Interaction of speech and script in human auditory cortex: insights from neuro-imaging and effective connectivity.

In addition to visual information from the face of the speaker, a less natural, but nowadays extremely important visual component of speech is its representation in script. In this review, neuro-imaging studies are examined which were aimed to understand how speech and script are associated in the adult "literate" brain. The reviewed studies focused on the role of different stimulus and task factors and effective connectivity between different brain regions. The studies will be summarized in a neural mechanism for the integration of speech and script that can serve as a basis for future studies addressing (the failure of) literacy acquisition. In this proposed mechanism, speech sound processing in auditory cortex is modulated by co-presented visual letters, depending on the congruency of the letter-sound pairs. Other factors of influence are temporal correspondence, input quality and task instruction. We present results showing that the modulation of auditory cortex is most likely mediated by feedback from heteromodal areas in the superior temporal cortex, but direct influences from visual cortex are not excluded. The influence of script on speech sound processing occurs automatically and shows extended development during reading acquisition. This review concludes with suggestions to answer currently still open questions to get closer to understanding the neural basis of normal and impaired literacy.