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Central Alexia

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Alexia

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Abstract

Central alexia, also known as alexia with agraphia, occurs when reading is affected along with other aspects of language function (speaking, writing, or comprehension). Traditionally it has been split into three canonical types based on the type of errors different patients make when reading different classes of words. Indeed, these different error types are what the traditional neuropsychological models of reading have been built on. Two of the three subtypes can be considered mirror images of each other and are responsible for the main models of reading having to explain how it is possible to get from print to the spoken word via at least two separate routes.

Patients with surface dyslexia tend to overly rely on “rule-based” reading and will thus misread irregularly spelt words, e.g., [colonel], but will have no problem with words they have never encountered before, e.g., nonwords like [deggle]. Patients with phonological dyslexia on the other hand can often read irregular words (if they are familiar with them) but cannot read novel words like [deggle]. Deep dyslexia is probably on a continuum with phonological dyslexia; patients with this disorder show additional part-of-speech effects; that is, they have more trouble with rare words (low frequency), words that have little semantic association (functors such as [with]) and nonwords. We cover the theoretical background to these conditions and discuss their nosology and the many therapeutic efforts made to remediate them.

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References

  1. Dejerine J. Sur un cas de cécité verbale avec agraphie, suivi d’autopsie. CR Société du Biologie. 1891;43:197–201.

    Google Scholar 

  2. Benson FD. The third alexia. Arch Neurol. 1977;34:327–31.

    Article  PubMed  CAS  Google Scholar 

  3. Damasio AR. Varieties and significance of the alexias. Arch Neurol. 1977;34:325–6.

    Article  PubMed  CAS  Google Scholar 

  4. Shallice T, Warrington EK, Mccarthy R. Reading without semantics. Q J Exper Psychol Sect A Human Exper Psychol. 1983;35:111–38.

    Article  Google Scholar 

  5. Jared D, Mcrae K, Seidenberg MS. The basis of consistency effects in word naming. J Memory Lang. 1990;29:687–715.

    Article  Google Scholar 

  6. Glushko RJ. Organization and activation of orthographic knowledge in reading aloud. J Exp Psychol Hum Percept Perform. 1979;5:674–91.

    Article  Google Scholar 

  7. Van Orden GC, Pennington BF, Stone GO. What do double dissociations prove? Cognit Sci. 2001;25:111–72.

    Google Scholar 

  8. Marshall JC, Newcombe F. Patterns of paralexia: a psycholinguistic approach. J Psycholinguist Res. 1973;2:175–99.

    Article  PubMed  CAS  Google Scholar 

  9. Lyman RS, Kwan ST, Chao WH. Left occipito-parietal brain tumor with observations on alexia and agraphia in Chinese and in English. Chin Med J. 1938;3:491–516.

    Google Scholar 

  10. Warrington EK. The selective impairment of semantic memory. Q J Exp Psychol. 1975;27:635–57.

    Article  PubMed  CAS  Google Scholar 

  11. Tulving G. Episodic and semantic memory. In: Tulving G, Donaldson W, editors. Organization of memory. New York/London: Academic; 1972.

    Google Scholar 

  12. Coltheart M, Masterson J, Byng S, et al. Surface dyslexia. Q J Exper Psychol Sect A Human Exper Psychol. 1983;35:469–95.

    Article  CAS  Google Scholar 

  13. Patterson K, Hodges JR. Deterioration of word meaning: implications for reading. Neuropsychologia. 1992;30:1025–40.

    Article  PubMed  CAS  Google Scholar 

  14. Arsland D, Larsen JP, Hoien T. Alexia in dementia of the Alzheimer’s type. Acta Neurol Scand. 1993;88:434–9.

    Article  PubMed  CAS  Google Scholar 

  15. Folstein MF, Folstein SE, Mchugh PR. Mini-mental state – practical method for grading cognitive state of patients for clinician. J Psychiatr Res. 1975;12:189–98.

    Article  PubMed  CAS  Google Scholar 

  16. Patterson KE, Graham N, Hodges JR. Reading in dementia of the Alzheimer type: a preserved ability? Neuropsychology. 1994;8:395–412.

    Article  Google Scholar 

  17. Watt S, Jokel R, Behrmann M. Surface dyslexia in nonfluent progressive aphasia. Brain Lang. 1997;56:211–33.

    Article  PubMed  CAS  Google Scholar 

  18. Westbury C, Bub D. Primary progressive aphasia: a review of 112 cases. Brain Lang. 1997;60:381–406.

    Article  PubMed  CAS  Google Scholar 

  19. Hodges JR, Patterson K, Ward R, et al. The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variants of frontotemporal dementia) from early Alzheimer’s disease: a comparative neuropsychological study. Neuropsychology. 1999;13:31–40.

    Article  PubMed  CAS  Google Scholar 

  20. Nelson HE, Willison J. The National Adult Reading Test (NART:2): test manual. Windsor: NFER-Nelson; 1991.

    Google Scholar 

  21. McMonagle P, Deering F, Berliner Y, Kertesz A. The cognitive profile of posterior cortical atrophy. Neurology. 2006;66:331–8.

    Article  PubMed  Google Scholar 

  22. Crutch SJ, Warrington EK. The relationship between visual crowding and letter confusability: towards an understanding of dyslexia in posterior cortical atrophy. Cogn Neuropsychol. 2009;26:471–98.

    Article  PubMed  Google Scholar 

  23. Yong KX, Warren JD, Warrington EK, Crutch SJ. Intact reading in patients with profound early visual dysfunction. Cortex. 2013. Epub ahead of print. doi:10.1016/j.cortex.2013.01.009.

  24. Crutch SJ. Seeing why they cannot see: understanding the syndrome and causes of posterior cortical atrophy. J Neuropsychol. 2013. Epub ahead of print. doi:10.1111/jnp.12011.

  25. Formaglio M, Krolak-Salmon P, Tilikete C, et al. Homonymous hemianopia and posterior cortical atrophy. Rev Neurol. 2009;165:256–62.

    Article  PubMed  CAS  Google Scholar 

  26. Fushimi T, Ijuin M, Patterson K, Tatsumi IF. Consistency, frequency, and lexicality effects in naming Japanese Kanji. J Exp Psychol Hum Percept Perform. 1999;25:382–407.

    Article  Google Scholar 

  27. Fushimi T, Komori K, Ikeda M, et al. The association between semantic dementia and surface dyslexia in Japanese. Neuropsychologia. 2009;47:1061–8.

    Article  PubMed  Google Scholar 

  28. Patterson K, Suzuki T, Wydell T, Sasanuma S. Progressive aphasia and surface alexia in Japanese. Neurocase. 1995;1:155–65.

    Article  Google Scholar 

  29. Woollams AM, Ralph MAL, Plaut DC, Patterson K. SD-squared: on the association between semantic dementia and surface dyslexia. Psychol Rev. 2007;114:316–39.

    Article  PubMed  Google Scholar 

  30. Blazely AM, Coltheart M, Casey BJ. Semantic impairment with and without surface dyslexia: Implications for models of reading. Cogn Neuropsychol. 2005;22:695–717.

    Article  PubMed  Google Scholar 

  31. Beauvois M-F, Derouesne J. Phonological alexia: three dissociations. J Neurol Neurosurg Psychiatry. 1979;42:1115–24.

    Article  PubMed  CAS  Google Scholar 

  32. Cohen L, Dehaene S, Verstichel P. Number words and number Non-words – a case of deep dyslexia extending to Arabic numerals. Brain. 1994;117:267–79.

    Article  PubMed  Google Scholar 

  33. Funnell E. Phonological processes in reading – new evidence from acquired dyslexia. Br J Psychol. 1983;74:159–80.

    Article  PubMed  CAS  Google Scholar 

  34. Bradley VA, Thomson ME. Residual ability to use grapheme phoneme conversion rules in phonological dyslexia. Brain Lang. 1984;22:292–302.

    Article  PubMed  CAS  Google Scholar 

  35. Friedman RB. Two types of phonological alexia. Cortex. 1995;31:397–403.

    Article  PubMed  CAS  Google Scholar 

  36. Tree JJ. Two types of phonological dyslexia – a contemporary review. Cortex. 2008;44:698–706.

    Article  PubMed  Google Scholar 

  37. Nolan KA, Caramazza A. Modality-independent impairments in word-processing in a deep dyslexic patient. Brain Lang. 1982;16:237–64.

    Article  PubMed  CAS  Google Scholar 

  38. Bisiacchi PS, Cipolotti L, Denes G. Impairment in processing meaningless verbal material in several modalities – the relationship between short-term-memory and phonological skills. Q J Exper Psychol Sect A Human Exper Psychol. 1989;41:293–319.

    Article  CAS  Google Scholar 

  39. Tree JJ, Kay J. Phonological dyslexia and phonological impairment: an exception to the rule? Neuropsychologia. 2006;44:2861–73.

    Article  PubMed  Google Scholar 

  40. Jefferies E, Sage K, Ralph MAL. Do deep dyslexia, dysphasia and dysgraphia share a common phonological impairment? Neuropsychologia. 2007;45:1553–70.

    Article  PubMed  Google Scholar 

  41. Nickels L, Biedermann B, Coltheart M, et al. Computational modelling of phonological dyslexia: how does the DRC model fare? Cogn Neuropsychol. 2008;25:165–93.

    Article  PubMed  Google Scholar 

  42. Rapcsak SZ, Beeson PM, Henry ML, et al. Phonological dyslexia and dysgraphia: cognitive mechanisms and neural substrates. Cortex. 2009;45:575–91.

    Article  PubMed  Google Scholar 

  43. Kay J, Lesser R, Coltheart M. Psycholinguistic assessments of language processing in aphasia (PALPA): reading and spelling. Hove: Lawrence Erlbaum Associates; 1992.

    Google Scholar 

  44. Woollams AM, Patterson K. The consequences of progressive phonological impairment for reading aloud. Neuropsychologia. 2012;50:3469–77.

    Article  PubMed  Google Scholar 

  45. Schofield TM, Penny WD, Stephan KE, et al. Changes in auditory feedback connections determine the severity of speech processing deficits after stroke. J Neurosci. 2012;32:4260–70.

    Article  PubMed  CAS  Google Scholar 

  46. Franz SI. The relations of aphasia. J Gen Psychol. 1930;3:401–11.

    Article  Google Scholar 

  47. Goldstein K. Language and language disturbances. New York: Grune & Stratton; 1948.

    Google Scholar 

  48. Lhermitte J, Lecours AR, Ouvry B. Essai d’analyse structurale des paralexies et des paragraphies. Acta Neurol Psych Belg. 1967;67:1021–1044

    Google Scholar 

  49. Patterson KE. What is right with deep dyslexic patients. Brain Lang. 1979;8:111–29.

    Article  PubMed  CAS  Google Scholar 

  50. Friedman RB, Perlman MB. On the underlying causes of semantic paralexias in a patient with deep dyslexia. Neuropsychologia. 1982;20:559–68.

    Article  PubMed  CAS  Google Scholar 

  51. Gerhand S, Barry C. When does a deep dyslexic make a semantic error? The roles of age-of-acquisition, concreteness, and frequency. Brain Lang. 2000;74:26–47.

    Article  PubMed  CAS  Google Scholar 

  52. Funnell E. Morphological errors in acquired dyslexia – a case of mistaken identity. Q J Exper Psychol Sect A Human Exper Psychol. 1987;39:497–539.

    Article  CAS  Google Scholar 

  53. Rastle K, Tyler LK, Marslen-Wilson W. New evidence for morphological errors in deep dyslexia. Brain Lang. 2006;97:189–99.

    Article  PubMed  Google Scholar 

  54. Friedman RB. Recovery from deep alexia to phonological alexia: points on a continuum. Brain Lang. 1996;52:114–28.

    Article  PubMed  CAS  Google Scholar 

  55. Crisp J, Ralph MAL. Unlocking the nature of the phonological-deep dyslexia continuum: the keys to reading aloud are in phonology and semantics. J Cogn Neurosci. 2006;18:348–62.

    PubMed  Google Scholar 

  56. Price CJ, Seghier ML, Leff AP. Predicting language outcome and recovery after stroke: the PLORAS system. Nat Rev Neurol. 2010;6:202–10.

    Article  PubMed  Google Scholar 

  57. Swinburn K, Porter G, Howard D. Comprehensive aphasia test. Hove: Psychology Press; 2004.

    Google Scholar 

  58. Ciaghi M, Pancheri E, Miceli G. Semantic paralexias: a group-case study on the underlying functional mechanisms, incidence and clinical features in a consecutive series of 340 Italian aphasics. Brain Lang. 2010;115:121–32.

    Article  PubMed  Google Scholar 

  59. Friedman RB, Robinson SR. Whole-word training therapy in a stable surface alexic patient – it works. Aphasiology. 1991;5:521–7.

    Article  Google Scholar 

  60. Biedermann B, Nickels L. The representation of homophones: more evidence from the remediation of anomia. Cortex. 2008;44:276–93.

    Article  PubMed  Google Scholar 

  61. Moss SE, Gonzalez Rothi LJ, Fennell EB. Treating a case of surface dyslexia after closed head injury. Arch Clin Neuropsychol. 1991;6:35–47.

    PubMed  CAS  Google Scholar 

  62. Weekes B, Coltheart M. Surface dyslexia and surface dysgraphia: treatment studies and their theoretical implications. Cogn Neuropsychol. 1996;13:277–315.

    Article  Google Scholar 

  63. Kendall DL, McNeil MR, Small SL. Rule-based treatment for acquired phonological dyslexia. Aphasiology. 1998;12:587–600.

    Article  Google Scholar 

  64. Friedman RB, Sample DM, Lott SN. The role of level of representation in the use of paired associate learning for rehabilitation of alexia. Neuropsychologia. 2002;40:223–34.

    Article  PubMed  CAS  Google Scholar 

  65. Lott SN, Sample DM, Oliver RT, et al. A patient with phonologic alexia can learn to read “much” from “mud pies”. Neuropsychologia. 2008;46:2515–23.

    Article  PubMed  Google Scholar 

  66. Friedman RB, Lott SN. Successful blending in a phonological reading treatment for deep alexia. Aphasiology. 2002;16:355–72.

    Article  Google Scholar 

  67. Kim M, Beaudoin-Parsons D. Training phonological reading in deep alexia: does it improve reading words with low imageability? Clin Linguist Phon. 2007;21:321–51.

    Article  PubMed  Google Scholar 

  68. Kiran S, Thompson CK, Hashimoto N. Training grapheme to phoneme conversion in patients with oral reading and naming deficits: a model-based approach. Aphasiology. 2001;15:855–76.

    Article  Google Scholar 

  69. Mitchum CC, Berndt RS. Diagnosis and treatment of the non-lexical route in acquired dyslexia: an illustration of the cognitive neuropsychological approach. J Neurolinguist. 1991;6:103–37.

    Article  Google Scholar 

  70. Yampolsky S, Waters G. Treatment of single word oral reading in an individual with deep dyslexia. Aphasiology. 2002;16:455–71.

    Article  Google Scholar 

  71. Nickels L. The autocue? self-generated phonemic cues in the treatment of a disorder of reading and naming. Cogn Neuropsychol. 1992;9:155–82.

    Article  Google Scholar 

  72. de Partz MPD. Re-education of a deep dyslexic patient: rationale of the method and results. Cogn Neuropsychol. 1986;3:149–77.

    Article  Google Scholar 

  73. Bruce C, Howard D. Why don’t Broca’s aphasics cue themselves? An investigation of phonemic cueing and tip of the tongue information. Neuropsychologia. 1988;26:253–64.

    Article  PubMed  CAS  Google Scholar 

  74. Ska B, Garneau-Beaumont D, Chesneau S, Damien B. Diagnosis and rehabilitation attempt of a patient with acquired deep dyslexia. Brain Cogn. 2003;53:359–63.

    Article  PubMed  Google Scholar 

  75. Leff AP, Schofield TM, Crinion JT, et al. The left superior temporal gyrus is a shared substrate for auditory short-term memory and speech comprehension: evidence from 210 patients with stroke. Brain. 2009;132:3401–10.

    Article  PubMed  Google Scholar 

  76. Stadie N, Rilling E. Evaluation of lexically and nonlexically based reading treatment in a deep dyslexic. Cogn Neuropsychol. 2006;23:643–72.

    Article  PubMed  Google Scholar 

  77. Code HC. Services for aphasia, other acquired adult neurogenic communication and swallowing disorders in the United Kingdom, 2000. Disabil Rehabil. 2003;25:1231–7.

    Article  PubMed  Google Scholar 

  78. Katz RC, Wertz RT. The efficacy of computer-provided reading treatment for chronic aphasic adults. J Speech Lang Hear Res. 1997;40:493–507.

    PubMed  CAS  Google Scholar 

  79. Porch B. Porch Index of Communicative Ability (PICA). Palo Alto: Consulting Psychologists Press; 1981.

    Google Scholar 

  80. Cherney LR. Oral Reading for Language in Aphasia (ORLA): Evaluating the efficacy of computer-delivered therapy in chronic nonfluent aphasia. Top Stroke Rehabil. 2010;17:423–31.

    Article  PubMed  Google Scholar 

  81. Kertesz A. The western aphasia battery. New York: Grune & Stratton; 1982.

    Google Scholar 

  82. Price CJ, Howard D, Patterson K, et al. A functional neuroimaging description of two deep dyslexic patients. J Cogn Neurosci. 1998;10:303–15.

    Article  PubMed  CAS  Google Scholar 

  83. Coltheart M. Deep dyslexia is right-hemisphere reading. Brain Lang. 2000;71:299–309.

    Article  PubMed  CAS  Google Scholar 

  84. Adair JC, Nadeau SE, Conway TW, et al. Alterations in the functional anatomy of reading induced by rehabilitation of an alexic patient. Neuropsychiatry Neuropsychol Behav Neurol. 2000;13:303–11.

    PubMed  CAS  Google Scholar 

  85. Kurland J, Cortes CR, Wilke M, et al. Neural mechanisms underlying learning following semantic mediation treatment in a case of phonologic alexia. Brain Imaging Behav. 2008;2:147.

    Article  PubMed  Google Scholar 

  86. Woodhead ZV, Barnes GR, Penny W, et al. Reading front to back: MEG evidence for early feedback effects during word recognition. Cereb Cortex. 2012. Epub ahead of print. doi:10.1093/cercor/bhs365.

  87. Woodhead ZVJ, Penny W, Barnes GR, et al. Reading therapy strengthens top-down connectivity in patients with pure alexia. Brain. 2013;136(Pt 8):2579–91.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Neurology, University College London, London, UK

    Alexander Leff MBBS, BSc, PhD, FRCP

  2. Department of Psychology, University of Copenhagen, Copenhagen, Denmark

    Randi Starrfelt MSc Psych, PhD

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  1. Alexander Leff MBBS, BSc, PhD, FRCP
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  2. Randi Starrfelt MSc Psych, PhD
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Leff, A., Starrfelt, R. (2014). Central Alexia. In: Alexia. Springer, London. https://doi.org/10.1007/978-1-4471-5529-4_4

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