interference in mono-and bilingual speakers

The many-to-many hypothesis suggests that face and visual-word processing tasks share neural resources in the brain, even though they show opposing hemispheric asymmetries in neuroimaging and neuropsychologic studies. Recently it has been suggested that both stimulus and task effects need to be incorporated into the hypothesis. A recent study found dual-task interference between face and text functions that lateralized to the same hemisphere, but not when they lateralized to different hemispheres. However, it is not clear whether a lack of interference between word and face recognition would occur for other languages, particularly those with a morpho-syllabic script, like Chinese, for which there is some evidence of greater right hemispheric involvement. Here, we used the same technique to probe for dual-task interference between English text, Chinese characters and face recognition. We tested 20 subjects monolingual for English and 20 subjects bilingual for Chinese and English. We replicated the prior result for English text and showed similar results for Chinese text with no evidence of interference with faces. We also did not find interference between Chinese and English text. The results support a view in which reading English words, reading Chinese characters and face identification have minimal sharing of neural resources.

Decoding semantic representations in mind and brain

A key goal for cognitive neuroscience is to understand the neurocognitive systems that support semantic memory. Recent multivariate analyses of neuroimaging data have contributed greatly to this effort, but the rapid development of these novel approaches has made it difficult to track the diversity of findings and to understand how and why they sometimes lead to contradictory conclusions. We address this challenge by reviewing cognitive theories of semantic representation and their neural instantiation. We then consider contemporary approaches to neural decoding and assess which types of representation each can possibly detect. The analysis suggests why the results are heterogeneous and identifies crucial links between cognitive theory, data collection, and analysis that can help to better connect neuroimaging to mechanistic theories of semantic cognition.

Dysfunctions associated with the intraparietal sulcus and a distributed network in individuals with math learning difficulties: An ALE meta-analysis

Math learning difficulty (MLD) is a learning disorder characterized by persistent impairments in the understanding and application of numbers independent of intelligence or schooling. The current study aims to review existing neuroimaging studies to characterize the neurobiological basis in MLD for their quantity and arithmetic dysfunctions. We identified a total of 24 studies with 728 participants through the literature. Using the activation likelihood estimate (ALE) method, we found that the most consistent neurobiological dysfunction in MLD was observed in the right intraparietal sulcus (IPS) with distinct patterns of the anterior and posterior aspects. Meanwhile, neurobiological dysfunctions were also observed in a distributed network including the fusiform gyrus, inferior temporal gyrus, insula, prefrontal cortex, anterior cingulate cortex, and claustrum. Our results suggest a core dysfunction in the right anterior IPS and left fusiform gyrus with atypically upregulated functions in brain regions for attention, working memory, visual processing, and motivation, serving as the neurobiological basis of MLD.

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.

Face familiarity revealed by fixational eye movements and fixation-related potentials in free viewing

Event-related potentials (ERPs) and the oculomotor inhibition (OMI) in response to visual transients are known to be sensitive to stimulus properties, attention, and expectation. We have recently found that the OMI is also sensitive to face familiarity. In natural vision, stimulation of the visual cortex is generated primarily by saccades, and it has been recently suggested that fixation-related potentials (FRPs) share similar components with the ERPs. Here, we investigated whether FRPs and microsaccade inhibition (OMI) in free viewing are sensitive to face familiarity. Observers freely watched a slideshow of seven unfamiliar and one familiar facial images presented randomly for 4-s periods, with multiple images per identity. We measured the occipital fixation-related N1 relative to the P1 magnitude as well as the associated fixation-triggered OMI. We found that the average N1-P1 was significantly smaller and the OMI was shorter for the familiar face, compared with any of the seven unfamiliar faces. Moreover, the P1 was suppressed across saccades for the familiar but not for the unfamiliar faces. Our results highlight the sensitivity of the occipital FRPs to stimulus properties such as face familiarity and advance our understanding of the integration process across successive saccades in natural vision.

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

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

With childhood hemispherectomy, one hemisphere can support—but is suboptimal for—word and face recognition

The right and left cerebral hemispheres are important for face and word recognition, respectively—a specialization that emerges over human development. The question is whether this bilateral distribution is necessary or whether a single hemisphere, be it left or right, can support both face and word recognition. Here, face and word recognition accuracy in patients (median age 16.7 y) with a single hemisphere following childhood hemispherectomy was compared against matched typical controls. In experiment 1, participants viewed stimuli in central vision. Across both face and word tasks, accuracy of both left and right hemispherectomy patients, while significantly lower than controls' accuracy, averaged above 80% and did not differ from each other. To compare patients' single hemisphere more directly to one hemisphere of controls, in experiment 2, participants viewed stimuli in one visual field to constrain initial processing chiefly to a single (contralateral) hemisphere. Whereas controls had higher word accuracy when words were presented to the right than to the left visual field, there was no field/hemispheric difference for faces. In contrast, left and right hemispherectomy patients, again, showed comparable performance to one another on both face and word recognition, albeit significantly lower than controls. Altogether, the findings indicate that a single developing hemisphere, either left or right, may be sufficiently plastic for comparable representation of faces and words. However, perhaps due to increased competition or “neural crowding,” constraining cortical representations to one hemisphere may collectively hamper face and word recognition, relative to that observed in typical development with two hemispheres.

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

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

Context-sensitive computational mechanistic explanation in cognitive neuroscience

Mainstream cognitive neuroscience aims to build mechanistic explanations of behavior by mapping abilities described at the organismal level via the subpersonal level of computation onto specific brain networks. We provide an integrative review of these commitments and their mismatch with empirical research findings. Context-dependent neural tuning, neural reuse, degeneracy, plasticity, functional recovery, and the neural correlates of enculturated skills each show that there is a lack of stable mappings between organismal, computational, and neural levels of analysis. We furthermore highlight recent research suggesting that task context at the organismal level determines the dynamic parcellation of functional components at the neural level. Such instability prevents the establishment of specific computational descriptions of neural function, which remains a central goal of many brain mappers - including those who are sympathetic to the notion of many-to-many mappings between organismal and neural levels. This between-level instability presents a deep epistemological challenge and requires a reorientation of methodological and theoretical commitments within cognitive neuroscience. We demonstrate the need for change to brain mapping efforts in the face of instability if cognitive neuroscience is to maintain its central goal of constructing computational mechanistic explanations of behavior; we show that such explanations must be contextual at all levels.

The Relationship Between Attention, Interpretation, and Memory Bias During Facial Perception in Social Anxiety

Although cognitive theories suggest the interactive nature of information processing biases in contributing to social anxiety, most studies to date have investigated these biases in isolation. This study aimed at (a) testing the association between social anxiety and each of the threat-related cognitive biases: attention, interpretation, and memory bias; and (b) examining the relationship between these cognitive biases in facial perception. We recruited an unselected sample of 188 adult participants and measured their level of social anxiety and cognitive biases using faces displaying angry, disgusted, happy, and ambiguous versions of these expressions. All bias tasks were assessed with the same set of facial stimuli. Regression analyses showed that social anxiety symptoms significantly predicted attention avoidance and poorer sensitivity in recognizing threatening faces. Social anxiety was, however, unrelated to interpretation bias in our sample. Results of path analysis suggested that attention bias influenced memory bias indirectly through interpretation bias for angry but not disgusted faces. Our findings suggest that, regardless of social anxiety level, when individuals selectively oriented to faces displaying anger, the faces were interpreted to be more negative. This, in turn, predicted better memory for the angry faces. The results provided further empirical support for the combined cognitive bias hypothesis.

Altered Intrinsic Regional Spontaneous Brain Activity in Patients With Severe Obesity and Meibomian Gland Dysfunction: A Resting-State Functional Magnetic Resonance Imaging Study

Purpose

To evaluate potential regional homogeneity (ReHo) cerebrum function lesions in people with severe obesity and meibomian gland dysfunction (SM) and probe the connection between aberrant cerebrum activity and clinical manifestations.

Patients and Methods

An aggregation of 12 patients with SM, and 12 healthy controls (HCs) closely matched in age and gender were enrolled. We applied corneal confocal microscopy and fundus angiography to compare imaging distinctions between the two groups. SMs were required to carefully fill out the Hospital Anxiety Depression Scale (HADS) forms, and a correlation analysis was performed. ReHo was also utilized to appraise partial differences in spontaneous cerebrum function. Receiver operating characteristic (ROC) curves were created to partition ReHo values between patients with SM and the HCs.

Results

ReHo values for the left cerebellum (LC), right fusiform gyrus (RFG), left inferior temporal gyrus (LITG), left rectus gyrus (LRG), right thalamus (RT), right caudate (RC), left insula (LI), and left thalamus (LT) of subjects with SM were notably higher than those of the HCs (P < 0.05). ReHo values of the right middle frontal gyrus (RMFG) in subjects with SM were decreased notably compared to the HCs (P < 0.05). ReHo values for the RMFG showed a negative correlation with the anxiety scores (ASs; r = −0.961, P < 0.001) and ReHo values for the RFG showed a positive correlation with the depression scores (DSs; r = 0.676, P = 0.016). The areas under the ROC curve were 1.000 (P < 0.001) for the RMFG, LC, LITG, LRG, RC, LI, and LT and 0.993 (P < 0.001) for the RFG and RT. The results from the ROC curve analysis indicated that changes in the ReHo values of some brain regions may help diagnose SM.

Conclusion

Our research emphasized that patients with SM had lesions in synchronized neural activity in many encephalic areas. Our discoveries may provide beneficial information for exploring the neuromechanics of SM.

Shallow or deep? The impact of orthographic depth on visual processing impairments in developmental dyslexia

The extent to which impaired visual and phonological mechanisms may contribute to the manifestation of developmental dyslexia across orthographies of varying depth has yet to be fully established. By adopting a cross-linguistic approach, the current study aimed to explore the nature of visual and phonological processing in developmental dyslexic readers of shallow (Italian) and deep (English) orthographies, and specifically the characterisation of visual processing deficits in relation to orthographic depth. To achieve this aim, we administered a battery of non-reading visual and phonological tasks. Developmental dyslexics performed worse than typically developing readers on all visual and phonological tasks. Critically, readers of the shallow orthography were disproportionately impaired on visual processing tasks. Our results suggest that the impaired reading and associated deficits observed in developmental dyslexia are anchored by dual impairments to visual and phonological mechanisms that underpin reading, with the magnitude of the visual deficit varying according to orthographic depth.

Lateralization of word and face processing in developmental dyslexia and developmental prosopagnosia

In right-handed adults, face processing is lateralized to the right hemisphere and visual word processing to the left hemisphere. According to the many-to-many account (MTMA) of functional cerebral organization this lateralization pattern is partly dependent on the acquisition of literacy. Hence, the MTMA predicts that: (i) processing of both words and faces should show no or at least less lateralization in individuals with developmental dyslexia compared with controls, and (ii) lateralization in word processing should be normal in individuals with developmental prosopagnosia whereas lateralization in face processing should be absent. To test these hypotheses, 21 right-handed adults with developmental dyslexia and 21 right-handed adults with developmental prosopagnosia performed a divided visual field paradigm with delayed matching of faces, words and cars. Contrary to the predictions, we find that lateralization effects in face processing are within the normal range for both developmental dyslexics and prosopagnosics. Moreover, the group with developmental dyslexia showed right hemisphere lateralization for word processing. We argue that these findings are incompatible with the specific predictions of the MTMA.

The spatiotemporal characteristics of N170s for faces and words: A meta-analysis study

N170 is a negative event-related potential (ERP) component in response to visual stimuli, such as faces. It remains controversial whether N170 reflects the specific processing of faces or can also be elicited by objects of expertise (e.g., words). In this research, we conducted a meta-analysis for the spatiotemporal characteristics of N170 of face and word stimuli from 24 studies in which both stimuli were presented for each subject. We observed that (1) both face and word stimuli can elicit conspicuous N170s and that there was no difference between the amplitude of face-N170 and word-N170; (2) there is no difference in the latencies between the two N170s; and (3) both N170s are distributed in the occipitotemporal regions but with a reversed hemispheric distribution pattern-face-N170 is more negative in the right than left occipitotemporal regions, while word-N170 is the opposite. These results showed that the face- and word-N170s are qualitatively the same but have different hemispheric lateralization advantages-N170 might be a general neural index of the expertise-dependent object-recognition process in occipitotemporal regions.

Holistic processing of faces and words predicts reading accuracy and speed in dyslexic readers

We compared the performance of dyslexic and typical readers on two perceptual tasks, the Vanderbilt Holistic Face Processing Task and the Holistic Word Processing Task. Both yield a metric of holistic processing that captures the extent to which participants automatically attend to information that is spatially nearby but irrelevant to the task at hand. Our results show, for the first time, that holistic processing of faces is comparable in dyslexic and typical readers but that dyslexic readers show greater holistic processing of words. Remarkably, we show that these metrics predict the performance of dyslexic readers on a standardized reading task, with more holistic processing in both tasks associated with higher accuracy and speed. In contrast, a more holistic style on the words task predicts less accurate reading of both words and pseudowords for typical readers. We discuss how these findings may guide our conceptualization of the visual deficit in dyslexia.

Dissociated face- and word-selective intracerebral responses in the human ventral occipito-temporal cortex

The extent to which faces and written words share neural circuitry in the human brain is actively debated. Here, we compare face-selective and word-selective responses in a large group of patients (N = 37) implanted with intracerebral electrodes in the ventral occipito-temporal cortex (VOTC). Both face-selective (i.e., significantly different responses to faces vs. non-face visual objects) and word-selective (i.e., significantly different responses to words vs. pseudofonts) neural activity is isolated with frequency-tagging. Critically, this sensitive approach allows to objectively quantify category-selective neural responses and disentangle them from general visual responses. About 70% of significant electrode contacts show either face-selectivity or word-selectivity only, with the expected right and left hemispheric dominance, respectively. Spatial dissociations are also found within core regions of face and word processing, with a medio-lateral dissociation in the fusiform gyrus (FG) and surrounding sulci, respectively. In the 30% of overlapping face- and word-selective contacts across the VOTC or in the FG and surrounding sulci, between-category-selective amplitudes (faces vs. words) show no-to-weak correlations, despite strong correlations in both the within-category-selective amplitudes (face-face, word-word) and the general visual responses to words and faces. Overall, these observations support the view that category-selective circuitry for faces and written words is largely dissociated in the human adult VOTC.

Music-reading expertise associates with face but not Chinese character processing ability

A growing number of behavioural and neuroimaging studies have investigated the cognitive mechanisms and neural substrates underlying various forms of visual expertise, such as face and word processing. However, it remains poorly understood whether and to what extent the acquisition of one form of expertise would be associated with that of another. The current study examined the relationship between music-reading expertise and face and Chinese character processing abilities. In a series of experiments, music experts and novices performed discrimination and recognition tasks of musical notations, faces, and words. Results consistently showed that musical experts responded more accurately to musical notations and faces, but not to words, than did musical novices. More intriguingly, the music expert's age of training onset could well predict their face but not word processing performance: the earlier musical experts began musical notation reading, the better their face processing performance. Taken together, our findings provide preliminary and converging evidence that music-reading expertise links with face, but not word, processing, and lend support to the notion that the development of different types of visual expertise may not be independent, but rather interact with each other during their acquisition.

Word Detection in Individual Subjects Is Difficult to Probe With Fast Periodic Visual Stimulation

Measuring cognition in single subjects presents unique challenges. On the other hand, individually sensitive measurements offer extraordinary opportunities, from informing theoretical models to enabling truly individualised clinical assessment. Here, we test the robustness of fast, periodic, and visual stimulation (FPVS), an emerging method proposed to elicit detectable responses to written words in the electroencephalogram (EEG) of individual subjects. The method is non-invasive, passive, and requires only a few minutes of testing, making it a potentially powerful tool to test comprehension in those who do not speak or who struggle with long testing procedures. In an initial study, Lochy et al. (2015) used FPVS to detect word processing in eight out of 10 fluent French readers. Here, we attempted to replicate their study in a new sample of 10 fluent English readers. Participants viewed rapid streams of pseudo-words with words embedded at regular intervals, while we recorded their EEG. Based on Lochy et al. (2015) we expected that words would elicit a steady-state response at the word-presentation frequency (2 Hz) over parieto-occipital electrode sites. However, across 40 datasets (10 participants, two conditions, and two regions of interest–ROIs), only four datasets met the criteria for a unique response to words. This corresponds to a 10% detection rate. We conclude that FPVS should be developed further before it can serve as an individually-sensitive measure of written word processing.

Category-selective deficits are the exception and not the rule: Evidence from a case-series of 64 patients with ventral occipito-temporal cortex damage

The organisational principles of the visual ventral stream are still highly debated, particularly the relative association/dissociation between word and face recognition and the degree of lateralisation of the underlying processes. Reports of dissociations between word and face recognition stem from single case-studies of category selective impairments, and neuroimaging investigations of healthy participants. Despite the historical reliance on single case-studies, more recent group studies have highlighted a greater commonality between word and face recognition. Studying individual patients with rare selective deficits misses (a) important variability between patients, (b) systematic associations between task performance, and (c) patients with mild, severe and/or non-selective impairments; meaning that the full spectrum of deficits is unknown. The Back of the Brain project assessed the range and specificity of visual perceptual impairment in 64 patients with posterior cerebral artery stroke recruited based on lesion localization and not behavioural performance. Word, object, and face processing were measured with comparable tests across different levels of processing to investigate associations and dissociations across domains. We present two complementary analyses of the extensive behavioural battery: (1) a data-driven analysis of the whole patient group, and (2) a single-subject case-series analysis testing for deficits and dissociations in each individual patient. In both analyses, the general organisational principle was of associations between words, objects, and faces even following unilateral lesions. The majority of patients either showed deficits across all domains or in no domain, suggesting a spectrum of visuo-perceptual deficits post stroke. Dissociations were observed, but they were the exception and not the rule: Category-selective impairments were found in only a minority of patients, all of whom showed disproportionate deficits for words. Interestingly, such selective word impairments were found following both left and right hemisphere lesions. This large-scale investigation of posterior cerebral artery stroke patients highlights the bilateral representation of visual perceptual function.

Patterns of perceptual performance in developmental prosopagnosia: An in-depth case series

Developmental prosopagnosia (DP) is a syndrome characterized by lifelong impairment in face recognition in the absence of brain damage. A key question regarding DP concerns which process(es) might be affected to selectively/disproportionally impair face recognition. We present evidence from a group of DPs, combining an overview of previous results with additional analyses important for understanding their pattern of preserved and impaired perceptual abilities. We argue that for most of these individuals, the common denominator is a deficit in (rapid) processing of global shape information. We conclude that the deficit in this group of DPs is not face-selective, but that it may appear so because faces are more visually similar-and recognized at a more fine-grained level-than objects. Indeed, when the demand on perceptual differentiation and visual similarity are held constant for faces and objects, we find no evidence for a disproportionate deficit for faces in this group of DPs.

Reading and alexia

Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In neuropsychology, a distinction is made between central alexia (commonly seen in aphasia) and peripheral alexia (a perceptual or attentional deficit). The prototypical peripheral alexia is alexia without agraphia (pure alexia), where patients can write but are impaired in reading words and letters. Pure alexia is associated with damage to the left ventral occipitotemporal cortex (vOT) or its connections. Hemianopic alexia is associated with less extensive occipital damage and is caused by a visual field defect, which creates problems reading longer words and passages of text. Reading impairment can also arise due to attentional deficits, most commonly following right hemisphere or bilateral lesions. Studying patients with alexia, along with functional imaging studies of normal readers, has improved our understanding of the neurobiological processes involved in reading. A key question is whether an area in the left ventral occipitotemporal cortex is specialized for or selectively involved in word processing, or whether reading relies on tuning of more general purpose perceptual areas. Reading deficits may also be observed in dementia and traumatic brain injury, but often with less consistent deficit patterns than in patients with focal lesions.

Investigation of Changes in Retinal Detachment-Related Brain Region Activities and Functions Using the Percent Amplitude of Fluctuation Method: A Resting-State Functional Magnetic Resonance Imaging Study

PURPOSE

The percent amplitude of fluctuation (PerAF) method was used to study the changes in neural activities and functions in specific brain regions of patients with a retinal detachment (RD).

PATIENTS AND METHODS

In this study, we recruited 15 RD patients (nine males and six females) and 15 healthy controls (HCs) matched for gender, age, and weight. All participants were scanned with resting functional magnetic resonance imaging (rs-fMRI). The PerAF method was then used for data analysis to evaluate and detect changes in neural activity in relevant brain regions. Receiver operating characteristic (ROC) curve analysis was used to evaluate the two groups.

RESULTS

The PerAF signal values of the right fusiform gyrus and the left inferior temporal gyrus of RD patients were significantly higher than those of HCs. This may indicate changes in neural activity and function in the related brain regions. The anxiety and depression scores of hospital anxiety and depression scale (HADS) and the durations in RD patients were positively correlated with the PerAF values of the left inferior temporal gyrus.

CONCLUSION

In this study, we demonstrated that there were significant changes in the PerAF values in specific areas of the brain in patients with RD. The change of PerAF values represent the changes of BOLD signal intensity, which reflect the hyperactivity or weakening of specific brain regions in RD patients, which are helpful to predict the development and prognosis of RD patients, and play an important role in the early diagnosis of RD. In addition, according to the results, changes in neural activity in specific brain regions of RD patients increase the risk of brain dysfunction related diseases, which may help to understand the pathological mechanism of vision loss in RD patients.

Face recognition in developmental dyslexia: evidence for dissociation between faces and words

Developmental dyslexia is primarily a reading disorder, but recent studies have indicated that face processing problems may also be present. Using a case-series approach, we tested face recognition and visual word recognition in 24 high school students diagnosed with developmental dyslexia. Contrary to previous findings, no face recognition problems were found on the group-level. Rather, a significant classical dissociation with impaired word reading and normal face recognition was demonstrated on a group-level and for six individuals with developmental dyslexia. However, four individuals with dyslexia did show face recognition problems. Thus, while problems in face recognition can be present in developmental dyslexia, the dissociation strongly suggests that face recognition can also be preserved. Combined with previously reported dissociations between face and word recognition in developmental prosopagnosia, this constitutes a double dissociation.

Alternating dual-task interference between visual words and faces

The many-to-many hypothesis proposes that face and visual word recognition share and even compete for high-level perceptual resources in both hemispheres. However, it is still not clear whether the processing performed by the two hemispheres on faces and visual words is equivalent or complementary. We performed an alternating dual-task experiment to determine if the processing of visual words and faces interfered with each other, and if such interference depended upon the stimulus attribute being processed. Subjects saw a series of alternating stimuli and made same-different judgments comparing the current stimulus with the one two trials before. In some blocks faces or visual words alternated with colored gratings, in other blocks they alternated between different sets of words or different sets of faces. In the key experimental blocks they alternated between visual words and faces. Subjects were also asked to focus on different properties of the stimuli (identity or speech sounds for faces, handwriting or word content for visual words, color or orientation for gratings). There was no evidence of specific interference when subjects alternated between face and word attributes thought to be processed by opposite hemispheres (e.g. face identity and word identity, facial speech and handwriting). Rather interference occurred when subjects alternated between attributes that may be processed by the same hemisphere. The results support a modified version of the many-to-many hypothesis which takes into account complementary functions of the left and the right hemispheres in the processing of faces and visual words.

Altered large-scale organization of shape processing in visual agnosia

Recent findings suggest that both dorsal and ventral visual pathways process shape information. Nevertheless, a lesion to the ventral pathway alone can result in visual agnosia, an impairment in shape perception. Here, we explored the neural basis of shape processing in a patient with visual agnosia following a circumscribed right hemisphere ventral lesion and evaluated longitudinal changes in the neural profile of shape representations. The results revealed a reduction of shape sensitivity slopes along the patient's right ventral pathway and a similar reduction in the contralesional left ventral pathway. Remarkably, posterior parts of the dorsal pathway bilaterally also evinced a reduction in shape sensitivity. These findings were similar over a two-year interval, revealing that a focal cortical lesion can lead to persistent large-scale alterations of the two visual pathways. These alterations are consistent with the view that a distributed network of regions contributes to shape perception.

Selective defects of face familiarity associated to a left temporo-occipital lesion

Acquired prosopagnosia is usually a consequence of bilateral or right hemisphere lesions and is often associated with topographical disorientation and dyschromatopsia. Left temporo-occipital lesions sometimes result in a face recognition disorder but in a context of visual object agnosia with spared familiarity feelings for faces, usually in left-handers. We describe a patient with a left temporo-occipital hemorrhagic lesion unexpectedly resulting in a deficit of face familiarity, which could represent a mild form of associative prosopagnosia. Our patient failed to feel familiarity feelings even with very well-known famous faces but had neither visual object agnosia nor defects with semantics or naming of celebrities. This was confirmed even when the patient was re-tested a year later. We speculate that a graded lateralization of face processing could be at the basis of occasional cases of prosopagnosia.

Time to Face Language: Embodied Mechanisms Underpin the Inception of Face-Related Meanings in the Human Brain

In construing meaning, the brain recruits multimodal (conceptual) systems and embodied (modality-specific) mechanisms. Yet, no consensus exists on how crucial the latter are for the inception of semantic distinctions. To address this issue, we combined electroencephalographic (EEG) and intracranial EEG (iEEG) to examine when nouns denoting facial body parts (FBPs) and nonFBPs are discriminated in face-processing and multimodal networks. First, FBP words increased N170 amplitude (a hallmark of early facial processing). Second, they triggered fast (~100 ms) activity boosts within the face-processing network, alongside later (~275 ms) effects in multimodal circuits. Third, iEEG recordings from face-processing hubs allowed decoding ~80% of items before 200 ms, while classification based on multimodal-network activity only surpassed ~70% after 250 ms. Finally, EEG and iEEG connectivity between both networks proved greater in early (0–200 ms) than later (200–400 ms) windows. Collectively, our findings indicate that, at least for some lexico-semantic categories, meaning is construed through fast reenactments of modality-specific experience.

Investigating face and house discrimination at foveal to parafoveal locations reveals category-specific characteristics

Since perceptual and neural face sensitivity is associated with a foveal bias, and neural place sensitivity is associated with a peripheral bias (integration over space), we hypothesized that face perception ability will decline more with eccentricity than place perception ability. We also wanted to examine whether face perception ability would show a left visual field (LeVF) bias due to earlier reports suggesting right hemisphere dominance for faces, or would show an upper or lower visual field bias. Participants performed foveal and parafoveal face and house discrimination tasks for upright or inverted stimuli (≤4°) while their eye movements were monitored. Low-level visual tasks were also measured. The eccentricity-related accuracy reductions were evident for all categories. Through detailed analyses we found (i) a robust face inversion effect across the parafovea, while for houses an opposite effect was found, (ii) higher eccentricity-related sensitivity for face performance than for house performance (via inverted vs. upright within-category eccentricity-driven reductions), (iii) within-category but not across-category performance associations across eccentricities, and (iv) no hemifield biases. Our central to parafoveal investigations suggest that high-level vision processing may be reflected in behavioural performance.

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

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

Left hemisphere abnormalities in developmental prosopagnosia when looking at faces but not words

Developmental prosopagnosia is a disorder characterized by profound and lifelong difficulties with face recognition in the absence of sensory or intellectual deficits or known brain injury. While there has been a surge in research on developmental prosopagnosia over the last decade and a half, the cognitive mechanisms behind the disorder and its neural underpinnings remain elusive. Most recently it has been proposed that developmental prosopagnosia may be a manifestation of widespread disturbance in neural migration which affects both face responsive brain regions as well as other category-sensitive visual areas. We present a combined behavioural and functional MRI study of face, object and word processing in a group of developmental prosopagnosics (N = 15). We show that developmental prosopagnosia is associated with reduced activation of core ventral face areas during perception of faces. The reductions were bilateral but tended to be more pronounced in the left hemisphere. As the first study to address category selectivity for word processing in developmental prosopagnosia, we do not, however, find evidence for reduced activation of the visual word form area during perception of orthographic material. We also find no evidence for reduced activation of the lateral occipital complex during perception of objects. These imaging findings correspond well with the behavioural performance of the developmental prosopagnosics, who show severe impairment for faces but normal reading and recognition of line drawings. Our findings suggest that a general deficit in neural migration across ventral occipito-temporal cortex is not a viable explanation for developmental prosopagnosia. The finding of left hemisphere involvement in our group of developmental prosopagnosics was at first surprising. However, a closer look at existing studies shows similar, but hitherto undiscussed, findings. These left hemisphere abnormalities seen in developmental prosopagnosia contrasts with lesion and imaging studies suggesting primarily right hemisphere involvement in acquired prosopagnosia, and this may reflect that the left hemisphere is important for the development of a normal face recognition network.

The visual word form area (VWFA) is part of both language and attention circuitry

While predominant models of visual word form area (VWFA) function argue for its specific role in decoding written language, other accounts propose a more general role of VWFA in complex visual processing. However, a comprehensive examination of structural and functional VWFA circuits and their relationship to behavior has been missing. Here, using high-resolution multimodal imaging data from a large Human Connectome Project cohort (N = 313), we demonstrate robust patterns of VWFA connectivity with both canonical language and attentional networks. Brain-behavior relationships revealed a striking pattern of double dissociation: structural connectivity of VWFA with lateral temporal language network predicted language, but not visuo-spatial attention abilities, while VWFA connectivity with dorsal fronto-parietal attention network predicted visuo-spatial attention, but not language abilities. Our findings support a multiplex model of VWFA function characterized by distinct circuits for integrating language and attention, and point to connectivity-constrained cognition as a key principle of human brain organization.

The visual word form area (VWFA) is a brain region associated with written language, but it has also been linked to visuospatial attention. Here, the authors reveal distinct structural and functional circuits linking VWFA with language and attention networks, and demonstrate that these circuits separately predict language and attention abilities.

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

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

Are children with developmental dyslexia all the same? A cluster analysis with more than 300 cases

Reading is vital to every aspect of modern life, exacerbated by reliance of the internet, email, and social media on the written medium. Developmental dyslexia (DD) characterizes a disorder in which the core deficit involves reading. Traditionally, DD is thought to be associated with a phonological impairment. However, recent evidence has begun to suggest that the reading impairment in some individuals is provoked by a visual processing deficit. In this paper, we present WISC-IV data from more than 300 Italian children with a diagnosis of DD to investigate the manifestation of phonological and visual subtypes. Our results indicate the existence of two clusters of children with DD. In one cluster, the deficit was more pronounced in the phonological component, while both clusters were impaired in visual processing. These data indicate that DD may be an umbrella term that encompasses different profiles. From a theoretical perspective, our results demonstrate that dyslexia cannot be explained in terms of an isolated phonological deficit alone; visual impairment plays a crucial role. Moreover, general rather than specific accounts of DD are discussed.

Progress in perceptual research: the case of prosopagnosia

Prosopagnosia is an impairment in the ability to recognize faces and can be acquired after a brain lesion or occur as a developmental variant. Studies of prosopagnosia make important contributions to our understanding of face processing and object recognition in the human visual system. We review four areas of advances in the study of this condition in recent years. First are issues surrounding the diagnosis of prosopagnosia, including the development and evaluation of newer tests and proposals for diagnostic criteria, especially for the developmental variant. Second are studies of the structural basis of prosopagnosia, including the application of more advanced neuroimaging techniques in studies of the developmental variant. Third are issues concerning the face specificity of the defect in prosopagnosia, namely whether other object processing is affected to some degree and in particular the status of visual word processing in light of recent predictions from the "many-to-many hypothesis". Finally, there have been recent rehabilitative trials of perceptual learning applied to larger groups of prosopagnosic subjects that show that face impairments are not immutable in this condition.

Object recognition in acquired and developmental prosopagnosia

Whether face and object recognition are dissociated in prosopagnosia continues to be debated: a recent review highlighted deficiencies in prior studies regarding the evidence for such a dissociation. Our goal was to study cohorts with acquired and developmental prosopagnosia with a complementary battery of tests of object recognition that address prior limitations, as well as evaluating for residual effects of object expertise. We studied 15 subjects with acquired and 12 subjects with developmental prosopagnosia on three tests: the Old/New Tests, the Cambridge Bicycle Memory Test, and the Expertise-adjusted Test of Car Recognition. Most subjects with developmental prosopagnosia were normal on the Old/New Tests: for acquired prosopagnosia, subjects with occipitotemporal lesions often showed impairments while those with anterior temporal lesions did not. Ten subjects showed a putative classical dissociation between the Cambridge Face and Bicycle Memory Tests, seven of whom had normal reaction times. Both developmental and acquired groups showed reduced car recognition on the expertise-adjusted test, though residual effects of expertise were still evident. Two subjects with developmental prosopagnosia met criteria for normal object recognition across all tests. We conclude that strong evidence for intact object recognition can be found in a few subjects but the majority show deficits, particularly those with the acquired form. Both acquired and developmental forms show residual but reduced object expertise effects.

Tests of whole upright face processing in prosopagnosia: A literature review

Prosopagnosia refers to an acquired or developmental deficit in face recognition. This neuropsychological impairment has received increasing attention over the last decade, in particular because of an increased scientific interest in developmental prosopagnosia. Studies investigating prosopagnosia have used a variety of different clinical and experimental tests to assess face processing abilities. With such a large variety of assessment methods available, test selection can be challenging. Some previous works have aimed to provide an overview of tests used to diagnose prosopagnosia. However, no overview that is based on a structured review of the literature is available. We review the literature to identify tests that have been used to assess the processing of whole upright faces in acquired and developmental prosopagnosia over the last five years (2013-2017). We not only review tests that have been used for diagnostic purposes, but also tests that have been used for experimental purposes. Tests are categorised according to i) their experimental designs and, ii) the stage of face processing that they assess. On this basis, we discuss considerations regarding test designs for future studies. A visual illustration providing a structured overview of paradigms available for testing the processing of whole upright faces is provided. This visual illustration can be used to inform test selection when designing a study and to apply a structured approach to interpreting findings from the literature. The different approaches to assessment of face processing in prosopagnosia have been necessary and fruitful in generating data and hypotheses about the cause of face processing deficits. However, impairments at different levels of face processing have often been interpreted as reflecting a deficit in the recognition stage of face processing. Based on the data now available on prosopagnosia, we advocate for a more structured approach to assessment, which may facilitate a better understanding of the key deficits in prosopagnosia and of the level(s) of face processing that are impaired.