Does literacy improve brain function? Does it also entail losses? Using functional magnetic resonance imaging, we measured brain responses to spoken and written language, visual faces, houses, tools, and checkers in adults of variable literacy (10 were illiterate, 22 became literate as adults, and 31 were literate in childhood). As literacy enhanced the left fusiform activation evoked by writing, it induced a small competition with faces at this location, but also broadly enhanced visual responses in fusiform and occipital cortex, extending to area V1. Literacy also enhanced phonological activation to speech in the planum temporale and afforded a top-down activation of orthography from spoken inputs. Most changes occurred even when literacy was acquired in adulthood, emphasizing that both childhood and adult education can profoundly refine cortical organization.

The ability to recognize 2 mirror images as the same picture across left-right inversions exists early on in humans and other primates. In order to learn to read, however, one must discriminate the left-right orientation of letters and distinguish, for instance, b from d. We therefore reasoned that literacy may entail a loss of mirror invariance. To evaluate this hypothesis, we asked adult literates, illiterates, and ex-illiterates to perform a speeded same-different task with letter strings, false fonts, and pictures regardless of their orientation (i.e., they had to respond "same" to mirror pairs such as "iblo oldi"). Literates presented clear difficulties with mirror invariance. This "mirror cost" effect was strongest with letter strings, but crucially, it was also observed with false fonts and even with pictures. In contrast, illiterates did not present any cost for mirror pairs. Interestingly, subjects who learned to read as adults also exhibited a mirror cost, suggesting that modest reading practice, late in life, can suffice to break mirror invariance.

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The effect of the degree of illiteracy (complete or incomplete) on phonological skills, verbal and visual memory and visuospatial skills is examined in 97 normal Brazilian adults who considered themselves illiterate, and 41 Brazilian school children aged 7 to 8 years, either nonreaders or beginning readers. Similar literacy effects were observed in children and in adults. Tasks involving phonological awareness and visual recognition memory of nonsense figures distinguish the best nonreaders and beginning readers. Children performed better than adults at oral repetition of short items and figure recall, and adults better than children at semantic verbal fluency, digit span, and word list recall. A principal component analysis of the correlations between tasks showed that phonological awareness/reading, phonological memory/oral repetition, and semantic verbal memory/fluency tasks, generated different components. The respective role of culturally based preschool activities and literacy on the cognitive functions that are explored in this study is discussed.

Children with TBI report significantly reduced QoL compared to a control group in the physical, psychological, cognitive and total score dimensions. However, TBI children with average academic performance (65%) obtained the same QoL scores as the control group.