A distinctive neural nexus predicts Braille reading proficiency in blind individuals

Natural Braille reading, a demanding cognitive skill, poses a huge challenge for the brain network of the blind. Here, with behavioral measurement and functional MRI imaging data, we pinpointed the neural pathway and investigated the neural mechanisms of individual differences in Braille reading in late blindness. Using resting state fMRI, we identified a distinct neural link between the higher-tier visual cortex--the lateral occipital cortex (LOC), and the inferior frontal cortex (IFC) in the late blind brain, which is significantly stronger than sighted controls. Individual Braille reading proficiency positively correlated with the left-lateralized LOC-IFC functional connectivity. In a natural Braille reading task, we found an enhanced bidirectional information flow with a stronger top-down modulation of the IFC-to-LOC effective connectivity. Greater top-down modulation contributed to higher Braille reading proficiency via a broader area of task-engaged LOC. Together, we established a model to predict Braille reading proficiency, considering both functional and effective connectivity of the LOC-IFC pathway. This two-tale model suggests that developing the underpinning neural circuit and the top-down cognitive strategy contributes uniquely to superior Braille reading performance. SIGNIFICANCE STATEMENTFor late blind humans, one of the most challenging cognitive skills is natural Braille reading. However, little is known about the neural mechanisms of significant differences in individual Braille reading performance. Using functional imaging data, we identified a distinct neural link between the left lateral occipital cortex (LOC) and the left inferior frontal cortex (IFC) for natural Braille reading in the late blind brain. To better predict individual Braille reading proficiency, we proposed a linear model with two variables of the LOC-IFC link: the resting-state functional connectivity and the task-engaged top-down effective connectivity. These findings suggest that developing the underpinning neural pathway and the top-down cognitive strategy contributes uniquely to superior Braille reading performance.