The visual word form area (VWFA), a region systematically involved in the identification of written words, occupies a reproducible location in the left occipitotemporal sulcus in expert readers of all cultures. Such a reproducible localization is paradoxical, given that reading is a recent invention that could not have influenced the genetic evolution of the cortex. Here, we test the hypothesis that the VWFA recycles a region of the ventral visual cortex that shows a high degree of anatomical connectivity to perisylvian language areas, thus providing an efficient circuit for both grapheme-phoneme conversion and lexical access. In two distinct experiments, using highresolution diffusion-weighted data from 75 human subjects, we show that (1) the VWFA, compared with the fusiform face area, shows higher connectivity to left-hemispheric perisylvian superior temporal, anterior temporal and inferior frontal areas; (2) on a posteriorto-anterior axis, its localization within the left occipitotemporal sulcus maps onto a peak of connectivity with language areas, with slightly distinct subregions showing preferential projections to areas respectively involved in grapheme-phoneme conversion and lexical access. In agreement with functional data on the VWFA in blind subjects, the results suggest that connectivity to language areas, over and above visual factors, may be the primary determinant of VWFA localization.

Efficient reading requires a fast conversion of the written word to both phonological and semantic codes. We tested the hypothesis that, within the left occipitotemporal cortical regions involved in visual word recognition, distinct subregions harbor slightly different orthographic codes adapted to those 2 functions. While the lexico-semantic pathway may operate on letter or open-bigram information, the phonological pathway requires the identification of multiletter graphemes such as “ch” or “ou” in order to map them onto phonemes. To evaluate the existence of a specific stage of graphemic encoding, 20 adults performed lexical decision and naming tasks on words and pseudowords during functional MRI. Graphemic encoding was facilitated or disrupted by coloring and spacing the letters either congruently with multiletter graphemes (ch-ai-r) or incongruently with them (c-ha-ir). This manipulation affected behavior, primarily during the naming of pseudowords, and modulated brain activity in the left midfusiform sulcus, at a site medial to the classical visual word form area (VWFA). This putative grapheme-related area (GRA) differed from the VWFA in being preferentially connected functionally to dorsal parietal areas involved in letter-by-letter reading, while the VWFA showed effects of lexicality and spelling-to-sound regularity. Our results suggest a partial dissociation within left occipitotemporal cortex: the midfusiform GRA would encode orthographic information at a sublexical graphemic level, while the lateral occipitotemporal VWFA would contribute primarily to direct lexico-semantic access.