Spoken language coding neurons in the Visual Word Form Area: Evidence from a TMS adaptation paradigm.

While part of the left ventral occipito-temporal cortex (left-vOT), known as the Visual Word Form Area, plays a central role in reading, the area also responds to speech. This cross-modal activation has been explained by three competing hypotheses. Firstly, speech is converted to orthographic representations that activate, in a top-down manner, written language coding neurons in the left-vOT. Secondly, the area contains multimodal neurons that respond to both language modalities. Thirdly, the area comprises functionally segregated neuronal populations that selectively encode different language modalities. A transcranial magnetic stimulation (TMS)-adaptation protocol was used to disentangle these hypotheses. During adaptation, participants were exposed to spoken or written words in order to tune the initial state of left-vOT neurons to one of the language modalities. After adaptation, they performed lexical decisions on spoken and written targets with TMS applied to the left-vOT. TMS showed selective facilitatory effects. It accelerated lexical decisions only when the adaptors and the targets shared the same modality, i.e., when left-vOT neurons had initially been adapted to the modality of the target stimuli. Since this within-modal adaptation was observed for both input modalities and no evidence for cross-modal adaptation was found, our findings suggest that the left-vOT contains neurons that selectively encode written and spoken language rather than purely written language coding neurons or multimodal neurons encoding language regardless of modality.