Early life stress, literacy and dyslexia: an evolutionary perspective

Stress and learning co-evolved in parallel, with their interdependence critical to the survival of the species. Even today, the regulation of moderate levels of stress by the central autonomic network (CAN), especially during pre- and post-natal periods, facilitates biological adaptability and is an essential precursor for the cognitive requisites of learning to read. Reading is a remarkable evolutionary achievement of the human brain, mysteriously unusual, because it is not pre-wired with a genetic address to facilitate its acquisition. There is no gene for reading. The review suggests that reading co-opts a brain circuit centered in the left hemisphere ventral occipital cortex that evolved as a domain-general visual processor. Its adoption by reading depends on the CAN's coordination of the learning and emotional requirements of learning to read at the metabolic, cellular, synaptic, and network levels. By stabilizing a child's self-control and modulating the attention network's inhibitory controls over the reading circuit, the CAN plays a key role in school readiness and learning to read. In addition, the review revealed two beneficial CAN evolutionary adjustments to early-life stress "overloads" that come with incidental costs of school under-performance and dyslexia. A short-term adaptation involving methylation of the FKBP5 and NR3C1 genes is a liability for academic achievement in primary school. The adaptation leading to dyslexia induces alterations in BDNF trafficking, promoting long-term adaptive fitness by protecting against excessive glucocorticoid toxicity but risks reading difficulties by disruptive signaling from the CAN to the attention networks and the reading circuit.

Music literacy improves reading skills via bilateral orthographic development

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

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

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

Detecting the visual word form area in a bilingual brain

Utilizing a millimeter-scale fMRI technique and individual-based analysis, Zhan and colleagues drew a new cortical map of the visual word form area (VWFA) and examined how it processes diverse languages among different bilinguals. This research advances the current understanding of cortical language organization in the bilingual brain.

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

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

Functional neuroanatomy of reading in Czech: Evidence of a dual-route processing architecture in a shallow orthography

Introduction

According to the strong version of the orthographic depth hypothesis, in languages with transparent letter-sound mappings (shallow orthographies) the reading of both familiar words and unfamiliar nonwords may be accomplished by a sublexical pathway that relies on serial grapheme-to-phoneme conversion. However, in languages such as English characterized by inconsistent letter-sound relationships (deep orthographies), word reading is mediated by a lexical-semantic pathway that relies on mappings between word-specific orthographic, semantic, and phonological representations, whereas the sublexical pathway is used primarily to read nonwords.

Methods

In this study, we used functional magnetic resonance imaging to elucidate neural substrates of reading in Czech, a language characterized by a shallo worthography. Specifically, we contrasted patterns of brain activation and connectivity during word and nonword reading to determine whether similar or different neural mechanisms are involved. Neural correlates were measured as differences in simple whole-brain voxel-wise activation, and differences in visual word form area (VWFA) task-related connectivity were computed on the group level from data of 24 young subject. Trial-to-trial reading reaction times were used as a measure of task difficulty, and these effects were subtracted from the activation and connectivity effects in order to eliminate difference in cognitive effort which is naturally higher for nonwords and may mask the true lexicality effects.

Results

We observed pattern of activity well described in the literature mostly derived from data of English speakers - nonword reading (as compared to word reading) activated the sublexical pathway to a greater extent whereas word reading was associated with greater activation of semantic networks. VWFA connectivity analysis also revealed stronger connectivity to a component of the sublexical pathway - left inferior frontal gyrus (IFG), for nonword compared to word reading.

Discussion

These converging results suggest that the brain mechanism of skilled reading in shallow orthography languages are similar to those engaged when reading in languages with a deep orthography and are supported by a universal dual-pathway neural architecture.

The relationship between reading abilities and the left occipitotemporal sulcus: A dual perspective study

Reading activates a region within the left lateral occipitotemporal sulcus (OTS) known as the 'visual word form area' (VWFA). While several studies have investigated the impact of reading on brain structure through neuroplastic mechanisms, it has been recently suggested that individual differences in the pattern of the posterior OTS may predict reading skills in adults. In the present study, we first examined whether the structure and morphology and the anatomical connectivity of the left OTS are associated to reading ability. Second, we explored whether reading skills are predicted by the pattern of the left OTS. We found that reading skills were positively associated with increased connectivity between the left OTS and a network of reading-related regions in the left hemisphere. On the other hand, we did not observe an association between the pattern of the left OTS and reading skills. Finally, we found evidence that the morphology and the connectivity of the left OTS are correlated to its sulcal pattern.

How Does Literacy Affect Speech Processing? Not by Enhancing Cortical Responses to Speech, But by Promoting Connectivity of Acoustic-Phonetic and Graphomotor Cortices

Previous research suggests that literacy, specifically learning alphabetic letter-to-phoneme mappings, modifies online speech processing and enhances brain responses, as indexed by the BOLD, to speech in auditory areas associated with phonological processing (Dehaene et al., 2010). However, alphabets are not the only orthographic systems in use in the world, and hundreds of millions of individuals speak languages that are not written using alphabets. In order to make claims that literacy per se has broad and general consequences for brain responses to speech, one must seek confirmatory evidence from nonalphabetic literacy. To this end, we conducted a longitudinal fMRI study in India probing the effect of literacy in Devanagari, an abubgida, on functional connectivity and cerebral responses to speech in 91 variously literate Hindi-speaking male and female human participants. Twenty-two completely illiterate participants underwent 6 months of reading and writing training. Devanagari literacy increases functional connectivity between acoustic-phonetic and graphomotor brain areas, but we find no evidence that literacy changes brain responses to speech, either in cross-sectional or longitudinal analyses. These findings shows that a dramatic reconfiguration of the neurofunctional substrates of online speech processing may not be a universal result of learning to read, and suggest that the influence of writing on speech processing should also be investigated.SIGNIFICANCE STATEMENT It is widely claimed that a consequence of being able to read is enhanced auditory processing of speech, reflected by increased cortical responses in areas associated with phonological processing. Here we find no relationship between literacy and the magnitude of brain response to speech stimuli in individuals who speak Hindi, which is written using a nonalphabetic script, Devanagari, an abugida. We propose that the exact nature of the script under examination must be considered before making sweeping claims about the consequences of literacy for the brain. Further, we find evidence that literacy enhances functional connectivity between auditory processing areas and graphomotor areas, suggesting a mechanism whereby learning to write might influence speech perception.

Repetition Probability Effects for Chinese Characters and German Words in the Visual Word Form Area

The magnitude of repetition suppression (RS), measured by fMRI, is modulated by the probability of repetitions (P(rep)) for various sensory stimulus categories. It has been suggested that for visually presented simple letters this P(rep) effect depends on the prior practices of the participants with the stimuli. Here we tested further if previous experiences affect the neural mechanisms of RS, leading to the modulatory effects of stimulus P(rep), for more complex lexical stimuli as well. We measured the BOLD signal in the Visual Word Form Area (VWFA) of native Chinese and German participants and estimated the P(rep) effects for Chinese characters and German words. The results showed a significant P(rep) effect for stimuli of the mother tongue in both participant groups. Interestingly, Chinese participants, learning German as a second language, also showed a significant P(rep) modulation of RS for German words while the German participants who had no prior experiences with the Chinese characters showed no such effects. Our findings suggest that P(rep) effects on RS are manifest for visual word processing as well, but only for words of a language with which participants are highly familiar. These results support further the idea that predictive processes, estimated by P(rep) modulations of RS, require prior experiences.

Anatomy and physiology of word-selective visual cortex: from visual features to lexical processing

Over the past 2 decades, researchers have tried to uncover how the human brain can extract linguistic information from a sequence of visual symbols. The description of how the brain's visual system processes words and enables reading has improved with the progressive refinement of experimental methodologies and neuroimaging techniques. This review provides a brief overview of this research journey. We start by describing classical models of object recognition in non-human primates, which represent the foundation for many of the early models of visual word recognition in humans. We then review functional neuroimaging studies investigating the word-selective regions in visual cortex. This research led to the differentiation of highly specialized areas, which are involved in the analysis of different aspects of written language. We then consider the corresponding anatomical measurements and provide a description of the main white matter pathways carrying neural signals crucial to word recognition. Finally, in an attempt to integrate structural, functional, and electrophysiological findings, we propose a view of visual word recognition, accounting for spatial and temporal facets of word-selective neural processes. This multi-modal perspective on the neural circuitry of literacy highlights the relevance of a posterior-anterior differentiation in ventral occipitotemporal cortex for visual processing of written language and lexical features. It also highlights unanswered questions that can guide us towards future research directions. Bridging measures of brain structure and function will help us reach a more precise understanding of the transformation from vision to language.

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

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

Is human face recognition lateralized to the right hemisphere due to neural competition with left-lateralized visual word recognition? A critical review

The right hemispheric lateralization of face recognition, which is well documented and appears to be specific to the human species, remains a scientific mystery. According to a long-standing view, the evolution of language, which is typically substantiated in the left hemisphere, competes with the cortical space in that hemisphere available for visuospatial processes, including face recognition. Over the last decade, a specific hypothesis derived from this view according to which neural competition in the left ventral occipito-temporal cortex with selective representations of letter strings causes right hemispheric lateralization of face recognition, has generated considerable interest and research in the scientific community. Here, a systematic review of studies performed in various populations (infants, children, literate and illiterate adults, left-handed adults) and methodologies (behavior, lesion studies, (intra)electroencephalography, neuroimaging) offers little if any support for this reading lateralized neural competition hypothesis. Specifically, right-lateralized face-selective neural activity already emerges at a few months of age, well before reading acquisition. Moreover, consistent evidence of face recognition performance and its right hemispheric lateralization being modulated by literacy level during development or at adulthood is lacking. Given the absence of solid alternative hypotheses and the key role of neural competition in the sensory-motor cortices for selectivity of representations, learning, and plasticity, a revised language-related neural competition hypothesis for the right hemispheric lateralization of face recognition should be further explored in future research, albeit with substantial conceptual clarification and advances in methodological rigor.

Neural Representation in Visual Word Form Area during Word Reading

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

Linguistic experience acquisition for novel stimuli selectively activates the neural network of the visual word form area

The human ventral visual cortex is functionally organized into different domains that sensitively respond to different categories, such as words and objects. There is heated debate over what principle constrains the locations of those domains. Taking the visual word form area (VWFA) as an example, we tested whether the word preference in this area originates from the bottom-up processes related to word shape (the shape hypothesis) or top-down connectivity of higher-order language regions (the connectivity hypothesis). We trained subjects to associate identical, meaningless, non-word-like figures with high-level features of either words or objects. We found that the word-feature learning for the figures elicited the neural activation change in the VWFA, and learning performance effectively predicted the activation strength of this area after learning. Word-learning effects were also observed in other language areas (i.e., the left posterior superior temporal gyrus, postcentral gyrus, and supplementary motor area), with increased functional connectivity between the VWFA and the language regions. In contrast, object-feature learning was not associated with obvious activation changes in the language regions. These results indicate that high-level language features of stimuli can modulate the activation of the VWFA, providing supportive evidence for the connectivity hypothesis of words processing in the ventral occipitotemporal cortex.

Dynamic Neural Representations: An Inferential Challenge for fMRI

Measures of brain activity with high temporal resolution have shown that the information represented in a single brain region undergoes dynamic changes on the scale of milliseconds. This dynamic process presents a unique inferential challenge to low temporal resolution neural measures, such as BOLD fMRI. Potential solutions for fMRI requiring further investigation and development are discussed.

Word inversion sensitivity as a marker of visual word form area lateralization: An application of a novel multivariate measure of laterality

An area within the ventral occipitotemporal cortex (vOTC), the "visual word form area" (VWFA), typically exhibits a strongly left-lateralized response to orthographic stimuli in skilled readers. While individual variation in VWFA lateralization has been observed, the behavioral significance of laterality differences remains unclear. Here, we test the hypothesis that differences in VWFA lateralization reflect differing preferences for holistic orthographic analysis. To examine this hypothesis, we implemented a new multivariate method that uses machine learning to assess functional lateralization, along with a traditional univariate lateralization method. We related these neural metrics to behavioral indices of holistic orthographic analysis (inversion sensitivity). The multivariate measure successfully detected the lateralization of orthographic processing in the VWFA, and as hypothesized, predicted behavioral differences in holistic orthographic analysis. An exploratory whole brain analysis identified further regions with a relationship between inversion sensitivity and lateralization: one near the junction of the inferior frontal and precentral sulci, and another along the superior temporal gyrus. We conclude that proficient native readers of English exhibit differences in cortical lateralization of the VWFA that have significant implications for reading behavior.

Disrupted left fusiform response to print in beginning kindergartners is associated with subsequent reading

Dyslexia is a common neurobiological disorder in which a child fails to acquire typical word reading skills despite adequate opportunity and intelligence. The visual word form area (VWFA) is a region within the left fusiform gyrus that specializes for print over the course of reading acquisition and is often hypoactivated in individuals with dyslexia. It is currently unknown whether atypicalities in this brain region are already present in kindergarten children who will subsequently develop dyslexia. Here, we measured fMRI activation in response to letters and false fonts in bilateral fusiform gyrus in children with and without risk for dyslexia (defined by family history or low scores on assessments of pre-reading skills, such as phonological awareness). We then followed these children longitudinally through the end of second grade to evaluate whether brain activation patterns in kindergarten were related to second-grade reading outcomes. Compared to typical readers who exhibited no risk factors for reading impairment in kindergarten, there was significant hypoactivation to both letters and false-fonts in the left fusiform gyrus in at-risk children who subsequently developed reading impairment, but not in at-risk children who developed typical reading skills. There were no significant differences in letter- or false-font responses in the right fusiform gyrus among the groups. The finding that hypoactivation to print in the VWFA is present in children who subsequently develop reading impairment even prior to the onset of formal reading instruction suggests that atypical responses to print play an early role in the development of reading impairments such as dyslexia.

Local response heterogeneity indexes experience-based neural differentiation in reading

The ability to read requires learning letter-string representations whose neural codes would be expected to vary depending on the amount of experience that an individual has with reading them. Motivated by sparse coding theories (e.g., Rolls and Tovee, 1995; Olshausen and Field, 1996), recent work has demonstrated that better-learned relative to less well-learned neural representations are associated with more strongly differentiated, locally heterogeneous blood oxygenation level dependent (BOLD) responses (e.g., Jiang et al., 2013). Here we report a novel analysis method we call local heterogeneity regression (Local-Hreg) that quantifies the cross-voxel heterogeneity of BOLD responses, thereby providing a sensitive and methodologically flexible method for quantifying the local neural differentiation of neural representations. In a study of literate adults, we applied Local-Hreg to fMRI data obtained when participants read letter strings that varied in their frequency of occurrence in the written language. Consistent with previous research identifying the left ventral occipitotemporal cortex (vOTC) as a key site for orthographic representation in reading and spelling, we found that the cross-voxel heterogeneity of neural responses in this region varies according to the frequency with which the written letter strings have been experienced. This work provides a novel approach for examining the local differentiation of neural representations, and demonstrates that well-learned words have greater representational differentiation than less well-learned or unfamiliar words.

Orthographic and phonological selectivity across the reading system in deaf skilled readers

People who are born deaf often have difficulty learning to read. Recently, several studies have examined the neural substrates involved in reading in deaf people and found a left lateralized reading system similar to hearing people involving temporo-parietal, inferior frontal, and ventral occipito-temporal cortices. Previous studies in typical hearing readers show that within this reading network there are separate regions that specialize in processing orthography and phonology. We used fMRI rapid adaptation in deaf adults who were skilled readers to examine neural selectivity in three functional ROIs in the left hemisphere: temporoparietal cortex (TPC), inferior frontal gyrus (IFG), and the visual word form area (VWFA). Results show that in deaf skilled readers, the left VWFA showed selectivity for orthography similar to what has been reported for hearing readers, the TPC showed less sensitivity to phonology than previously reported for hearing readers using the same paradigm, and the IFG showed selectivity to orthography, but not phonology (similar to what has been reported previously for hearing readers). These results provide evidence that while skilled deaf readers demonstrate coarsely tuned phonological representations in the TPC, they develop finely tuned representations for the orthography of written words in the VWFA and IFG. This result suggests that phonological tuning in the TPC may have little impact on the neural network associated with skilled reading for deaf adults.

Orthographic and Phonological Representations in the Fusiform Cortex

Mental and neural representations of words are at the core of understanding the cognitive and neural mechanisms of reading. Despite extensive studies, the nature of visual word representation remains highly controversial due to methodological limitations. In particular, it is unclear whether the fusiform cortex contains only abstract orthographic representation, or represents both lower and higher level orthography as well as phonology. Using representational similarity analysis, we integrated behavioral ratings, computational models of reading and visual object recognition, and neuroimaging data to examine the nature of visual word representations in the fusiform cortex. Our results provided clear evidence that the middle and anterior fusiform represented both phonological and orthographic information. Whereas lower level orthographic information was represented at every stage of the ventral visual stream, abstract orthographic information was increasingly represented along the posterior-to-anterior axis. Furthermore, the left and right hemispheres were tuned to high- and low-frequency orthographic information, respectively. These results help to resolve the long-standing debates regarding the role of the fusiform in reading, and have significant implications for the development of psychological, neural, and computational theories of reading.

The consonant/vowel pattern determines the structure of orthographic representations in the left fusiform gyrus

Recent findings demonstrated readers' sensitivity to the distinction between consonant and vowel letters. Especially, the way consonants and vowels are organised within written words determines their perceptual structure. The present work attempted to overcome two limitations of previous studies by examining the neurophysiological correlates of this perceptual structure through magnetoencephalography (MEG). One aim was to establish that the extraction of vowel-centred units takes place during early stages of processing. The second objective was to confirm that the vowel-centred structure pertains to the word recognition system and may constitute one level in a hierarchy of neural detectors coding orthographic strings. Participants performed a cross-case matching task in which they had to judge pairs of stimuli as identical or different. The critical manipulation concerned pairs obtained by transposing two letters, so that the vowel-centred structure was either preserved (FOUVERT-fovuert, two vowel letter clusters) or modified (BOUVRET-bovuret). Mismatches were detected faster when the structure was modified. This effect was associated with a significant difference in evoked neuromagnetic fields extending from 129 to 239 msec after the stimulation. Source localization indicated a significant effect in the visual word form area around 200 msec. The results confirm the hypothesis that the vowel-centred structure is extracted during the early phases of letter string processing and that it is encoded in left fusiform regions devoted to visual word recognition.

Development of the Visual Word Form Area Requires Visual Experience: Evidence from Blind Braille Readers

Learning to read causes the development of a letter- and word-selective region known as the visual word form area (VWFA) within the human ventral visual object stream. Why does a reading-selective region develop at this anatomical location? According to one hypothesis, the VWFA develops at the nexus of visual inputs from retinotopic cortices and linguistic input from the frontotemporal language network because reading involves extracting linguistic information from visual symbols. Surprisingly, the anatomical location of the VWFA is also active when blind individuals read Braille by touch, suggesting that vision is not required for the development of the VWFA. In this study, we tested the alternative prediction that VWFA development is in fact influenced by visual experience. We predicted that in the absence of vision, the "VWFA" is incorporated into the frontotemporal language network and participates in high-level language processing. Congenitally blind (n = 10, 9 female, 1 male) and sighted control (n = 15, 9 female, 6 male), male and female participants each took part in two functional magnetic resonance imaging experiments: (1) word reading (Braille for blind and print for sighted participants), and (2) listening to spoken sentences of different grammatical complexity (both groups). We find that in blind, but not sighted participants, the anatomical location of the VWFA responds both to written words and to the grammatical complexity of spoken sentences. This suggests that in blindness, this region takes on high-level linguistic functions, becoming less selective for reading. More generally, the current findings suggest that experience during development has a major effect on functional specialization in the human cortex.SIGNIFICANCE STATEMENT The visual word form area (VWFA) is a region in the human cortex that becomes specialized for the recognition of written letters and words. Why does this particular brain region become specialized for reading? We tested the hypothesis that the VWFA develops within the ventral visual stream because reading involves extracting linguistic information from visual symbols. Consistent with this hypothesis, we find that in congenitally blind Braille readers, but not sighted readers of print, the VWFA region is active during grammatical processing of spoken sentences. These results suggest that visual experience contributes to VWFA specialization, and that different neural implementations of reading are possible.

How interindividual differences in brain anatomy shape reading accuracy

The capacity to read develops throughout intensive academic learning and training. Several studies have investigated the impact of reading on the brain, and particularly how the anatomy of the brain changes with reading acquisition. In the present study, we investigated the converse issue, namely whether and how reading acquisition is constrained by the anatomy of the brain. Using multimodal MRI, we found that (a) the pattern (continuous or interrupted sulcus) of the posterior part of the left lateral occipito-temporal sulcus (OTS) hosting the visual word form area (VWFA) predicts reading skills in adults; that (b) this effect is modulated by the age of reading acquisition; and that (c) the length of the OTS sulcal interruption is associated with reading skills. Because the sulcal pattern is determined in utero, our findings suggest that individual difference in reading skills can be traced back to early stages of brain development in addition to the well-established socioeconomic and educational factors.

Development of sensitivity versus specificity for print in the visual word form area

An area near the left lateral occipito-temporal sulcus that responds preferentially to print has been designated as the visual word form area (VWFA). Research suggests that specialization in this brain region increases as reading expertise is achieved. Here we aimed to characterize that development in terms of sensitivity (response to printed words relative to non-linguistic faces) versus specificity (response to printed words versus line drawings of nameable objects) in typically reading children ages 7-14 versus young adults as measured by functional magnetic resonance imaging (fMRI). Relative to adults, children displayed equivalent sensitivity but reduced specificity. These findings suggest that sensitivity for print relative to non-linguistic stimuli develops relatively early in the VWFA in the course of reading development, but that specificity for printed words in VWFA is still developing through at least age 14.

Recovery of orthographic processing after stroke: A longitudinal fMRI study

An intact orthographic processing system is critical for normal reading and spelling. Here we investigate the neural changes associated with impairment and subsequent recovery of the orthographic lexical processing system in an individual with an ischemic left posterior cerebral artery (PCA) stroke. This work describes a longitudinal case study of a patient, whose initials are MMY, with impairments in orthographic lexical processing for reading and spelling at stroke onset, and who recovered these skills within 1 year post stroke. We tested the hypothesis that this acute impairment to reading and spelling would be associated with a selective loss of neural activation in the left fusiform gyrus (FG), and that subsequent recovery would be associated with a gain of neural activation in this region. MMY's case provided a unique opportunity to assess the selectivity of neural changes because she demonstrated a behavioral recovery of naming as well; i.e., if there is neural recovery for reading and spelling, but not naming, then these neural changes are selective to the recovery of orthographic processing. To test our hypothesis, we examined longitudinal behavioral and functional magnetic resonance imaging (fMRI) data of reading, spelling, and visual object naming acquired acutely, 3 weeks, 5 months, and one year post stroke. In confirmation of our hypothesis, the loss and subsequent gain of orthographic lexical processing was associated with up-regulation of neural activation in areas previously associated with orthographic lexical processing: i.e., the left mid-FG and inferior frontal junction (IFJ). Furthermore, these neural changes were found to be selective to orthographic processing, as they were observed for reading and spelling, but not for visual object naming within the left mid-FG. This work shows that left PCA stroke can temporarily and selectively disrupt the orthographic lexical processing system, not only in the posterior region adjacent to the stroke, but also in relatively distant frontal orthographic processing regions.

Privileged Functional Connectivity between the Visual Word Form Area and the Language System

The visual word form area (VWFA) is a region in the left occipitotemporal sulcus of literate individuals that is purportedly specialized for visual word recognition. However, there is considerable controversy about its functional specificity and connectivity, with some arguing that it serves as a domain-general, rather than word-specific, visual processor. The VWFA is a critical region for testing hypotheses about the nature of cortical organization, because it is known to develop only through experience (i.e., reading acquisition), and widespread literacy is too recent to have influenced genetic determinants of brain organization. Using a combination of advanced fMRI analysis techniques, including individual functional localization, multivoxel pattern analysis, and high-resolution resting-state functional connectivity (RSFC) analyses, with data from 33 healthy adult human participants, we demonstrate that (1) the VWFA can discriminate words from nonword letter strings (pseudowords); (2) the VWFA has preferential RSFC with Wernicke's area and other core regions of the language system; and (3) the strength of the RSFC between the VWFA and Wernicke's area predicts performance on a semantic classification task with words but not other categories of visual stimuli. Our results are consistent with the hypothesis that the VWFA is specialized for lexical processing of real words because of its functional connectivity with Wernicke's area.SIGNIFICANCE STATEMENT The visual word form area (VWFA) is critical for determining the nature of category-related organization of the ventral visual system. However, its functional specificity and connectivity are fiercely debated. Recent work concluded that the VWFA is a domain-general, rather than word-specific, visual processor with no preferential functional connectivity with the language system. Using more advanced techniques, our results stand in stark contrast to these earlier findings. We demonstrate that the VWFA is highly specialized for lexical processing of real words, and that a fundamental factor driving this specialization is its preferential intrinsic functional connectivity with core regions of the language system. Our results support the hypothesis that intrinsic functional connectivity contributes to category-related specialization within the human ventral visual system.

Shared orthographic neuronal representations for spelling and reading

A central question in the study of the neural basis of written language is whether reading and spelling utilize shared orthographic representations. While recent studies employing fMRI to test this question report that the left inferior frontal gyrus (IFG) and ventral occipitotemporal cortex (vOTC) are active during both spelling and reading in the same subjects (Purcell et al., 2011a; Rapp and Lipka, 2011), the spatial resolution of fMRI limits the interpretation of these findings. Specifically, it is unknown if the neurons which encode orthography for reading are also involved in spelling of the same words. Here we address this question by employing an event-related functional magnetic resonance imaging-adaptation (fMRI-A) paradigm designed to examine shared orthographic representations across spelling and reading. First, we identified areas that independently showed adaptation to reading, and adaptation to spelling. Then we identified spatial convergence for these two separate maps via a conjunction analysis. Consistent with previous studies (Purcell et al., 2011a; Rapp and Lipka, 2011), this analysis revealed the left dorsal IFG, vOTC and supplementary motor area. To further validate these observations, we then interrogated these regions using an across-task adaptation technique, and found adaptation across reading and spelling in the left dorsal IFG (BA 44/9). Our final analysis focused specifically on the Visual Word Form Area (VWFA) in the vOTC, whose variability in location among subjects requires the use of subject-specific identification mechanisms (Glezer and Riesenhuber, 2013). Using a functional localizer for reading, we defined the VWFA in each subject, and found adaptation effects for both within the spelling and reading conditions, respectively, as well as across spelling and reading. Because none of these effects were observed during a phonological/semantic control condition, we conclude that the left dorsal IFG and VWFA are involved in accessing the same orthography-specific representations for spelling and reading.

Evidence for rapid localist plasticity in the ventral visual stream: The example of words

Our recent work has shown that the Visual Word Form Area (VWFA) in left occipitotemporal cortex contains an orthographic lexicon based on neuronal representations highly selective for individual written real words (RW) and that learning novel words selectively increases neural specificity in the VWFA. But, how quickly does this change in neural tuning occur and how much training is required for new words to be codified in the VWFA? Here we present evidence that plasticity in the VWFA from broad to tight tuning can be obtained in a short time span, with no explicit training, and with comparatively few exposures, further strengthening the case for a highly plastic visual lexicon in the VWFA and for localist representations in the visual processing hierarchy.

Modulation of Orthographic Decoding by Frontal Cortex

Opinions are divided on whether word reading processes occur in a hierarchical, feedforward fashion or within an interactive framework. To critically evaluate these competing theories, we recorded electrocorticographic (ECoG) data from 15 human patients with intractable epilepsy during a word completion task and evaluated brain network dynamics across individuals. We used a novel technique of analyzing multihuman ECoG recordings to identify cortical regions most relevant to processing lexical information. The mid fusiform gyrus showed the strongest, earliest response after stimulus onset, whereas activity was maximal in frontal, dorsal lateral prefrontal, and sensorimotor regions toward articulation onset. To evaluate interregional functional connectivity, ECoG data from electrodes situated over specific cortical regions of interest were fit into linear multivariate autoregressive (MVAR) models. Spectral characteristics of the MVAR models were used to precisely reveal the timing and the magnitude of information flow between localized brain regions. This is the first application of MVAR for developing a comprehensive account of interregional interactions from a word reading ECoG dataset. Our comprehensive findings revealed both top-down and bottom-up influences between higher-level language areas and the mid fusiform gyrus. Our findings thus challenge strictly hierarchical, feedforward views of word reading and suggest that orthographic processes are modulated by prefrontal and sensorimotor regions via an interactive framework.

SIGNIFICANCE STATEMENT

Word reading is a critical part of everyday life. When the ability to read is disrupted, it can lead to learning disorders, as well as emotional and academic difficulties. The neural mechanisms underlying word reading are not well understood due to limitations in the spatial and temporal specificity of prior word reading studies. Our research analyzed data recorded from sensors implanted directly from surface of human brains while these individuals performed a word reading task. Our research analyzed these recordings to infer how brain regions communicate during word reading. Our original results improve upon current models of word reading and can be used to develop treatment plans for individuals with reading disabilities.

Uncovering phonological and orthographic selectivity across the reading network using fMRI-RA

Reading has been shown to rely on a dorsal brain circuit involving the temporoparietal cortex (TPC) for grapheme-to-phoneme conversion of novel words (Pugh et al., 2001), and a ventral stream involving left occipitotemporal cortex (OTC) (in particular in the so-called "visual word form area", VWFA) for visual identification of familiar words. In addition, portions of the inferior frontal cortex (IFC) have been posited to be an output of the dorsal reading pathway involved in phonology. While this dorsal versus ventral dichotomy for phonological and orthographic processing of words is widely accepted, it is not known if these brain areas are actually strictly sensitive to orthographic or phonological information. Using an fMRI rapid adaptation technique we probed the selectivity of the TPC, OTC, and IFC to orthographic and phonological features during single word reading. We found in two independent experiments using different task conditions in adult normal readers, that the TPC is exclusively sensitive to phonology and the VWFA in the OTC is exclusively sensitive to orthography. The dorsal IFC (BA 44), however, showed orthographic but not phonological selectivity. These results support the theory that reading involves a specific phonological-based temporoparietal region and a specific orthographic-based ventral occipitotemporal region. The dorsal IFC, however, was not sensitive to phonological processing, suggesting a more complex role for this region.

Intrinsic Functional Connectivity in the Adult Brain and Success in Second-Language Learning

There is considerable variability in an individual's ability to acquire a second language (L2) during adulthood. Using resting-state fMRI data acquired before training in English speakers who underwent a 12 week intensive French immersion training course, we investigated whether individual differences in intrinsic resting-state functional connectivity relate to a person's ability to acquire an L2. We focused on two key aspects of language processing--lexical retrieval in spontaneous speech and reading speed--and computed whole-brain functional connectivity from two regions of interest in the language network, namely the left anterior insula/frontal operculum (AI/FO) and the visual word form area (VWFA). Connectivity between the left AI/FO and left posterior superior temporal gyrus (STG) and between the left AI/FO and dorsal anterior cingulate cortex correlated positively with improvement in L2 lexical retrieval in spontaneous speech. Connectivity between the VWFA and left mid-STG correlated positively with improvement in L2 reading speed. These findings are consistent with the different language functions subserved by subcomponents of the language network and suggest that the human capacity to learn an L2 can be predicted by an individual's intrinsic functional connectivity within the language network. Significance statement: There is considerable variability in second-language learning abilities during adulthood. We investigated whether individual differences in intrinsic functional connectivity in the adult brain relate to success in second-language learning, using resting-state functional magnetic resonance imaging in English speakers who underwent a 12 week intensive French immersion training course. We found that pretraining functional connectivity within two different language subnetworks correlated strongly with learning outcome in two different language skills: lexical retrieval in spontaneous speech and reading speed. Our results suggest that the human capacity to learn a second language can be predicted by an individual's intrinsic functional connectivity within the language network.

Machine learning and dyslexia: Classification of individual structural neuro-imaging scans of students with and without dyslexia

Meta-analytic studies suggest that dyslexia is characterized by subtle and spatially distributed variations in brain anatomy, although many variations failed to be significant after corrections of multiple comparisons. To circumvent issues of significance which are characteristic for conventional analysis techniques, and to provide predictive value, we applied a machine learning technique--support vector machine--to differentiate between subjects with and without dyslexia. In a sample of 22 students with dyslexia (20 women) and 27 students without dyslexia (25 women) (18-21 years), a classification performance of 80% (p < 0.001; d-prime = 1.67) was achieved on the basis of differences in gray matter (sensitivity 82%, specificity 78%). The voxels that were most reliable for classification were found in the left occipital fusiform gyrus (LOFG), in the right occipital fusiform gyrus (ROFG), and in the left inferior parietal lobule (LIPL). Additionally, we found that classification certainty (e.g. the percentage of times a subject was correctly classified) correlated with severity of dyslexia (r = 0.47). Furthermore, various significant correlations were found between the three anatomical regions and behavioural measures of spelling, phonology and whole-word-reading. No correlations were found with behavioural measures of short-term memory and visual/attentional confusion. These data indicate that the LOFG, ROFG and the LIPL are neuro-endophenotype and potentially biomarkers for types of dyslexia related to reading, spelling and phonology. In a second and independent sample of 876 young adults of a general population, the trained classifier of the first sample was tested, resulting in a classification performance of 59% (p = 0.07; d-prime = 0.65). This decline in classification performance resulted from a large percentage of false alarms. This study provided support for the use of machine learning in anatomical brain imaging.

Functional characterisation of letter-specific responses in time, space and current polarity using magnetoencephalography

Recent neurophysiological evidence suggests that a hierarchical neural network of low-to-high level processing subserves written language comprehension. While a considerable amount of research has identified distinct regions and stages of processing, the relations between them and to this hierarchical model remain unclear. Magnetoencephalography (MEG) is a technique frequently employed in such investigations; however, no studies have sought to test whether the conventional method of reconstructing currents at the source of the magnetic field is best suited for such across-subject designs. The present study details the results of three MEG experiments addressing these issues. Neuronal populations supporting responses to low-level orthographic properties were housed posteriorly near the primary visual cortex. More anterior regions along the fusiform gyrus encoded higher-level processes and became active ~80ms later. A functional localiser of these early letter-specific responses was developed for the production of functional regions of interest in future studies. Previously established response components were successfully grouped based on proximity to the localiser, which characterised location, latency and functional sensitivity. Unconventional anatomically constrained signed minimum norm estimates of MEG data were most sensitive to the primary experimental manipulation, suggesting that the conventional unsigned unconstrained method is sub-optimal for studying written word processing.

Reprint of: Visual processing of words in a patient with visual form agnosia: A behavioural and fMRI study

Patient D.F. has a profound and enduring visual form agnosia due to a carbon monoxide poisoning episode suffered in 1988. Her inability to distinguish simple geometric shapes or single alphanumeric characters can be attributed to a bilateral loss of cortical area LO, a loss that has been well established through structural and functional fMRI. Yet despite this severe perceptual deficit, D.F. is able to "guess" remarkably well the identity of whole words. This paradoxical finding, which we were able to replicate more than 20 years following her initial testing, raises the question as to whether D.F. has retained specialized brain circuitry for word recognition that is able to function to some degree without the benefit of inputs from area LO. We used fMRI to investigate this, and found regions in the left fusiform gyrus, left inferior frontal gyrus, and left middle temporal cortex that responded selectively to words. A group of healthy control subjects showed similar activations. The left fusiform activations appear to coincide with the area commonly named the visual word form area (VWFA) in studies of healthy individuals, and appear to be quite separate from the fusiform face area (FFA). We hypothesize that there is a route to this area that lies outside area LO, and which remains relatively unscathed in D.F.

Distinct but Overlapping Patterns of Response to Words and Faces in the Fusiform Gyrus

Converging evidence suggests that the fusiform gyrus is involved in the processing of both faces and words. We used fMRI to investigate the extent to which the representation of words and faces in this region of the brain is based on a common neural representation. In Experiment 1, a univariate analysis revealed regions in the fusiform gyrus that were only selective for faces and other regions that were only selective for words. However, we also found regions that showed both word-selective and face-selective responses, particularly in the left hemisphere. We then used a multivariate analysis to measure the pattern of response to faces and words. Despite the overlap in regional responses, we found distinct patterns of response to both faces and words in the left and right fusiform gyrus. In Experiment 2, fMR adaptation was used to determine whether information about familiar faces and names is integrated in the fusiform gyrus. Distinct regions of the fusiform gyrus showed adaptation to either familiar faces or familiar names. However, there was no adaptation to sequences of faces and names with the same identity. Taken together, these results provide evidence for distinct, but overlapping, neural representations for words and faces in the fusiform gyrus.

Adding words to the brain's visual dictionary: novel word learning selectively sharpens orthographic representations in the VWFA

The nature of orthographic representations in the human brain is still subject of much debate. Recent reports have claimed that the visual word form area (VWFA) in left occipitotemporal cortex contains an orthographic lexicon based on neuronal representations highly selective for individual written real words (RWs). This theory predicts that learning novel words should selectively increase neural specificity for these words in the VWFA. We trained subjects to recognize novel pseudowords (PWs) and used fMRI rapid adaptation to compare neural selectivity with RWs, untrained PWs (UTPWs), and trained PWs (TPWs). Before training, PWs elicited broadly tuned responses, whereas responses to RWs indicated tight tuning. After training, TPW responses resembled those of RWs, whereas UTPWs continued to show broad tuning. This change in selectivity was specific to the VWFA. Therefore, word learning appears to selectively increase neuronal specificity for the new words in the VWFA, thereby adding these words to the brain's visual dictionary.

Selective Neural Synchrony Suppression as a Forward Gatekeeper to Piecemeal Conscious Perception

The emergence of conscious visual perception is assumed to ignite late (∼250 ms) gamma-band oscillations shortly after an initial (∼100 ms) forward sweep of neural sensory (nonconscious) information. However, this neural evidence is not utterly congruent with rich behavioral data which rather point to piecemeal (i.e., graded) perceptual processing. To address the unexplored neural mechanisms of piecemeal ignition of conscious perception, hierarchical script sensitivity of the putative visual word form area (VWFA) was exploited to signal null (i.e., sensory), partial (i.e., letter-level), and full (i.e., word-level) conscious perception. Two magnetoencephalography experiments were conducted in which healthy human participants viewed masked words (Experiment I: active task, Dutch words; Experiment II: passive task, Hebrew words) while high-frequency (broadband gamma) brain activity was measured. Findings revealed that piecemeal conscious perception did not ignite a linear piecemeal increase in oscillations. Instead, whereas late (∼250 ms) gamma-band oscillations signaled full conscious perception (i.e., word-level), partial conscious perception (i.e., letter-level) was signaled via the inhibition of the early (∼100 ms) forward sweep. This inhibition regulates the downstream broadcast to filter out irrelevant (i.e., masks) information. The findings thus highlight a local (VWFA) gatekeeping mechanism for conscious perception, operating by filtering out and in selective percepts.

Adaptation to recent conflict in the classical color-word Stroop-task mainly involves facilitation of processing of task-relevant information

To process information selectively and to continuously fine-tune selectivity of information processing are important abilities for successful goal-directed behavior. One phenomenon thought to represent this fine-tuning are conflict adaptation effects in interference tasks, i.e., reduction of interference after an incompatible trial and when incompatible trials are frequent. The neurocognitive mechanisms of these effects are currently only partly understood and results from brainimaging studies so far are mixed. In our study we validate and extend recent findings by examining adaption to recent conflict in the classical Stroop task using functional magnetic resonance imaging. Consistent with previous research we found increased activity in a fronto-parietal network comprising the medial prefrontal cortex, ventro-lateral prefrontal cortex, and posterior parietal cortex when contrasting incompatible with compatible trials. These areas have been associated with attentional processes and might reflect increased cognitive conflict and resolution thereof during incompatible trials. While carefully controlling for non-attentional sequential effects we found smaller Stroop interference after an incompatible trial (conflict adaptation effect). These behavioral conflict adaptation effects were accompanied by changes in activity in visual color-selective areas (V4, V4α), while there was no modulation by previous trial compatibility in a visual word-selective area (VWFA). Our results provide further evidence for the notion, that adaptation to recent conflict seems to be based mainly on enhancement of processing of the task-relevant information.

Reading faces: investigating the use of a novel face-based orthography in acquired alexia

Skilled visual word recognition is thought to rely upon a particular region within the left fusiform gyrus, the visual word form area (VWFA). We investigated whether an individual (AA1) with pure alexia resulting from acquired damage to the VWFA territory could learn an alphabetic "FaceFont" orthography, in which faces rather than typical letter-like units are used to represent phonemes. FaceFont was designed to distinguish between perceptual versus phonological influences on the VWFA. AA1 was unable to learn more than five face-phoneme mappings, performing well below that of controls. AA1 succeeded, however, in learning and using a proto-syllabary comprising 15 face-syllable mappings. These results suggest that the VWFA provides a "linguistic bridge" into left hemisphere speech and language regions, irrespective of the perceptual characteristics of a written language. They also suggest that some individuals may be able to acquire a non-alphabetic writing system more readily than an alphabetic writing system.

How reading acquisition changes children's spoken language network

To examine the influence of age and reading proficiency on the development of the spoken language network, we tested 6- and 9-years-old children listening to native and foreign sentences in a slow event-related fMRI paradigm. We observed a stable organization of the peri-sylvian areas during this time period with a left dominance in the superior temporal sulcus and inferior frontal region. A year of reading instruction was nevertheless sufficient to increase activation in regions involved in phonological representations (posterior superior temporal region) and sentence integration (temporal pole and pars orbitalis). A top-down activation of the left inferior temporal cortex surrounding the visual word form area, was also observed but only in 9year-olds (3years of reading practice) listening to their native language. These results emphasize how a successful cultural practice, reading, slots in the biological constraints of the innate spoken language network.

The changing brain--insights into the mechanisms of neural and behavioral adaptation to the environment

The Kavli Prize in Neuroscience was awarded for the third time in September 2012, by the Norwegian Academy of Science and Letters in Oslo. The accompanying Kavli Prize Symposium on Neuroscience, held in Bergen and Trondheim, was a showcase of excellence in neuroscience research. The common theme of the Symposium presentations was the mechanisms by which animals adapt to their environment. The symposium speakers--Michael Greenberg, Erin Schuman, Chiara Cirelli, Michael Meaney, Catherine Dulac, Hopi Hoekstra, and Stanislas Dehaene--covered topics ranging from the molecular and cellular levels to the systems level and behavior. Thus a single amino acid change in a transcriptional repressor can disrupt gene regulation through neural activity (Greenberg). Deep sequencing analysis of the neuropil transcriptome indicates that a large fraction of the synaptic proteome is synthesized in situ in axons and dendrites, permitting local regulation (Schuman). The nature of the 'reset' function that makes animals dependent of sleep is being revealed (Cirelli). Maternal behavior can cause changes in gene expression that stably modify behavior in the offspring (Meaney). Removal of a single sensory channel protein in the vomero-nasal organ can switch off male-specific and switch on female-specific innate behavior of mice in response to environmental stimulation (Dulac). Innate behaviors can be stably transmitted from parent to offspring through generations even when those behaviors cannot be expressed, as illustrated by the elaborate burrowing behavior in a rodent species, in which independent genetic regions regulate distinct modules of the burrowing pattern (Hoekstra). Finally, at the other extreme of the nature-nurture scale, functional magnetic resonance imaging (fMRI) analysis in children and adults identified a brain area specifically involved in reading (Dehaene). As the area must originally have developed for a purpose other than reading, such as shape recognition, this illustrates the use of a previously formed neural structure to tackle a new challenge.

Opposite effects of visual and auditory word-likeness on activity in the visual word form area

The present fMRI study investigated the effects of word-likeness of visual and auditory stimuli on activity along the ventral visual stream. In the context of a one-back task, we presented visual and auditory words, pseudowords, and artificial stimuli (i.e., false-fonts and reversed-speech, respectively). Main findings were regionally specific effects of word-likeness on activation in a left ventral occipitotemporal region corresponding to the classic localization of the Visual Word Form Area (VWFA). Specifically, we found an inverse word-likeness effect for the visual stimuli in the form of decreased activation for words compared to pseudowords which, in turn, elicited decreased activation compared to the artificial stimuli. For the auditory stimuli, we found positive word-likeness effects as both words and pseudowords elicited more activation than the artificial stimuli. This resulted from a marked deactivation in response to the artificial stimuli and no such deactivation for words and pseudowords. We suggest that the opposite effects of visual and auditory word-likeness on VWFA activation can be explained by assuming the involvement of visual orthographic memory representations. For the visual stimuli, these representations reduce the coding effort as a function of word-likeness. This results in highest activation to the artificial stimuli and least activation to words for which corresponding representations exist. The positive auditory word-likeness effects may result from activation of orthographic information associated with the auditory words and pseudowords. The view that the VWFA has a primarily visual function is supported by our findings of high activation to the visual artificial stimuli (which have no phonological or semantic associations) and deactivation to the auditory artificial stimuli. According to the phenomenon of cross-modal sensory suppression such deactivations during demanding auditory processing are expected in visual regions.