Reading is a uniquely human task and therefore any sign of neuronal activation that is specific to reading is of considerable interest. One intriguing observation is that ventral occipitotemporal (vOT) activation is more strongly left lateralized for written words than other visual stimuli. This has contributed to claims that left vOT plays a special role in reading. Here, we investigated whether left lateralized vOT responses for words were the consequence of visual feature processing, visual word form selectivity, or higher level language processing. Using fMRI in 82 skilled readers, our paradigm compared activation and lateralization for words and nonlinguistic stimuli during different tasks. We found that increased left lateralization for words relative to pictures was the consequence of reduced activation in right vOT rather than increased activation in left vOT. We also found that the determinants of lateralization varied with the subregion of vOT tested. In posterior vOT, lateralization depended on the spatial frequency of the visual inputs. In anterior vOT, lateralization depended on the semantic demands of the task. In middle vOT, lateralization depended on a combination of visual expertise in the right hemisphere and semantics in the left hemisphere. These results have implications for interpreting left lateralized vOT activation during reading. Specifically, left lateralized activation in vOT does not necessarily indicate an increase in left vOT processing but is instead a consequence of decreased right vOT function. Moreover, the determinants of lateralization include both visual and semantic factors depending on the subregion tested.
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