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Background:There is definitive evidence for effectiveness of thrombectomy for acute stroke with large vessel occlusion (LVO). A clinical tool to identify patients with LVO is therefore required for effective triage and prehospital decision making. We developed the FAST VAN tool, which follows from the Heart and Stroke Foundation FAST stroke screen, with the addition of cortical features of vision, aphasia, and neglect, to differentiate from lacunar syndromes.Methods:Consecutive acute stroke alerts initiated by emergency medical services (EMS) were prospectively analyzed from April 2017 to Jan 2021. FAST VAN signs were recorded by first responders who had received online education about the tool. These findings were compared to the presence or absence of LVO on CT angiography. Analysis was also performed by appropriateness for comprehensive stroke centers (CSC) transfer if no LVO was present. EMS providers were surveyed regarding ease of use in terms of learning the tool and using in real-world practice.Results:Data from 1080 consecutive acute strokes included 440 patients considered to have VAN signs by EMS. Fifty-four percent of VAN-positive patients showed LVO on CTA. Sensitivity, specificity, and accuracy were 86%, 75%, and 77%, respectively. In 204 false-positive cases, 143 (70%) were considered appropriate for evaluation at the CSC. EMS providers reported high satisfaction with learning and using the tool.Discussion:The FAST VAN tool for identification of LVO meets desired characteristics of an effective screening tool in ease of use, efficiency, and accuracy. Aphasia remains the most challenging cortical feature to identify accurately.

Ipsilateral corticospinal innervation is rare. No prior cases have described ipsilateral tumor-associated symptoms as the presentation of an uncrossed corticospinal tract. Herein, we describe a case associated with a left frontal tumor, presenting with transient ipsilateral hemiparesis and aphasia. Due to the fluctuating symptomatology, we suspected a cerebrovascular cause and initially performed a workup for stroke. Ipsilateral motor innervation was discovered with intraoperative monitoring during the resection of the tumor, and confirmed with postoperative diffusion tensor imaging (DTI). Neurosurgeons should be aware of uncrossed motor system, and include it in the differential of ipsilateral deficit in patients with intracranial tumors.

Identifying printed words and pictures concurrently is ubiquitous in daily tasks, and so it is important to consider the extent to which reading words and naming pictures may share a cognitive-neurophysiological functional architecture. Two functional magnetic resonance imaging (fMRI) experiments examined whether reading along the left ventral occipitotemporal region (vOT; often referred to as a visual word form area, VWFA) has activation that is overlapping with referent pictures (i.e., both conditions significant and shared, or with one significantly more dominant) or unique (i.e., one condition significant, the other not), and whether picture naming along the right lateral occipital complex (LOC) has overlapping or unique activation relative to referent words. Experiment 1 used familiar regular and exception words (to force lexical reading) and their corresponding pictures in separate naming blocks, and showed dominant activation for pictures in the LOC, and shared activation in the VWFA for exception words and their corresponding pictures (regular words did not elicit significant VWFA activation). Experiment 2 controlled for visual complexity by superimposing the words and pictures and instructing participants to either name the word or the picture, and showed primarily shared activation in the VWFA and LOC regions for both word reading and picture naming, with some dominant activation for pictures in the LOC. Overall, these results highlight the importance of including exception words to force lexical reading when comparing to picture naming, and the significant shared activation in VWFA and LOC serves to challenge specialized models of reading or picture naming.

Stroke is a leading cause of severe disability that often presents with unilateral motor impairment. Conventional rehabilitation approaches focus on motor practice of the affected limb and aim to suppress brain activity in the contralesional hemisphere to facilitate ipsilesional hemispheric neuroplasticity subserving motor recovery. Previous research has also demonstrated that exercise of the less-affected limb can promote motor recovery of the affected limb through the interlimb transfer of the trained motor task, termed cross-education. One of the leading theories for cross-education proposes that the interlimb transfer manifests from ipsilateral cortical activity during unimanual motor tasks, and that this ipsilateral cortical activity results in motor related neuroplasticity giving rise to contralateral improvements in motor performance. Conversely, exercise of the less-affected limb promotes contralesional brain activity which is typically viewed as contraindicated in stroke recovery due to the interhemispheric inhibitory influence onto the ipsilesional hemisphere. High-force unimanual handgrip contractions are known to increase ipsilateral brain activation in control participants, but it remains to be determined if this would be observed in participants with stroke. Therefore, this study aimed to determine how parametric increases in handgrip force during repeated contractions with the less-affected limb impacts brain activity bilaterally in participants with stroke and in a cohort of neurologically intact controls. In this study, higher force contractions were found to increase brain activation in the ipsilesional/ipsilateral hemisphere in both groups (p = .002), but no between group differences were observed. These data suggest that high-force exercise with the less-affected limb may promote ipsilesional cortical plasticity to promote motor recovery of the affected-limb in participants with stroke.

Recent research has shown a relationship between reading and attention, however the neuroanatomical overlap of these two processes has remained relatively unexplored. Therefore, we sought to investigate the overlapping neural mechanisms of spatial attention and reading using functional magnetic resonance imaging. Participants performed two attentional orienting tasks (reflexive and voluntary), and two overt word-reading tasks (lexical and sublexical). We hypothesized that there would be greater unique activation overlap of reflexive attention with lexical reading, and of voluntary attention with sublexical reading. Results indicated that lexical reading had greater overlapping activation in reflexive orienting areas compared to sublexical reading, suggesting that lexical reading may employ more automatic attentional mechanisms. In contrast, sublexical reading had greater overlapping activation with voluntary attention areas compared to lexical reading, suggesting that phonetic decoding may rely more heavily on voluntary attention. This research broadens our understanding of the neural overlap that underlies the relationship between reading and spatial attention.

In cases of brain disease such as temporal lobe epilepsy (TLE), damage may lead to functional reorganization and a shift in language dominance to homolog regions in the other hemisphere. If the effects of TLE on language dominance are hemisphere-focused, then brain regions and connections involved in word reading should be less left-lateralized in left temporal lobe epilepsy (lTLE) than right temporal lobe epilepsy (rTLE) or healthy controls, and the opposite effect should be observed in patients with rTLE. In our study, functional magnetic resonance imaging (fMRI) showed that patients with rTLE had more strongly lateralized left hemisphere (LH) activation than patients with lTLE and healthy controls in language-related brain regions (pars opercularis and fusiform gyrus (FuG)). Corresponding with this difference, diffusion tensor imaging (DTI) found differences in connectivity indicative of patients with lTLE having greater tract integrity than patients with rTLE in the right hemisphere (RH) uncinate fasciculus (UF), inferior longitudinal fasciculus (ILF), and inferior fronto-occipital fasciculus (IFOF) using the network-based statistic analysis method. The UF, ILF, and IFOF tract integrity have previously been associated with lexical (whole-word) processing abilities. Multivariate distance matrix regression provided converging evidence for regions of the IFOF having different connectivity patterns between groups with lTLE and rTLE. This research demonstrates language lateralization differences between patient groups with lTLE and rTLE, and corresponding differences in the connectivity strength of the ILF, IFOF, and UF. This research provides a novel approach to measuring lateralization of language in general, and the fMRI and DTI findings were integral for guiding the neurosurgeons performing the TLE resections. This approach should inform future studies of language lateralization and language reorganization in patients such as those with TLE.

The contralateral effects of unilateral strength training, known as cross-education of strength, date back well over a century. In the last decade, a limited number of studies have emerged demonstrating the preservation or “sparing” effects of cross-education during immobilization. Recently published evidence reveals that the sparing effects of cross-education show muscle site specificity and involve preservation of muscle cross-sectional area. The new research also demonstrates utility of training with eccentric contractions as a potent stimulus to preserve immobilized limb strength across multiple modes of contraction. The cumulative data in nonclinical settings suggest that cross-education can completely abolish expected declines in strength and muscle size in the range of ∼13% and ∼4%, respectively, after 3–4 weeks of immobilization of a healthy arm. The evidence hints towards the possibility that unique mechanisms may be involved in preservation effects of cross-education, as compared with those that lead to functional improvements under normal conditions. Cross-education effects after strength training appear to be larger in clinical settings, but there is still only 1 randomized clinical trial demonstrating the potential utility of cross-education in addition to standard treatment. More work is necessary in both controlled and clinical settings to understand the potential interaction of neural and muscle adaptations involved in the observed sparing effects, but there is growing evidence to advocate for the clinical utility of cross-education.

Prevalent theories of semantic processing assert that the sensorimotor system plays a functional role in the semantic processing of manipulable objects. While motor execution has been shown to impact object processing, involvement of the somatosensory system has remained relatively unexplored. Therefore, we developed two novel priming paradigms. In Experiment 1, participants received a vibratory hand prime (on half the trials) prior to viewing a picture of either an object interacted primarily with the hand (e.g., a cup) or the foot (e.g., a soccer ball) and reported how they would interact with it. In Experiment 2, the same objects became the prime and participants were required to identify whether the vibratory stimulation occurred to their hand or foot. In both experiments, somatosensory priming effects arose for the hand objects, while foot objects showed no priming benefits. These results suggest that object semantic knowledge bidirectionally converges with the somatosensory system.

We report a patient with a cavernous malformation involving the right lentiform nucleus. Pre-surgical planning included fMRI localization of language, motor, and sensory processing, and DTI of white matter tracts. fMRI results revealed no activation near the planned resection zone. However, post-surgery the patient developed a subdural fluid collection, which applied pressure to the primary motor cortex (M1). Follow-up scans revealed that motor activation had shifted due to pressure, and then shifted to a new location after the fluid collection subsided. This case report suggests that long-term neural reorganization can occur in response to short term compression in the cortex.

Neurobiological models of reading account for two ways in which orthography is converted to phonology: (1) familiar words, particularly those with exceptional spelling-sound mappings (e.g., shoe) a...

Objectives We report a 61-year-old woman who developed left hemiparesis following a right frontal stroke. She underwent rehabilitation and regained function of the left side of her body. Three years after her first stroke, she developed a large left subdural hematoma and again presented with left hemiparesis. Materials and Methods Prior to the cranioplasty, an fMRI scan involving left and right hand movement, arm movement, and foot peddling were conducted in order to determine whether the patient showed ipsilateral activation for the motor tasks, thus explaining the left hemiparesis following the left subdural hematoma. Diffusion tensor imaging (DTI) tractography was also collected to visualize the motor and sensory tracts. Results The fMRI results revealed activation in the expected contralateral left primary motor cortex (M1) for the right-sided motor tasks, and bilateral M1 activation for the left-sided motor tasks. Intraoperative neurophysiology confirmed these findings, whereby electromyography revealed left-sided (i.e., ipsilateral) responses for four of the five electrode locations. The DTI results indicated that the corticospinal tracts and spinothalamic tracts were within normal limits and showed no displacement or disorganization. Conclusions These results suggest that there may have been reorganization of the M1 following her initial stroke, and that the left hemisphere may have become involved in moving the left side of the body thereby leading to left hemiparesis following the left subdural hematoma. The findings suggest that cortical reorganization may occur in stroke patients recovering from hemiparesis, and specifically, that components of motor processing subserved by M1 may be taken over by ipsilateral regions.

Recent research has suggested an important role for spatial attention in reading, however the nature of this influence is unclear. Further, it has been shown that intention to engage in linguistic processing can enhance lexical processing. Therefore, we developed a novel paradigm to examine the impact of spatial attention on primed and unprimed lexical processing. In a lexical decision task, targets were preceded by a cue to lexical access and spatial location simultaneously. Results indicated that on spatially valid trials, the lexical cuing effect was large and word processing was enhanced, suggesting that spatial attention influences lexical access. On spatially invalid trials, lexical cuing effects were significantly decreased, resulting in a spatial cuing by lexical cuing interaction. Results from this experiment provide evidence that spatial attention interacts with lexical access during word processing. This novel paradigm provides a new avenue for exploring the relations between spatial at...

Temperature concepts and colour are commonly associated (i.e., red is “hot” and blue is “cold”), although their direction of influence (unidirectional, bidirectional) is unknown. Semantic Stroop effects, whereby words like fire influence colour categorization, suggest automatic semantic processing influences colour processing. The experiential framework of language comprehension indicates abstract concepts like temperature words simulate concrete experiences in their representation, where expressions like “red-hot” suggest colour processing influences conceptual processing. Participants categorized both colour (Experiment 1: red, blue; Experiment 2: red, green, blue) and word-meaning with matched lists of hot and cold meaning words in each colour. In Experiments 1 and 2, semantic categorization showed congruency effects across hot and cold words, while colour categorization showed facilitation only with hot words in Experiment 2. This asymmetry reflects a more consistent influence of colour catego...

The central aim of this experiment was to explore the connection between rhythm and reading processes by examining whether reading aloud is affected by the presentation of a rhythmic prime that was either congruent or incongruent with the syllabic stress of the target letter string. The targets were words that placed the stress on either the first or second syllable (practice vs. police), as well as their corresponding pseudohomophones (PHs) (praktis vs. poleese). The results demonstrated that naming reaction times were faster for PHs when the rhythmic prime was congruent with the syllabic stress, and slower when the rhythmic prime was incongruent. These results are taken to suggest that PHs showed a larger effect given that they must be phonetically decoded. The congruency by stimulus type interaction suggests that their effects reflect at least one common stage of processing, namely grapheme to phoneme translation. In general, these results indicate that a rhythmic prime matched to the syllabic ...

Background We report the case of a 40-year-old patient with a large, World Health Organization grade III oligodendroglioma in the left parietal lobe. Case Description Presurgical planning included functional magnetic resonance imaging (fMRI) localization of language, motor, and somatosensory processing. fMRI results for motor and somatosensory tasks revealed activation in perilesional regions near the surgical resection as well as deactivation in the tumor for the sensory task, suggesting decreased autoregulation in the region owing to the glioma. fMRI results showed left-hemisphere dominance for language and activation in perilesional regions for all 3 speech tasks (i.e., word reading, picture naming, and semantic questions). In addition, the results demonstrated that the high vascularity of the lesion altered the blood oxygen level–dependent function, resulting in false-positive and false-negative activation in the semantic questions and leg/foot rubbing task, respectively. Intraoperative direct cortical stimulation was conducted in the regions corresponding to fMRI activation while the patient performed motor, sensory, and language tasks and showed no loss of function. Follow-up fMRI revealed that there was no longer activation in the tumor or in perilesional regions, presumably owing to the resection of the vascularized tumor. Conclusions This case highlights the importance of presurgical fMRI to inform the neurosurgical approach and emphasizes the need for careful interpretation of fMRI data, especially in cases of malignant glioma, which can decrease autoregulation in surrounding regions, affecting fMRI blood oxygen level–dependent signal.

Background and Importance: Functional magnetic resonance imaging (fMRI) is a noninvasive and reliable tool for mapping eloquent cortex in patients prior to brain surgery. Ensuring intact perceptual and cognitive processing is a key goal for neurosurgeons, and recent research has indicated the value of including attentional network processing in pre-surgical fMRI in order to help preserve such abilities, including reading, after surgery. Clinical Presentation: We report a 42-year-old patient with a large cavernous malformation, near the left basal ganglia. The lesion measured 3.8 × 1.7 × 1.8 cm. In consultation with the patient and the multidisciplinary cerebrovascular team, the decision was made to offer the patient surgical resection. The surgical resection involved planned access via the left superior parietal lobule using stereotactic location. The patient declined an awake craniotomy; therefore, direct electrocortical stimulation (ECS) could not be used for intraoperative language localization in this case. Pre-surgical planning included fMRI localization of language, motor, sensory, and attentional processing. The key finding was that both reading and attention-processing tasks revealed consistent activation of the left superior parietal lobule, part of the attentional control network, and the site of the planned surgical access. Given this information, surgical access was adjusted to avoid interference with the attentional control network. The lesion was removed via the left inferior parietal lobule. The patient had no new neurologic deficits postoperatively but did develop mild neuropathic pain in the left hand. Conclusion: This case report supports recent research that indicates the value of including fMRI maps of attentional tasks along with traditional language-processing tasks in preoperative planning in patients undergoing neurosurgery procedures.

Dual route models of reading suggest there are 2 pathways for reading words: an orthographic-lexical pathway, used to read familiar regular words and exception words, and a grapheme-to-phoneme-conversion-(GPC)-sublexical pathway, used to read unfamiliar regular words, pseudohomophones (PHs), and nonwords. It is unclear, however, whether PHs activate lexical and semantic representations without intention in the GPC-sublexical pathway to the same extent as words along the orthographic-lexical pathway. The present study explored this by introducing a novel condition, color pseudohomophone associates (CPHAs; e.g., "skigh"), in 3 experiments using the Stroop paradigm. Experiment 1 examined 4 types of stimuli: color words (CWs), color word associates (CWAs), color PHs (CPHs), and color PH associates (CPHAs), in a mixed list context. Significant Stroop effects were found for all 4 types of stimuli. To ensure the robustness of this effect, Experiment 2 was conducted using pure list contexts whereby participants received only word stimuli (e.g., CWs, CWAs) or only PH stimuli (e.g., CPHs, CPHAs). The results replicated those of Experiment 1, suggesting that CPHAs activate lexical and semantic representations without intention in the GPC-sublexical pathway. Experiment 3 added 2 novel conditions: color exception word associates (which can only be pronounced correctly using the orthographic-lexical pathway) to compare the effects obtained with color exception PH associates (which rely on the GPC-sublexical pathway for correct pronunciation). Stroop effects of similar magnitude were found for both types of stimuli, suggesting lexical and semantic representations are accessed without intention in either reading pathway to a similar degree. Implications for models of reading are discussed.

Recent results from diffusion tensor imaging (DTI) studies provide evidence of a ventral-lexical stream and a dorsal-sublexical stream associated with reading processing. We investigated the relationship between behavioural reading speed for stimuli thought to rely on either the ventral-lexical, dorsal-sublexical, or both streams and white matter via fractional anisotropy (FA) and mean diffusivity (MD) using DTI tractography. Participants (N = 32) overtly named exception words (e.g., 'one', ventral-lexical), regular words (e.g., 'won', both streams), nonwords ('wum', dorsal-sublexical) and pseudohomophones ('wun', dorsal-sublexical) in a behavioural lab. Each participant then underwent a brain scan that included a 30-directional DTI sequence. Tractography was used to extract FA and MD values from four tracts of interest: inferior longitudinal fasciculus, uncinate fasciculus, arcuate fasciculus, and inferior fronto-occipital fasciculus. Median reaction times (RTs) for reading exception words and regular words both showed a significant correlation with the FA of the uncinate fasciculus thought to underlie the ventral processing stream, such that response time decreased as FA increased. In addition, RT for exception and regular words showed a relationship with MD of the uncinate fasciculus, such that response time increased as MD increased. Multiple regression analyses revealed that exception word RT accounted for unique variability in FA of the uncinate over and above regular words. There were no robust relationships found between pseudohomophones, or nonwords, and tracts thought to underlie the dorsal processing stream. These results support the notion that word recognition, in general, and exception word reading in particular, rely on ventral-lexical brain regions.

Some researchers have argued in favour of verbs primarily activating the left frontal operculum (FO) in the dorsal stream, and left middle temporal (MT) region in the ventral stream, and that nouns primarily activate the left inferior temporal (IT) region in the ventral stream. Others have suggested that the activation representing noun and verb processing involves a shared neural network. We explored these hypotheses through the naming of identical, homonymous, separately cued nouns (the bat) and verbs (to bat) presented in word format using a modified naming task that ensured participants were treating the target as the appropriate part of speech (POS). Using homonymous homographs for both the noun and verb referents provides for an optimally controlled comparison given the target stimuli and responses are physically identical. Experiment 1 was a functional magnetic resonance imaging (fMRI) experiment that showed that the majority of activation was shared by both the noun and verb naming conditions, acr...

Background: Language mapping is a key goal in neurosurgical planning. With the discontinuation of the Wada test in Canada, neurosurgeons often rely on fMRI and intraoperative techniques for determining language lateralization. Recent studies have also evaluated the utility of diffusion tensor imaging (DTI) for preoperative language lateralization, but further research is needed to confirm its efficacy. We report a patient with a left frontal AVM. fMRI and DTI was used to localize language and motor functioning. Methods: The tasks included word reading, picture naming, pseudohomophones (e.g., dawg) and semantic questions. All fMRI analyses were performed using BrainVoyager. Tensors were tracked from 30-direction diffusion MR images using DSI-Studio. Results: The fMRI results revealed consistent Broca’s and Wernicke’s areas, confirming left hemisphere dominance. There was also a region of activation in the precentral gyrus near the surgical resection. The results were loaded onto the neuronavigation system to help determine safe surgical margins. The DTI results revealed that the left arcuate and uncinate -fasciculus had three times more tracts than the right hemisphere, further supporting left hemisphere dominance. Conclusions: This case highlights the value of a combined, multimodal approach for preoperative language localization, which will further enhance surgical safety by helping preserve regions for essential brain functions.

We used functional magnetic resonance imaging (fMRI) to examine the brain regions associated with the effect of congruency between rhythmic stress and syllabic stress on reading aloud (Gould et al., 2016). The region of particular interest was the putamen, which has been shown to be involved in speech processing, rhythm processing, and predicting upcoming events. The task involved naming words that placed the stress on either the first or second syllable (practice versus police), as well as their corresponding pseudohomophones (praktis versus poleese) that were preceded by either a congruent or incongruent rhythmic prime. The fMRI results revealed that a network involving the putamen is involved, and the behavioural results demonstrated that a rhythmic prime matched to the syllabic stress aids reading processes of both words and PHs. Implications for neurobiological models of reading, as well as clinical applications (e.g. speech rehabilitation in Parkinson’s disease) are discussed.

Migraine is a headache disorder characterized by sensitivity to light and sound. Recent research has revealed abnormal visual-spatial attention in migraineurs in between headache attacks. Here, we ask whether these attentional abnormalities can be attributed to specific regions of the known attentional network to help characterize the abnormalities in migraine. Specifically, the ventral frontoparietal network of attention is involved with assessing the behavioural relevance of unattended stimuli. Given the decreased suppression of unattended stimuli reported in migraineurs, we hypothesized that migraineurs would have abnormal processing in the ventral portion of the frontoparietal network of attention. To address this, we used functional magnetic resonance imaging to assess the attentional control networks during visual spatial-orienting tasks in migraineurs (N = 16) as compared to non-migraine controls (N = 16). We employed two visual orienting paradigms with target discrimination tasks: (1) voluntary orienting to central arrow cues, and (2) reflexive orienting to peripheral flash cues. While both groups showed activation in the key areas of attentional processing networks, migraineurs showed less activation than non-migraine controls in a key area of the ventral frontoparietal network of attention, the right temporal parietal junction (rTPJ), during both voluntary and reflexive visual spatial orienting. Given the role of rTPJ is to assess the visual environment for behaviorally relevant sensory stimuli outside the focus of attention and signal other attentional areas to reorient attention to behaviorally salient stimuli, our findings fit with previous research showing that migraineurs lack suppression of unattended events and have heightened orienting to sudden onset stimuli in peripheral locations.

Background: Although surgery is the gold standard for treating brain arteriovenous malformations (AVMs), surgical techniques may not be suitable if the AVM is located in eloquent regions of the brain, such as the motor cortex. An alternative method for these cases is stereotactic radiosurgery. Localization of the motor cortex using functional magnetic resonance imaging (fMRI) is useful for helping the neurosurgeon determine which type of surgery is appropriate. We report a patient with a left frontal AVM near the motor cortex. fMRI was requested to localize motor functioning. Methods: The tasks included bilateral finger tapping, arm rubbing against the scanner, and abdominal tightening. All fMRI analyses were performed using BrainVoyager. Results: The fMRI results revealed that finger tapping and arm rubbing activated the precentral gyrus and supplementary motor area, and abdominal tightening activated the paracentral gyrus. These regions of activation were shown to be just posterior to the AVM and were mapped using neuronavigation during surgery. Conclusions: Given that the fMRI activation in the motor cortex was posterior to the AVM, the neurosurgeon felt confident that surgery could be performed. These findings elucidate the utility of fMRI for pre-surgical localization and for determining whether surgery or radiosurgery is appropriate in cases in which the AVM is near eloquent cortex.

Background: Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) are noninvasive and reliable tools for mapping eloquent cortex and white matter tracks prior to brain surgery. In this case, fMRI and DTI were used to inform the surgical approach in the resection of a deep cavernous malformation near the right lentiform nucleus. Post-surgery, the patient developed a fluid collection in the frontal cortex that applied pressure to M1, which led to reorganization of the motor cortex. Methods: The tasks included finger tapping, arm rubbing, and lip licking. All fMRI analyses were performed using BrainVoyager. Tensors were tracked from 20-direction diffusion MR images using DSIStudio. Results: An fMRI scan one-month pre-surgery revealed activation in M1 for the three tasks. A six-month follow-up scan revealed motor activation had been displaced by the fluid collection. A ten-month follow-up scan revealed that activation had shifted from its original location to more lateral and anterior regions. DTI revealed atrophy in the tracts through the insula, but increase in tracts through the lentiform nucleus. Conclusions: The results provide evidence that components of motor processing subserved by M1 can be taken over by adjacent regions, and that the rapid onset of pressure can lead to reorganization in a relatively short time period.

We examined onset reaction time (RT) in a word naming task using an additive factors method (AFM). The pattern of additive and over-additive joint effects on RT among Instructions (INST: name all, name words), Word Frequency (WF: log(10) HAL), Semantic Neighborhood Density (SND: Inverse Ncount), and Word Type (WT: regular, exception) supported a cognitive chronometric architecture consisting of at least two cascaded stages of processing, with the orthographic lexical system as the locus of the INST × WF and the INST × SND interactions, and the phonological output system as the locus of the WF × WT and the SND × WT interactions. Additivity between INST and WT supports the notion that these variables affect separable systems, and a WF × SND interaction supports a common locus of their effects. These results support stage-like/cascaded processing models over parallel processing models of basic reading. We also examined response duration (RD) in these data by recording and hand-marking vocal responses, which provides evidence that basic reading processes are ongoing even after the initiation of a vocal response, and supports the notion that the more lexically a word is read, the shorter the RD. As such, the effects of WT and INST on RD were opposite to their effects on RT however the effects of WF and SND on RD were in the same direction as their effects on RT. Given the combination of consistent and dissociating effects between RT and RD, these results provide new challenges to all models of basic reading processes.

Neurobiology of reading research has yet to explore whether reliance on the ventral-lexical stream during word reading can be enhanced by the instructed reading strategy, or whether it is impervious to such strategies. We examined Instructions: name all vs. name words (based on spelling), Word Type: regular words vs. exception words, and Word Frequency (WF) in print (log10 HAL WF) in an experiment while measuring fMRI BOLD and overt naming reaction time (RT) simultaneously. Instructions to name words increased overall reliance on the ventral-lexical stream, as measured by visible BOLD activation and the WF effect on RT, with regular words showing the greatest effects as a function of this reading strategy. Furthermore, the pattern of joint effects of these variables on RT supports the notion of cascaded, not parallel, processing. These results can be accommodated by dual-stream cascaded models of reading, and present a challenge to single-mechanism parallel processing models.