Lesions in language-dominant ventral occipitotemporal cortex (vOTC) can result in selective impairment of either reading and naming, resulting in alexia or anomia. Yet, functional imaging studies that show differential activation for naming and reading do not reveal activity exclusively tuned to one of these inputs. To resolve this dissonance in the functional architecture of vOTC, we used focused stimulation to the vOTC in 49 adult patients during reading and naming, and generated a population-level, probabilistic map to evaluate if reading and naming are clearly dissociable within individuals. Language mapping (50 Hz, 2,829 stimulations) was performed during passage reading (216 positive sites) and visual naming (304 positive sites). Within vOTC we isolated sites that selectively disrupted reading (24 sites, 11 patients) or naming (27 sites in 12 patients), and those that disrupted both processes (75 sites in 21 patients). The anteromedial vOTC had a higher probability of producing naming disruption while posterolateral regions resulted in greater reading specific disruption. Between them lay a multi-modal region where stimulation disrupted both reading and naming. This work provides a comprehensive view of vOTC organization - the existence of heteromodal cortex critical to both reading and naming, along with causally dissociable unimodal naming cortex, and a reading-specific visual word form area in vOTC. Their distinct roles as associative regions may thus relate to their connectivity within the broader language network that is disrupted by stimulation, more than to highly selective tuning properties. Our work also implies that pre-surgical mapping of both reading and naming is essential for patients requiring vOTC resections, as these functions are not co-localized and such mapping may prevent the occurrence of unexpected deficits.

中文翻译：

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腹侧枕颞皮质的阅读和命名分离

语言主导的腹侧枕颞叶皮层（vOTC）的损伤可导致选择性阅读和命名障碍，从而导致失读症或失读症。然而，功能成像研究显示命名和阅读的差异激活并没有揭示专门针对这些输入之一的活动。为了解决 vOTC 功能架构中的这种不和谐问题，我们在 49 名成年患者的阅读和命名过程中对 vOTC 进行了集中刺激，并生成了群体水平的概率图，以评估阅读和命名在个体内部是否明显可分离。在段落阅读（216 个阳性位点）和视觉命名（304 个阳性位点）期间进行语言映射（50 Hz，2,829 次刺激）。在 vOTC 中，我们隔离了选择性扰乱阅读（11 名患者中的 24 个站点）或命名（12 名患者中的 27 个站点）的站点，以及扰乱这两个过程的站点（21 名患者中的 75 个站点）。前内侧 vOTC 产生命名干扰的可能性较高，而后外侧区域则导致更大的阅读特定干扰。它们之间有一个多模式区域，刺激会扰乱阅读和命名。这项工作提供了 vOTC 组织的全面视图——对阅读和命名至关重要的异模态皮层的存在，以及因果分离的单模态命名皮层，以及 vOTC 中特定于阅读的视觉单词形式区域。因此，它们作为联想区域的独特作用可能与它们在更广泛的语言网络中的连接性有关，而这种连接性会被刺激所破坏，而不是与高度选择性的调谐特性有关。我们的工作还意味着，术前读取和命名的映射对于需要 vOTC 切除的患者至关重要，因为这些功能不是共定位的，并且这种映射可以防止意外缺陷的发生。