Selective kana jargonagraphia following right hemispheric infarction.
A strongly right-handed Japanese man showed an unusual writing disorder associated with Broca-type aphasia after suffering a right hemispheric infarction. Writing with his right hand produced a fluent output in contrast to his nonfluent speech. The patient's agraphia disproportionately affected the writing of kana (Japanese syllabograms), leaving relatively intact the writing of kanji (Japanese ideograms). His kana agraphia, consisting of substitutions, intrusions, transpositions, and deletions, became apparent as the number of syllables in target words increased. Quantitative analysis of the substitutions in terms of their phonological similarity to the target revealed that most of the substitutions were phonologically dissimilar. Those errors were distributed almost identically for familiar and novel words. Moreover, the errors were observed asymmetrically across the target: more errors occurred near the end than at the beginning of a word. The kana agraphia in association with fluent writing output resulted in kana jargonagraphia. These observations suggest that our patient's selective kana jargonagraphia is best explained by selective damage to the hypothesized kana graphemic buffer and by disinhibition of the motor engrams of writing behavior, both of which resulted from right hemispheric damage.