A test of the role of the medial temporal lobe in single-word decoding

The degree to which the MTL system contributes to effective language skills is not well delineated. We sought to determine if the MTL plays a role in single-word decoding in healthy, normal skilled readers. The experiment follows from the implications of the dual-process model of single-word decoding, which provides distinct predictions about the nature of MTL involvement. The paradigm utilized word (regular and irregularly spelled words) and pseudoword (phonetically regular) stimuli that differed in their demand for non-lexical as opposed lexical decoding. The data clearly showed that the MTL system was not involved in single word decoding in skilled, native English readers. Neither the hippocampus nor the MTL system as a whole showed significant activation during lexical or non-lexical based decoding. The results provide evidence that lexical and non-lexical decoding are implemented by distinct but overlapping neuroanatomical networks. Non-lexical decoding appeared most uniquely associated with cuneus and fusiform gyrus activation biased toward the left hemisphere. In contrast, lexical decoding appeared associated with right middle frontal and supramarginal, and bilateral cerebellar activation. Both these decoding operations appeared in the context of a shared widespread network of activations including bilateral occipital cortex and superior frontal regions. These activations suggest that the absence of MTL involvement in either lexical or non-lexical decoding appears likely a function of the skilled reading ability of our sample such that whole-word recognition and retrieval processes do not utilize the declarative memory system, in the case of lexical decoding, and require only minimal analysis and recombination of the phonetic elements of a word, in the case of non-lexical decoding.