Distinct neural pathway and its information flow for blind individual's Braille reading

Natural Braille reading presents significant challenges to the brain networks of late blind individuals, yet its underlying neural mechanisms remain largely unexplored. Using natural Braille texts in behavioral assessments and functional MRI, we sought to pinpoint the neural pathway and information flow crucial for Braille reading performance in late blind individuals. In the resting state, we discovered a unique neural connection between the higher-order 'visual' cortex, the lateral occipital cortex (LOC), and the inferior frontal cortex (IFC) in late blind individuals, but not in sighted controls. The left-lateralized LOC-IFC connectivity was correlated with individual Braille reading proficiency. Prolonged Braille reading practice led to increased strength of this connectivity. During a natural Braille reading task, bidirectional information flow between the LOC and the IFC was positively modulated, with a predominantly stronger top-down modulation from the IFC to the LOC. This stronger top- down modulation contributed to higher Braille reading proficiency. We thus proposed a two-predictor multiple regression model to predict individual Braille reading proficiency, incorporating both static connectivity and dynamic top-down communication between the LOC-IFC link. This work highlights the dual contributions of the occipito-frontal neural pathway and top-down cognitive strategy to superior natural Braille reading performance, offering guidance for training late blind individuals.