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Reading without the left ventral occipito-temporal cortex

机译：没有左腹枕颞皮层的阅读

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摘要

The left ventral occipito-temporal cortex (LvOT) is thought to be essential for the rapid parallel letter processing that is required for skilled reading. Here we investigate whether rapid written word identification in skilled readers can be supported by neural pathways that do not involve LvOT. Hypotheses were derived from a stroke patient who acquired dyslexia following extensive LvOT damage. The patient followed a reading trajectory typical of that associated with pure alexia, re-gaining the ability to read aloud many words with declining performance as the length of words increased. Using functional MRI and dynamic causal modelling (DCM), we found that, when short (three to five letter) familiar words were read successfully, visual inputs to the patient's occipital cortex were connected to left motor and premotor regions via activity in a central part of the left superior temporal sulcus (STS). The patient analysis therefore implied a left hemisphere "reading-without-LvOT" pathway that involved STS. We then investigated whether the same reading-without-LvOT pathway could be identified in 29 skilled readers and whether there was inter-subject variability in the degree to which skilled reading engaged LvOT. We found that functional connectivity in the reading-without-LvOT pathway was strongest in individuals who had the weakest functional connectivity in the LvOT pathway. This observation validates the findings of our patient's case study. Our findings highlight the contribution of a left hemisphere reading pathway that is activated during the rapid identification of short familiar written words, particularly when LvOT is not involved. Preservation and use of this pathway may explain how patients are still able to read short words accurately when LvOT has been damaged.
机译：左腹枕颞叶皮质（LvOT）被认为是熟练阅读所需的快速平行字母处理所必需的。在这里，我们研究了不涉及LvOT的神经通路是否可以支持熟练读者中的快速书面单词识别。假设来自中风患者，该患者在广泛的LvOT损伤后获得阅读障碍。患者遵循典型的与纯净性贫血有关的阅读轨迹，随着单词长度的增加，重新获得了朗读许多单词的能力，但性能下降。使用功能性MRI和动态因果模型（DCM），我们发现，当成功读取简短（三到五个字母）的熟悉单词时，通过中央部位的活动将患者枕叶皮质的视觉输入连接到左运动区和运动前区左上颞沟（STS）。因此，患者分析隐含了涉及STS的左半球“无LvOT阅读”途径。然后，我们调查了在29名熟练的读者中是否可以识别出没有LvOT的相同阅读途径，以及熟练阅读对LvOT的参与程度是否存在受试者间差异。我们发现，在LvOT途径中功能连接性最弱的个体中，无LvOT读取途径中的功能连接性最强。该观察结果证实了我们患者案例研究的结果。我们的发现强调了在快速识别熟悉的简短文字时，特别是在不涉及LvOT的情况下，激活的左半球阅读途径的作用。 LvOT受损时，该途径的保存和使​​用可以解释患者如何仍然能够准确地阅读简短的单词。

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