Reading Modality Modifies Reading Network: Insights from Neural basis of Braille in Proficient Blind Readers

The neural basis of reading is highly consistent across a variety of languages and visual scripts. An unanswered question is whether the sensory modality of symbols influences the neural basis of reading. According to the modality-invariant view, reading depends on the same neural mechanisms regardless of the sensory input modality. Consistent with this idea, previous studies find that the visual word form area (VWFA) within the ventral occipitotemporal cortex (vOTC) is active when blind individuals read Braille by touch. However, connectivity-based theories of brain function suggest that the neural entry point of written symbols (touch vs. vision) may influence the neural architecture of reading. We compared the neural basis of the visual print (sighted n=15) and tactile Braille (congenitally blind n=19) in proficient readers using analogous reading and listening tasks. Written stimuli varied in word-likeness from real words to consonant strings and non-letter shape strings. Auditory stimuli consisted of words and backward speech sounds. Consistent with prior work, vOTC was active during Braille and visual reading. However, in sighted readers, visual print elicited a posterior/anterior vOTC word-form gradient: anterior vOTC preferred larger orthographic units (words), middle vOTC preferring consonant strings, and posterior vOTC responded to shapes (i.e., lower-level physical features). No such gradient was observed in blind readers of Braille. Consistent with connectivity predictions, in blind Braille readers, posterior parietal cortices (PPC) and parieto-occipital areas were recruited to a greater degree and PPC contained word-preferring patches. Lateralization of Braille in blind readers was predicted by laterality of spoken language, as well as by reading hand. These results suggested that the neural basis of reading is influenced by symbol modality and support connectivity-based views of cortical function.Only sighted but not blind (Braille) readers show a posterior/anterior vOTC lexicality gradientPosterior parietal cortex distinctively contributes to Braille reading.Lateralization of spoken language and reading hand predict lateralization of BrailleThe sensory modality of written symbols influences the neural basis of reading