Visual Word Recognition in the Left and Right Hemispheres: Anatomical and Functional Correlates of Peripheral Alexias
Abstract
According to a simple anatomical and functional model of word reading, letters displayed in one hemifield are first analysed through a cascade of contralateral retinotopic areas, which compute increasingly abstract representations. Eventually, an invariant representation of letter identities is created in the visual word form area (VWFA), reproducibly located within the left occipito-temporal sulcus. The VWFA then projects to structures involved in phonological or lexico-semantic processing. This model yields detailed predictions on the reading impairments that may follow left occipitotemporal lesions. Those predictions were confronted to behavioural, anatomical and functional MRI data gathered in normals and in patients suffering from left posterior cerebral artery infarcts. In normal subjects, alphabetic stimuli activated both the VWFA and the right-hemispheric symmetrical region (R-VWFA) relative to fixation, but only the VWFA showed a preference for alphabetic strings over simple chequerboards. The comparison of normalized brain lesions with reading-induced activations showed that the critical lesion site for the classical syndrome of pure alexia can be tightly localized to the VWFA. Reading impairments resulting from deafferentation of an intact VWFA from right- or left-hemispheric input were dissected using the same methods, shedding light on the connectivity of the VWFA. Finally, the putative role of right-hemispheric processing in the letter-by-letter reading strategy was clarified. In a letter-by-letter reader, the R-VWFA assumed some of the functional properties normally specific to the VWFA. These data corroborate our initial model of normal word perception and underline that an alternative right-hemispheric pathway can underlie functional recovery from alexia.
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Pure alexia patients are able to identify single letters, and develop letter-by-letter reading strategies resulting in reading latencies that increase by hundreds of milliseconds for each additional letter.
“In contrast to global alexia, PA patients are able to identify single letters, and develop letter-by-letter reading strategies resulting in reading latencies that increase by hundreds of milliseconds for each additional letter [49].”
From The visual word form area: expertise for reading in the fusiform gyrus (2003) · cites this paper as [49]
This lesion overlap region was larger than the VWFA strictly defined but precisely encompassed the region of activation to words identified in fMRI studies of reading.
“Although this region was admittedly larger than the VWFA strictly defined, it precisely encompassed the region of activation to words identified in fMRI studies of reading (Cohen et al., 2003).”
From Specialization within the ventral stream: the case for the visual word form area (2004) · cites this paper as Cohen et al., 2003
The effect holds quite generally, at least in passive viewing conditions or with tasks that require equal attention to words and to consonant strings; no difference, or even a reversal, can be observed if the task is more difficult to perform with consonant strings than with words.
“This holds quite generally, at least in passive viewing conditions or with tasks that require equal attention to words and to consonant strings; no difference, or even a reversal, can be observed if the task is more difficult to perform with consonant strings than with words (Cohen et al., 2003).”
From Specialization within the ventral stream: the case for the visual word form area (2004) · cites this paper as Cohen et al., 2003
Binder and Mohr (1992), Damasio and Damasio (1983), and Cohen et al. (2003) agree on the lateral edge of the left fusiform gyrus as associated with pure alexia.
“Such work was done by Binder and Mohr (1992), Damasio and Damasio (1983), and more recently by our group (Cohen et al., 2003), with a good agreement of these studies on the lateral edge of the left fusiform gyrus.”
From Specialization within the ventral stream: the case for the visual word form area (2004) · cites this paper as Cohen et al., 2003
In the authors' recent work, a similar region of lesion overlap in the fusiform gyrus was found.
“In our recent work, we also found a similar region of lesion overlap in the fusiform gyrus.”
From Specialization within the ventral stream: the case for the visual word form area (2004) · cites this paper as Cohen et al., 2003
Simple considerations on the input and output pathways of the VWFA provide a detailed and consistent explanation for the variety of visual alexias seen in adult neuropsychological cases.
“Altogether, simple considerations on the input and output pathways of the VWFA provide a detailed and consistent explanation for the variety of visual alexias seen in adult neuropsychological cases (Cohen et al., 2003).”
From Specialization within the ventral stream: the case for the visual word form area (2004) · cites this paper as Cohen et al., 2003
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The visual word form area: expertise for reading in the fusiform gyrus
McCandliss, B. D., Cohen, L., & Dehaene, S. (2003) · Trends in Cognitive Sciences · doi:10.1016/s1364-6613(03)00134-7 · Cited by 1,489 · see citing works
Self-citationSpecialization within the ventral stream: the case for the visual word form area
Cohen, L., & Dehaene, S. (2004) · NeuroImage · doi:10.1016/j.neuroimage.2003.12.049 · Cited by 776 · see citing works
Self-citationReading normal and degraded words: Contribution of the dorsal and ventral visual pathways.
Cohen, L., Dehaene, S., Vinckier, F., Jobert, A., & Montavont, A. (2008) · NeuroImage · doi:10.1016/j.neuroimage.2007.11.036 · Cited by 303 · see citing works
Self-citationTuning of the human left fusiform gyrus to sublexical orthographic structure
Binder, J. R., Medler, D. A., Westbury, C. F., Liebenthal, E., & Buchanan, L. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2006.06.053 · Cited by 286 · see citing works
The Development of Cortical Sensitivity to Visual Word Forms
Ben-Shachar, M., Dougherty, R. F., Deutsch, G. K., & Wandell, B. A. (2011) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2011.21615 · Cited by 190 · see citing works
Word and non-word reading: What role for the Visual Word Form Area?
Vigneau, M., Jobard, G., Mazoyer, B., & Tzourio-Mazoyer, N. (2005) · NeuroImage · doi:10.1016/j.neuroimage.2005.04.038 · Cited by 169 · see citing works
Evidence for a dysfunction of left posterior reading areas in German dyslexic readers.
Kronbichler, M., Hutzler, F., Staffen, W., Mair, A., Ladurner, G., & Wimmer, H. (2006) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2006.03.010 · Cited by 131 · see citing works
“What” and “Where” in Word Reading: Ventral Coding of Written Words Revealed by Parietal Atrophy
Vinckier, F., Naccache, L., Papeix, C., Forget, J., Hahn-Barma, V., Dehaene, S., & Cohen, L. (2006) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2006.18.12.1998 · Cited by 69 · see citing works
Self-citationWoollams, A. M., Silani, G., Okada, K., Patterson, K., & Price, C. J. (2011) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2010.21502 · Cited by 54 · see citing works
Encoding in the Visual Word Form Area: An fMRI Adaptation Study of Words versus Handwriting
Barton, J. J. S., Fox, C. J., Sekunova, A., & Iaria, G. (2010) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2009.21286 · Cited by 49 · see citing works
An investigation of twenty/20 vision in reading
Hellyer, P. J., Woodhead, Z. V. J., Leech, R., & Wise, R. J. S. (2011) · The Journal of Neuroscience · doi:10.1523/jneurosci.2740-11.2011 · Cited by 13 · see citing works
- Authors
- Cohen, L.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Cohen, L.
- ORCID
- Cohen, L.
- Venue
- Cerebral Cortex
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-12-01
- Volume
- 13
- Issue
- 12
- Pages
- 1313-1333
- ISSN
- 1047-3211 (ISSN-L)
- 1460-2199
- OpenAlex
- W2113185660
- Semantic Scholar
- a4b3c1f893bc7e68e740835338163e5f9f69e037
- Cited by
- 400
- References
- 100
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 8 · 2023: 6 · 2022: 15 · 2021: 13 · 2020: 9 · 2019: 31 · 2018: 17 · 2017: 14 · 2016: 11 · 2015: 21 · 2014: 22 · 2013: 26 · 2012: 28
- FWCI
- 26.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cerebral Cortex (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
- Life Sciences › Neuroscience › Cognitive Neuroscience › Visual perception and processing mechanisms
- Keywords
- visual word recognition, pure alexia, visual word form area, hemispheric lateralization, posterior cerebral artery infarction, deafferentation, letter-by-letter reading, reading disorders
- MeSH terms
- Adult, Aged, Brain Mapping, Cerebral Cortex, Dyslexia, Acquired, Female, Humans, Language, Magnetic Resonance Imaging, Male, Middle Aged, Pattern Recognition, Visual, Reading, Visual Perception, Infarction, Posterior Cerebral Artery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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