Phonological and surface dyslexia in individuals with brain tumors: Performance pre-, intra-, immediately post-surgery and at follow-up.

We address existing controversies regarding neuroanatomical substrates of reading-aloud processes according to the dual-route processing models, in this particular instance in a series of 49 individuals with brain tumors who performed several reading tasks of real-time neuropsychological testing during surgery (low- to high-grade cerebral neoplasms involving the left hemisphere). We explored how reading abilities in individuals with brain tumors evolve during and after surgery for a brain tumor, and we studied the reading performance in a sample of 33 individuals in a 4-month follow-up after surgery. Impaired reading performance was seen pre-surgery in 7 individuals with brain tumors, intra-surgery in 18 individuals, at immediate post-surgery testing in 26 individuals, and at follow-up in 5 individuals. We classified their reading disorders according to operational criteria for either phonological or surface dyslexia. Neuroimaging results are discussed within the theoretical framework of the dual-route model of reading. Lesion-mask subtraction analyses revealed that areas selectively related with phonological dyslexia were located-along with the left hemisphere dorsal stream-in the Rolandic operculum, the inferior frontal gyrus, the precentral gyrus, the supramarginal gyrus, the insula (and/or the underlying external capsule), and parts of the superior longitudinal fasciculus, whereas lesions related to surface dyslexia involved the ventral stream, that is, the left middle and inferior temporal gyrus and parts of the left inferior longitudinal fasciculus.

Selective impairment of On-reading (Chinese-style pronunciation) in alexia with agraphia for kanji due to subcortical hemorrhage in the left posterior middle temporal gyrus.

We report a patient with alexia with agraphia for kanji after hemorrhage in the left posterior middle temporal gyrus. The results of single-character kanji reading and two-character on- (Chinese-style pronunciation), kun- (native Japanese pronunciation), and Jukujikun (irregular kun-) reading word tests revealed that the patient could not read kanji characters with on-reading but read the characters with kun-reading. We consider that this on-reading alexia was caused by disconnection between the posterior inferior temporal cortex (orthographic lexicon) and the posterior superior temporal gyrus (phonological lexicon), and preserved kun- and Jukujikun-reading was realized by bypassing the orthography-to-phonology route by the semantic route.

Visual and binocular status in elementary school children with a reading problem / Estado visual y binocular en niños de primaria con dificultades lectoras

Purpose: This descriptive study provides a summary of the binocular anomalies seen in elementary school children identified with reading problems. Methods: A retrospective chart review of all children identified with reading problems and seen by the University of Waterloo, Optometry Clinic, from September 2012 to June 2013. Results: Files of 121 children (mean age 8.6 years, range 6-14 years) were reviewed. No significant refractive error was found in 81% of children. Five and 8 children were identified as strabismic at distance and near respectively. Phoria test revealed 90% and 65% of patients had normal distance and near phoria. Near point of convergencia (NPC) was < 5cm in 68% of children, and 77% had stereoacuity of ≤40seconds of arc. More than 50% of the children had normal fusional vergence ranges except for near positive fusional vergencce (base out) break (46%). Tests for accommodation showed 91% of children were normal for binocular facility, and approximately 70% of children had an expected accuracy of accommodation. Conclusion: Findings indicate that some children with an identified reading problem also present with abnormal binocular test results compared to published normal values. Further investigation should be performed to investigate the relationship between binocular vision function and reading performance

Objetivo: Este estudio descriptivo aporta un resumen de las anomalías binoculares observadas en niños de primaria en los que se identificaron problemas de lectura. Métodos: Revisión retrospectiva de las historias clínicas de todos los niños en los que se identificaron problemas de lectura, examinados en la Universidad de Waterloo, Clínica de Optometría, desde Septiembre de 2012 a Junio de 2013. Resultados: Se revisaron las historias de 121 niños (edad media 8,6 años, rango 6-14 años). No se encontró ningún error refractivo significativo en el 81% de los niños. Se identificaron cinco y ocho niños con estrabismo de visión lejana y cercana, respectivamente. La prueba de foria reveló que el 90% y 65% de los pacientes padecían foria en rango de normalidad para lejos y cerca. El punto próximo de convergencia (PPC) fue < 5cm en el 68% de los niños, y el 77% reflejó estereoagudeza ≤ 40 segundos de arco. Más del 50% de los niños tenía rangos de vergencia fusional normal, excepto para el punto de rotura de vergencia fusional positiva de cerca (46%). Las pruebas de acomodación reflejaron que el 91% de los niños tenía una flexibilidad binocular normal, y aproximadamente el 70% de los niños tenía una precisión de acomodación con arreglo a lo previsto. Conclusión: Los hallazgos indican que algunos niños con dificultades lectoras identificadas presentan también alteraciones en los resultados de las pruebas binoculares, en comparación a los valores normales publicados. Deberá investigarse más con respecto a la relación entre la función de la visión binocular y el rendimiento lector

Visual and binocular status in elementary school children with a reading problem.

PURPOSE: This descriptive study provides a summary of the binocular anomalies seen in elementary school children identified with reading problems. METHODS: A retrospective chart review of all children identified with reading problems and seen by the University of Waterloo, Optometry Clinic, from September 2012 to June 2013. RESULTS: Files of 121 children (mean age 8.6 years, range 6-14 years) were reviewed. No significant refractive error was found in 81% of children. Five and 8 children were identified as strabismic at distance and near respectively. Phoria test revealed 90% and 65% of patients had normal distance and near phoria. Near point of convergencia (NPC) was <5cm in 68% of children, and 77% had stereoacuity of ≤40seconds of arc. More than 50% of the children had normal fusional vergence ranges except for near positive fusional vergencce (base out) break (46%). Tests for accommodation showed 91% of children were normal for binocular facility, and approximately 70% of children had an expected accuracy of accommodation. CONCLUSION: Findings indicate that some children with an identified reading problem also present with abnormal binocular test results compared to published normal values. Further investigation should be performed to investigate the relationship between binocular vision function and reading performance.

A formal analysis of alexia in persistent aura and a comparison to acquired pure alexia.

A patient is reported with reversible pure alexia in the context of migraine with aura. Following previous, anecdotal reports, the present study is the first to formally assess word reading, writing, and other linguistic and visual processing and to compare these to a patient with stroke-related pure alexia. The reading impairment, suggestive of letter-by-letter reading, was observed across 7 days but had remitted at a 3-month follow-up. The deficit also affected recognition of letters, suggesting a functional impairment at the level of letter recognition, not just word reading. It went along with reversible abnormalities in diffusion-weighted and fluid-attenuated inversion recovery imaging in areas known to be involved in word reading.

Promoting linguistic complexity, greater message length and ease of engagement in email writing in people with aphasia: initial evidence from a study utilizing assistive writing software.

BACKGROUND: Improving email writing in people with aphasia could enhance their ability to communicate, promote interaction and reduce isolation. Spelling therapies have been effective in improving single-word writing. However, there has been limited evidence on how to achieve changes to everyday writing tasks such as email writing in people with aphasia. One potential area that has been largely unexplored in the literature is the potential use of assistive writing technologies, despite some initial evidence that assistive writing software use can lead to qualitative and quantitative improvements to spontaneous writing. AIMS: This within-participants case series design study aimed to investigate the effects of using assistive writing software to improve email writing in participants with dysgraphia related to aphasia. METHODS & PROCEDURES: Eight participants worked through a hierarchy of writing tasks of increasing complexity within broad topic areas that incorporate the spheres of writing need of the participants: writing for domestic needs, writing for social needs and writing for business/administrative needs. Through completing these tasks, participants had the opportunity to use the various functions of the software, such as predictive writing, word banks and text to speech. Therapy also included training and practice in basic computer and email skills to encourage increased independence. Outcome measures included email skills, keyboard skills, email writing and written picture description tasks, and a perception of disability assessment. OUTCOMES & RESULTS: Four of the eight participants showed statistically significant improvements to spelling accuracy within emails when using the software. At a group level there was a significant increase in word length with the software; while four participants showed noteworthy changes to the range of word classes used. Enhanced independence in email use and improvements in participants' perceptions of their writing skills were also noted. CONCLUSIONS & IMPLICATIONS: This study provided some initial evidence that assistive writing technologies can support people with aphasia in email writing across a range of important performance parameters. However, more research is needed to measure the effects of these technologies on the writing of people with aphasia, and to determine the optimal compensatory mechanisms for specific people given the linguistic-strategic resources they bring to the task of email writing.

Assessing neglect dyslexia with compound words.

OBJECTIVE: The neglect syndrome is frequently associated with neglect dyslexia (ND), which is characterized by omissions or misread initial letters of single words. ND is usually assessed with standardized reading texts in clinical settings. However, particularly in the chronic phase of ND, patients often report reading deficits in everyday situations but show (nearly) normal performances in test situations that are commonly well-structured. To date, sensitive and standardized tests to assess the severity and characteristics of ND are lacking, although reading is of high relevance for daily life and vocational settings. METHOD: Several studies found modulating effects of different word features on ND. We combined those features in a novel test to enhance test sensitivity in the assessment of ND. Low-frequency words of different length that contain residual pronounceable words when the initial letter strings are neglected were selected. We compared these words in a group of 12 ND-patients suffering from right-hemispheric first-ever stroke with word stimuli containing no existing residual words. Finally, we tested whether the serially presented words are more sensitive for the diagnosis of ND than text reading. RESULTS: The severity of ND was modulated strongly by the ND-test words and error frequencies in single word reading of ND words were on average more than 10 times higher than in a standardized text reading test (19.8% vs. 1.8%). CONCLUSION: The novel ND-test maximizes the frequency of specific ND-errors and is therefore more sensitive for the assessment of ND than conventional text reading tasks. (PsycINFO Database Record

Online Sentence Reading in People With Aphasia: Evidence From Eye Tracking.

PURPOSE: There is a lot of evidence that people with aphasia have more difficulty understanding structurally complex sentences (e.g., object clefts) than simpler sentences (subject clefts). However, subject clefts also occur more frequently in English than object clefts. Thus, it is possible that both structural complexity and frequency affect how people with aphasia understand these structures. METHOD: Nine people with aphasia and 8 age-matched controls participated in the study. The stimuli consisted of 24 object cleft and 24 subject cleft sentences. The task was eye tracking during reading, which permits a more fine-grained analysis of reading performance than measures such as self-paced reading. RESULTS: As expected, controls had longer reading times for critical regions in object cleft sentences compared with subject cleft sentences. People with aphasia showed the predicted effects of structural frequency. Effects of structural complexity in people with aphasia did not emerge on their first pass through the sentence but were observed when they were rereading critical regions of complex sentences. CONCLUSIONS: People with aphasia are sensitive to both structural complexity and structural frequency when reading. However, people with aphasia may use different reading strategies than controls when confronted with relatively infrequent and complex sentence structures.

An Exploratory Study of Reading Comprehension in College Students After Acquired Brain Injury.

PURPOSE: This exploratory study builds on the small body of existing research investigating reading comprehension deficits in college students with acquired brain injury (ABI). METHOD: Twenty-four community college students with ABI completed a battery of questionnaires and standardized tests to characterize self-perceptions of academic reading ability, performance on a standardized reading comprehension measure, and a variety of cognitive functions of this population. Half of the participants in the sample reported traumatic brain injury (n = 12) and half reported nontraumatic ABI (n = 12). RESULTS: College students with both traumatic and nontraumatic ABI cite problems with reading comprehension and academic performance postinjury. Mean performance on a standardized reading measure, the Nelson-Denny Reading Test (Brown, Fischo, & Hanna, 1993), was low to below average and was significantly correlated with performance on the Speed and Capacity of Language Processing Test (Baddeley, Emslie, & Nimmo-Smith, 1992). Injury status of traumatic versus nontraumatic ABI did not differentiate results. Regression analysis showed that measures of verbal attention and suppression obtained from the California Verbal Language Test-II (Delis, Kramer, Kaplan, & Ober, 2000) predicted total scores on the Nelson-Denny Reading Test. CONCLUSIONS: College students with ABI are vulnerable to reading comprehension problems. Results align with other research suggesting that verbal attention and suppression problems may be contributing factors.

Cerebral processing of proper and common nouns: Perception and production following left hemisphere damage.

The goal of this study was to further investigate hemispheric specialization for proper and common nouns by examining the ability of individuals with left hemisphere damage (LHD) to perceive and verbally reproduce famous names and matched common names compared with the performance of matched healthy controls (HC). Ten individuals with LHD due to stroke and 16 age- and education-matched HC completed recognition and production tasks of famous proper and common nouns. All tasks were designed as split-visual field experiments, modelled after the study done by Ohnesorge and Van Lancker. Results contribute to a better understanding of hemispheric roles in perception and production of famous proper nouns, suggesting that (1) both hemispheres can recognize famous proper nouns, possibly due to a right hemisphere role in personal relevance and (2) production of proper nouns as well as common nouns is associated with left hemisphere.

An evaluation of reading comprehension of expository text in adults with traumatic brain injury.

PURPOSE: This project was conducted to obtain information about reading problems of adults with traumatic brain injury (TBI) with mild-to-moderate cognitive impairments and to investigate how these readers respond to reading comprehension strategy prompts integrated into digital versions of text. METHOD: Participants from 2 groups, adults with TBI (n = 15) and matched controls (n = 15), read 4 different 500-word expository science passages linked to either a strategy prompt condition or a no-strategy prompt condition. The participants' reading comprehension was evaluated using sentence verification and free recall tasks. RESULTS: The TBI and control groups exhibited significant differences on 2 of the 5 reading comprehension measures: paraphrase statements on a sentence verification task and communication units on a free recall task. Unexpected group differences were noted on the participants' prerequisite reading skills. For the within-group comparison, participants showed significantly higher reading comprehension scores on 2 free recall measures: words per communication unit and type-token ratio. There were no significant interactions. CONCLUSION: The results help to elucidate the nature of reading comprehension in adults with TBI with mild-to-moderate cognitive impairments and endorse further evaluation of reading comprehension strategies as a potential intervention option for these individuals. Future research is needed to better understand how individual differences influence a person's reading and response to intervention.

Reading impairment in an adolescent with temporo-occipital epilepsy. Pre- and post-surgical evaluation.

We present a 16 year-old right-handed case who underwent a left temporo-occipital resection to treat intractable epilepsy. Pre- and post-surgical evaluations showed an average intellectual quotient, preserved abilities in language and visuo-spatial functions and increased reading and spelling deficits (difficulties with irregular words, homophones and phonologically valid spelling errors of irregularly spelled words, associated with preserved performances in non-words). This pattern of characteristic lexical route deficits highlights the major role of the temporo-occipital areas in reading acquisition. We discussed the consequences of temporo-occipital dysfunction on reading.

Impaired reading not due to visual field loss in a patient with a right-hemipsheric lesion.

We describe a right-handed patient (M.B.), who developed left hemianopsia and a severe reading impairment after right occipital-parietal hemorrhage. The pattern of his reading deficit was very similar to that of pure alexia (alexia-without-agraphia): extremely slow reading times with frequent grapheme substitutions and omissions. A test of letter reading while controlling for saccadic eye movements and hemifield of presentation ruled out hemianoptic alexia. Although there have already been reports of reading impairments in right handers following right- hemispheric lesions, ours is, to the best of our knowledge, the first where visual field loss can be definitely excluded as the main cause. Based on a standard neuropsychological assessment and on additional behavioral tests, we argue that M.B.'s difficulties are unlikely to be due to right-hemisphere dominance for language. After considering several candidate explanations, we suggest that M.B.'s symptoms may be related to an impairment in attentional processes related to reading.

Acquired dyslexia in a transparent orthography: an analysis of acquired disorders of reading in the Slovak language.

The first reports of phonological, surface and deep dyslexia come from orthographies containing quasi-regular mappings between orthography and phonology including English and French. Slovakian is a language with a relatively transparent orthography and hence a mostly regular script. The aim of this study was to investigate impaired oral reading in Slovakian. A novel diagnostic procedure was devised to determine whether disorders of Slovakian reading resemble characteristics in other languages. Slovakian speaking aphasics showed symptoms similar to phonological dyslexia and deep dyslexia in English and French, but there was no evidence of surface dyslexia. The findings are discussed in terms of the orthographic depth hypothesis.

Lexical and buffer effects in reading and in writing Noun-Noun compound nouns.

Reading and writing Noun-Noun compound nouns was investigated in two Italian aphasic patients: one with phonological dyslexia and the other with phonological dysgraphia. The patients were required to read, write and repeat a list of Noun-Noun compounds and length-matched non-compound nouns. The dyslexic patient RF read compounds better than non-compounds, and his repetition was flawless for both categories. The dysgraphic patient DA wrote non-compounds better than compounds because of a deficit in keeping separate entries at the lemma level. Differential performance when processing compounds and non-compounds is the result of a deficit in different components within the mental lexicon architecture.

[Visual rehabilitation training for homonymous field defects]. / Visuelles Rehabilitationstraining bei homonymen Gesichtsfeldausfällen.

Homonymous field defects cause reading and orientation disorders. The reading disorder depends on the size of the macular sparing, the side of the field defect (unfavorable in reading direction) and spontaneous adaptive mechanisms. Methods which support compensation strategies should be recommended as evidence-based training procedures: optokinetic training with scrolled text for reading disorders and saccade training for orientation disorders. By optimized utilization of the total field of gaze, general exploration of the environment, reaction times during search tasks and quality of life can be improved.

Presenile dementia diagnosed as posterior cortical atrophy.

Posterior cortical atrophy (PCA) was originally proposed in 1988 based on five cases of dementia presenting characteristic clinical symptoms. The concept of PCA is still not generally accepted. Herein, we present a case of a presenile female with PCA. A 57-year-old woman was brought to the hospital by her older sister. The patient's chief complaints were that she could not drive a car safely and had caused numerous traffic accidents. Construction apraxia and unilateral spatial agnosia were detected by neuropsychological tests. The patient could not write a coherent the letter even though she was well educated. In addition, she demonstrated slight memory disturbance and she needed her sister's support in daily life. Magnetic resonance imaging and single photon emission computed tomography examinations confirmed bilateral posterior atrophy and significant hypoperfusion in the occipital regions. The neuropathological background of PCA remains unclear. Therefore, the concept of PCA should be validated by the accumulation of information from more cases.

HIV-associated dementia in older adults: clinical and tomographic aspects.

BACKGROUND: Elderly adults with human immunodeficiency virus (HIV) are at greater risk of developing cognitive impairment. The purpose of this study was to describe clinical and tomographic characteristics of HIV-1 associated dementia (HIVD) in older adults. METHODS: A descriptive study was carried out involving eight HIVD patients. Seven tests were employed for cognitive assessment and transformed to whole number z-scores using appropriate normative sets. RESULTS: The average age of the patients was 71 years; seven cases described the route of HIV infection as being heterosexual; and mean schooling was 6.5 years. Six subjects were using highly active anti-retroviral therapy (HAART), with an average CD4 count of 407.8 cells/mm3. Mild dementia was detected in most cases (87.5%). Deficits on neuropsychological tests showed results similar to multi-center transversal studies on HIVD. The classic HIVD triad observed in younger adults was also seen in this population: i.e. cognitive changes, psychiatric changes and motor impairment. Cortical injury shown by dyscalculia, visual-spatial change and language deficits were frequent. Brain images showed cortical atrophy in all patients but was restricted to frontal lobes in five cases. CONCLUSION: The findings on brain imaging were non-specific, revealing images similar to those of the elderly brain and to HIVD in younger adults. HIVD in the elderly is a challenge and become an increasingly significant differential diagnosis for cognitive loss in old age. This dementia must be clinically suspected and image exams are useful in excluding other central disorders. Prospective studies of HIV-positive elderly people are warranted to better understand HIVD.

A common left occipito-temporal dysfunction in developmental dyslexia and acquired letter-by-letter reading?

BACKGROUND: We used fMRI to examine functional brain abnormalities of German-speaking dyslexics who suffer from slow effortful reading but not from a reading accuracy problem. Similar to acquired cases of letter-by-letter reading, the developmental cases exhibited an abnormal strong effect of length (i.e., number of letters) on response time for words and pseudowords. RESULTS: Corresponding to lesions of left occipito-temporal (OT) regions in acquired cases, we found a dysfunction of this region in our developmental cases who failed to exhibit responsiveness of left OT regions to the length of words and pseudowords. This abnormality in the left OT cortex was accompanied by absent responsiveness to increased sublexical reading demands in phonological inferior frontal gyrus (IFG) regions. Interestingly, there was no abnormality in the left superior temporal cortex which--corresponding to the onological deficit explanation--is considered to be the prime locus of the reading difficulties of developmental dyslexia cases. CONCLUSIONS: The present functional imaging results suggest that developmental dyslexia similar to acquired letter-by-letter reading is due to a primary dysfunction of left OT regions.