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At least 19 recordsLinked to original sources
PubMed1996

Recovery from deep alexia to phonological alexia: points on a continuum.

Reports of five patients whose deep alexic reading all evolved into phonological alexia in a similar fashion point to the hypothesis that deep alexia and phonological alexia represent different points on the same continuum. This hypothesis is explored further through an examination of previously published case reports of eleven patients with phonological alexia. Data from these patients suggest that there is a predictable succession of symptoms which form a continuum of severity of phonological alexia, with deep alexia as its endpoint. An account of the recovery from deep to phonological alexia, based upon a lexical (no-rules) model of reading, is provided (Glosser & Friedman, 1990), and the implications for therapy are considered. The significance of the notion of a continuum of phonological/deep alexia is discussed.

Adolescent↗
PubMed1984

Alexia without agraphia: a study of a case of verbal alexia without accompanying colour-naming defect.

A 47-year-old man developed a persistent form of alexia without agraphia as the result of a haemorrhagic intracerebral lesion in the left inferior temporo-occipital region, due to the rupture of an arteriovenous malformation. Surgical evacuation of the haematoma and excision of the malformation did not produce any modification of the reading deficit, which remained unchanged during a 4-year follow-up. The reading deficit was restricted to words and the patient was able to read only letter-by-letter, so that the whole words were reconstructed from the auditory names of the letters. So far, the disconnection explanation is the standard explanation of alexia without agraphia and the present case of verbal alexia may be regarded as being within this overall category. However, this explanation meets with unanswered questions that suggest more flexible interpretations. Neurolinguistic studies have questioned the unique character of alexia without agraphia as a clinical entity and, in contrast to the disconnection hypothesis, support the notion that the different varieties of alexia that are traditionally described represent distinctive syndromes, each with its own clinical features and pathophysiological basis. In this context, the reading properties in this case seem fully compatible with a deficit of the visual word-form system postulated by Warrington and Shallice, that is, the relatively early stage of the reading process through which a word-form or equivalent unit is attained. This system might be lateralized to the left hemisphere, as suggested by the fact that this case, like other cases of verbal alexia, had sustained damage to the left hemisphere and did not show any differential preservation of the reading of concrete words.

Brain↗
PubMed1988

Pure alexia in Japanese and agraphia without alexia in kanji. The ability dissociation between reading and writing in kanji vs kana.

A 60-year-old right-handed Japanese man with infarction of the left occipital lobe and inferior temporal gyrus initially showed pure alexia in kana and kanji. Later, though pure alexia in kana persisted, his kanji reading improved markedly, but with little improvement of kanji writing. We speculate that different pathways are involved in kanji reading and writing. Wernicke's area and its surrounding left middle temporal lobe might play the most important role for kanji reading when visual information is transmitted by any pathway. The pathway from Wernicke's area to the left occipital lobe via the middle and inferior temporal pathway may be indispensable for kanji writing. We postulate "agraphia without alexia in kanji" due to left inferior temporal subcortical damage.

Agraphia↗
PubMed1984

Alexia for ideograms: implications for kanji alexia.

This study was concerned with a model for kanji reading applicable in a non-Japanese population of aphasics. The experimental task required aphasic subjects to match animals with their footprints, a type of ideogram "reading" requiring no special training. As is true for kanji, footprint reading defects were consistently associated with word reading impairment, but some aphasics with defects in word reading performed normally in footprint reading. All with defects in footprint reading were also impaired in letter recognition or pantomime recognition. One aphasic's pattern of symptoms was quite similar to the rare phenomenon of Gogi aphasia. Implications for kanji alexia are discussed.

Adult↗
PubMed1997

Music alexia in a patient with mild pure alexia: disturbed visual perception of nonverbal meaningful figures.

A 26-year-old female pianist suffered from an intracerebral hematoma caused by an arteriovenous malformation of the left occipital parasplenial region, which was operated on seven months after the onset. Incomplete right hemianopsia, mild pure alexia, and partially disturbed naming of visual objects persisted several months after the removal of the malformation. Evaluation of musical ability one and three months after surgery showed that her auditory recognition of music was intact. She could sing and play melodies already learned and could dictate well the notes after hearing tones. However, she had difficulty in reading music, especially the pitch of notes, even for simple sequences of 4 notes. In contrast, her rhythm reading was fairly good. Her visual recognition of other symbolic figures like road signs was also markedly impaired. These results suggest that her visual recognition of written music as well as of other symbolic figures underwent a preliminary verbal decoding in the left hemisphere and that pitch reading was more dependent on verbal processing than rhythm reading.

Adult↗
PubMed1991

[Central visual fields in pure alexia "without hemianopsia"--visual dysfunction in the right hemifield, and alexia for "kana" words in the left].

Following a left occipito-temporal subcortical hematoma, a 57-year-old, right-handed man developed pure alexia that was more prominent in kana words, especially in kana nonwords, than in kanji letters. Although a kinetic perimetry with a Goldmann perimeter showed his visual fields to be full, a static perimetry with a Humphrey visual field analyzer disclosed decreased visual sensitivity in the right visual field in its central 30 degrees. In addition, a tachnistoscopic examination with Landolt rings revealed his visual acuity (the ability of two points discrimination) to have decreased in the right half of his central visual filed in its 3 degrees. In the right central vision, he was unable to recognize the letters, pictures or colors presented by the tachistoscope. Concerning the reading, the more letters in kana words or the higher the number of strokes in kanji letters, the more difficulty he experienced in orally reading both kana and kanji. On the contrary, in the left central vision, kanji reading was not so affected by an increased number of strokes as the kana-word reading which became difficult when the number of the letters increased. CT scan showed subcortical hematoma in the left occipitotemporal region. Magnetic resonance imaging 3 months after onset revealed a localized injury in the region between the left postero-inferior temporal lobe and the infero-lateral occipital lobe, including the fusiform gyrus. None of the splenium, the lingual gyrus or the optic area were affected. The spared structures also included the angular gyrus, the Wernicke area and their subcortical white matter.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Hemorrhage↗
PubMed1987

[Aphasia without amusia in a blind organist. Verbal alexia-agraphia without musical alexia-agraphia in braille].

A 77 year old right handed male was blind since the age of 2. He presented with an infarction involving the territory of the left middle cerebral artery involving the temporal and the inferior parietal lobes. He had learned to read and write language as well as read and write music in braille, ultimately becoming a famous organist and composer. There were no motor or sensory deficits. Wernicke's aphasia with jargonaphasia, major difficulty in repetition, anomia and a significant comprehension deficit without word deafness was present; verbal alexia and agraphia in braille were also present. There was no evidence of amusia. He could execute in an exemplary fashion pieces of music for the organ in his repertory as well as improvise. All his musical capabilities: transposition, modulation, harmony, rythm, were preserved. The musical notation in braille remained intact: he could read by touch and play unfamiliar scores, he could also read and sing the musical notes, he could copy and write a score. Nine months after the stroke his aphasia remained unchanged. Nevertheless he composed pieces for the organ which were published. Such data highly suggest the independence of linguistic and musical competences, defined as the analysis and organization of sounds according to the rules of music. This independence in an extremely talented musician leads to a discussion of the role of the right hemisphere in the anatomical-functional processes at the origin of musical competence. The use of braille in which the same constellations of dots correspond either to letters of the alphabet or musical notes supports the independence between language and music.

Aged↗
PubMed1992

[A study of alexia in Chinese language].

Twenty-five cases of alexia were examined with Chinese Alexia Test which was devised according to the features of Chinese ideogram. The result of our study showed that alexia in Chinese ideographic language differs from alexia in western phonographic languages. It has its own characteristics and is manifested as following patterns: difficulty in reading aloud, dissociation of appearance and meaning of character, alexia of combinative character, alexia of associative compounds, alexia of abstract word, visual paralexia, surface alexia, deep alexis, phenomenon of word completion (formation of words by addition of another character), substitution with neologisms, perseveration in alexia, character and word alexia, syntactic alexia, and total alexia. Twenty-five cases of alexia were classified according to Benson's classification of alexia as anterior, central, subcortical aphasic and total alexis. One case with proterior alexia was briefly reviewed. The main differential points of various alexia in Chinese language were suggested.

Aged↗
PubMed2004

Varieties of alexia from fusiform, posterior inferior temporal and posterior occipital gyrus lesions.

Reading impairments of three alexia patients, two pure alexia and one alexia with agraphia, due to different lesions were examined quantitatively, using Kanji (Japanese morphogram) words, Kana (Japanese phonetic writing) words and Kana nonwords. Kana nonword reading was impaired in all three patients, suggesting that widespread areas in the affected occipital and occipitotemporal cortices were recruited in reading Kana characters (corresponding to European syllables). In addition, the findings in patient 1 (pure alexia for Kanji and Kana from a fusiform and lateral occipital gyri lesion) and patient 2 (pure alexia for Kana from a posterior occipital gyri lesion) suggested that pure alexia could be divided into two types, i.e. ventromedial type in which whole-word reading, together with letter identification, is primarily impaired because of a disconnection of word-form images from early visual analysis, and posterior type in which letter identification is cardinally impaired. Another type of alexia, alexia with agraphia for Kanji from a posterior inferior temporal cortex lesion (patient 3), results from deficient whole-word images of words per se, and thus should be designated "orthographic alexia with agraphia". To account for these impairments, a weighted dual-route hypothesis for reading is suggested.

Aged↗
PubMed2000

Alexia caused by a fusiform or posterior inferior temporal lesion.

We evaluated the alexia and agraphia of three patients with different lesions using Japanese kanji (morphograms) and kana (phonograms) and made a lesion-to-symptom analysis. Patient 1 (pure alexia for both kanji and kana and minor agraphia for kanji after a fusiform lesion) made more paragraphic errors for kanji, whereas patient 2 (alexia with agraphia for kanji after a posterior inferior temporal lesion) showed severe reading and writing disturbances and more agraphic errors for kanji. Brodmann Area 37 was affected in both patients, but in patient 2 the lesion was located lateral to that in patient 1. Patient 3 showed agraphia without alexia after restricted lesion to the angular gyrus. We believe that pure alexia (patient 1) results from a disconnection between the medial fusiform gyrus and posterior inferior temporal area (the lateral fusiform and inferior temporal gyri), whereas alexia with agraphia for kanji (patient 2), corresponding to lexical agraphia in Western countries, results from damage to the posterior inferior temporal area, in which whole-word images of words are thought to be stored. Furthermore, restricted lesion in the angular gyrus (patient 3) does not produce alexia; the alexic symptom of "angular" alexia with agraphia may be the result of damage to the adjacent lateral occipital gyri.

Aged↗
PubMed2004

[Peripheral alexias].

The brain lesions could lead to impairments of the comprehension and production of written language. This acquired inability is named alexia. It is a significant problem for neurologists and ophthalmologists. Our study presents a classification of the alexias, whose pathology was describe first by Dejerine (1891; 1892). There are two varieties of alexias: central alexias and peripheral alexias (especially agnozic alexia and attentional alexia). In agnozic alexia, the patient cannot read, but can write, understand and speak. It results from a type of cerebral disconnection in which the angular gyrus of the dominant hemisphere is disconnected from its bilateral visual input. The most commonly reported pathology is occlusion of the dominant (left) posterior cerebral artery, which leads to infarction of both the left occipital lobe (causing partial or complete right homonymous hemianpsia) and the splenium of the corpus callosum.

Corpus Callosum↗
PubMed2001

The functional anatomy of single-word reading in patients with hemianopic and pure alexia.

We investigated single-word reading in normal subjects and patients with alexia following a left occipital infarct, using PET. The most posterior brain region to show a lateralized response was at the left occipitotemporal junction, in the inferior temporal gyrus. This region was activated when normal subjects, patients with hemianopic alexia and patients with an incomplete right homonymous hemianopia, but no reading deficit, viewed single words presented at increasing rates. This same area was damaged in a patient with pure alexia ("alexia without agraphia") and no hemianopia, who read words slowly using a letter-by-letter strategy. Although the exact level of the functional deficit is controversial, pure alexia is the result of an inability to map a percept of all the letters in a familiar letter string on to the mental representation of the whole word form. However, the commonest deficit associated with "pure" alexia is a right homonymous field defect; an impairment that may, by itself, interfere with single-word reading because of inability to see the letters towards the end of a word. The relative contributions of pure and hemianopic alexia in individual patients needs to be assessed, as the latter has been shown to respond well to specific rehabilitation programmes.

Adult↗
PubMed1987

[A case of alexia with agraphia following left occipital lobe].

Since Dejerine reported cases of alexia with agraphia in 1891 and of pure alexia in 1892, it is generally said that the former may occur due to the lesion of the left angular gyrus and the latter due to that of the medial inferior area of the left occipital lobe. In this article, we reported a case of alexia with agraphia who had the main lesion in the medial inferior area of the occipital lobe of the left hemisphere. A 62-year-old right-handed male showed alexia with agraphia. CT scan and single photon emission CT revealed the main lesion in the medial occipital area on the left side. Alexia with agraphia of the patient was characterized as follows: with regard to reading, though his recognition of forms as letter was nearly spared, he could neither read letters or words nor differentiate Kana- from Kanji-letters. Paralexic errors included confusion of Kana and Kanji. He manifested no kinesthetic facilitation in reading. Regarding writing, his disturbances were more severe in Kanji-writing, but there were paragraphia and difficulty of letter-form evocation even in Kana-writing. He could not write spontaneously or to dictation. His copying of letters was also disturbed. Since it is said that there is no difference between Kana- and Kanji-disturbance in Japanese pure alexics, an aspect of alexia of the patient may be common to pure alexia.(ABSTRACT TRUNCATED AT 250 WORDS)

Agraphia↗
PubMed1984

Jules Dejerine and the third alexia.

Modern concepts of pure alexia and alexia with agraphia are derived from Dejerine's eloquent clinicopathologic studies of the late 19th century. More recently, a third variety of alexia has been described in association with left frontal lesions causing Broca's aphasia. Dejerine also recognized this "third alexia." For Dejerine, alexia with Broca's aphasia was indispensible to his view of a left-hemisphere language zone in which cortical lesions disrupt all language modalities (speech, reading, and writing). Viewed in light of modern neurolinguistic advances, Dejerine's descriptions of the third alexia are surprisingly prescient.

Agraphia↗
PubMed1990

The continuum of deep/phonological alexia.

Two patients exhibited all the characteristics of deep alexia shortly following brain injury. Both subsequently recovered some reading abilities and evolved to show a pattern of oral reading consistent with phonological alexia. These findings suggest that deep alexia and phonological alexia share common underlying deficits that are mediated by common neurological systems. A two-deficit psycholinguistic model is presented to account for the apparent continuity between deep alexia and phonological alexia.

Adult↗