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Sample records for agraphia

  1. Thalamic alexia with agraphia

    Directory of Open Access Journals (Sweden)

    Fábio Henrique de Gobbi Porto

    2012-02-01

    Full Text Available Alexia with agraphia is defined as an acquired impairment affecting reading and writing ability. It can be associated with aphasia, but can also occur as an isolated entity. This impairment has classically been associated with a left angular gyrus lesion In the present study, we describe a case involving a patient who developed alexia with agraphia and other cognitive deficits after a thalamic hemorrhage. In addition, we discuss potential mechanisms of this cortical dysfunction syndrome caused by subcortical injury. We examined a patient who presented with alexia with agraphia and other cognitive deficits due to a hemorrhage in the left thalamus. Neuropsychological evaluation showed attention, executive function, arithmetic and memory impairments. In addition, language tests revealed severe alexia with agraphia in the absence of aphasia. Imaging studies disclosed an old thalamic hemorrhage involving the anterior, dorsomedial and pulvinar nuclei. Tractography revealed asymmetric thalamocortical radiations in the parietal region (left - right, and single photon emission computed tomography demonstrated hypoperfusion in the left thalamus that extended to the frontal and parietal cortices. Cortical cognitive deficits, including alexia with agraphia, may occur as the result of thalamic lesions. The probable mechanism is a diaschisis phenomenon involving thalamic tract disconnections.

  2. Alexia without agraphia

    International Nuclear Information System (INIS)

    Two new cases of alexia without agraphia are presented. Pertinent clinical findings, anatomy, pathophysiology and differential diagnoses are reviewed. The importance of carefully examining the inferior portion of the left side of the splenium of the corpus callosum on CT and/or MR scans in patients who present with this clinical syndrome is stressed. (orig.)

  3. Lexical agraphia. Further support for the two-system hypothesis of linguistic agraphia.

    Science.gov (United States)

    Roeltgen, D P; Heilman, K M

    1984-09-01

    Eight patients with acquired agraphia were studied using the same writing tests and were compared with normal and brain-damaged controls. Four patients fulfilled the criteria for lexical agraphia and on CT scan had lesions of the posterior angular gyrus that spared the supramarginal gyrus. The other 4 fulfilled the criteria for phonological agraphia. They had lesions on CT scan that were similar to those found in previously described patients with phonological agraphia. Their lesions involved the supramarginal gyrus or insula deep to it and spared the angular gyrus. These studies support the hypothesis that there are two dissociable spelling systems and that these spelling systems are disrupted by focal lesions in separate but distinct brain regions. Further studies investigated the relationships between phonological agraphia and phonological dyslexia (alexia), and lexical agraphia and surface dyslexia (lexical alexia). The data support the hypothesis that individual systems subserve the four processes of phonological spelling, phonological reading, lexical spelling and lexical reading. PMID:6206909

  4. Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment

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    Jiong Zhou

    2016-01-01

    Conclusions: Our study confirmed that agraphia is an important feature in patients with AD. The writing error profile in patients whose native language is Chinese was unique compared to patients using the alphabetic language system.

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

    Science.gov (United States)

    Signoret, J L; van Eeckhout, P; Poncet, M; Castaigne, P

    1987-01-01

    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. PMID:3616363

  6. Characteristics of Agraphia in Chinese Patients with Alzheimer's Disease and Amnestic Mild Cognitive Impairment

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    Zhou, Jiong; Jiang, Biao; Huang, Xian-Hong; Kong, Lin-Lin; Li, Hong-Lei

    2016-01-01

    Background: Patients with Alzheimer's disease (AD) manifest progressive decline in writing abilities. Most studies on agraphia in AD have been performed in the alphabetic system, such as English. However, these findings may not be applicable to other written language systems. The unique features of the Chinese written script could affect the patterns of agraphia in Chinese AD patients. The aim of this study was to explore the features of writing errors in Chinese patients with AD and amnestic mild cognitive impairment (a-MCI), as well as to study the relationship between their writing errors and neuropsychological functions. Methods: In this study, we performed an observational study in a group of subjects including 17 AD patients, 14 patients with a-MCI, and 16 elderly healthy controls. We analyzed the writing errors in these subjects and also studied the relationship between their writing errors and neuropsychological functions. Results: Our study showed that in patients whose mother tongue is Chinese, writing ability was comparatively well preserved in the MCI phase but significantly impaired when the disease progressed to the stage of AD. The writing errors showed corresponding increase with the severity of cognition decline, both in the types of errors and rate of occurrence. Analysis of the writing errors showed that word substitution and unintelligible words were the most frequent error types that occurred in all the three study groups. The occurrence rate of unintelligible words was significantly higher in the AD group compared with the a-MCI group (P = 0.024) and control group (P = 0.018). In addition, the occurrence rates of word substitution were also significantly higher in AD (P = 0.013) and a-MCI groups (P = 0.037) than that of control group. However, errors such as totally no response, visuospatial impairment, paragraph agraphia, ideograph, and perseverative writing errors were only seen in AD group. Besides, we also found a high occurrence rate of

  7. Transient Beneficial Effects of Excitatory Theta Burst Stimulation in a Patient with Phonological Agraphia after Left Supramarginal Gyrus Infarction

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    Nardone, Raffaele; De Blasi, Pierpaolo; Zuccoli, Giulio; Tezzon, Frediano; Golaszewski, Stefan; Trinka, Eugen

    2012-01-01

    We report a patient showing isolated phonological agraphia after an ischemic stroke involving the left supramarginal gyrus (SMG). In this patient, we investigated the effects of focal repetitive transcranial magnetic stimulation (rTMS) given as theta burst stimulation (TBS) over the left SMG, corresponding to the Brodmann area (BA) 40. The patient…

  8. The Relationship between Localized Brain Damage and Agraphia%脑不同部位损害与失写症

    Institute of Scientific and Technical Information of China (English)

    谢秋幼; 孙红宇; 刘晓加

    2001-01-01

    Writing behavior is affected by many factors and depends on the functional integrity of the nervous system. Its neuropsychological mechanism remains unknown. The agraphic features involving different parts of brain damage are dissimilar. The neuroanatomic location of agraphia and its possible brain mechanism are reviewed.

  9. Treatment for Alexia with Agraphia Following Left Ventral Occipito-Temporal Damage: Strengthening Orthographic Representations Common to Reading and Spelling

    Science.gov (United States)

    Kim, Esther S.; Rising, Kindle; Rapcsak, Steven Z.; Beeson, Pélagie M.

    2015-01-01

    Purpose: Damage to left ventral occipito-temporal cortex can give rise to written language impairment characterized by pure alexia/letter-by-letter (LBL) reading, as well as surface alexia and agraphia. The purpose of this study was to examine the therapeutic effects of a combined treatment approach to address concurrent LBL reading with surface…

  10. A propos de l'agraphie des aphasiques sensoriels: etude comparative italien-francais (On Agraphia of Subjects with Sensory Aphasia: A Comparative Study of Italian and French)

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    De Agostini, Maria

    1977-01-01

    A report on research on agraphia using subjects afflicted with sensory aphasia. It compares performance in Italian, a phonetic language, with performance in French. The disorders in the Italian language appear less varied than in French. (Text is in French.)

  11. MRI in callosal apraxia and agraphia due to a traumatic lesion in the posterior trunk of the corpus callosum

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    Yasumura, Shuichi; Ito, Naoki; Terunuma, Hiroshi; Matsuzaki, Takayuki; Iwabuchi, Reiko

    1987-08-01

    We discussed functional topography of the corpus callosum in a case with ideo-motor apraxia and agraphia of the left hand due to a traumatic callosal hematoma confirmed by MRI. The patient was a 35-year-old right-handed woman with head injury in a traffic accident. On admission she was semi-comatose with left oculomotor palsy and her left upper limb showed a decorticate rigidity by noxious stimuli, however, she became alert within 14 days. X-ray CT showed an abnormal high density area in the posterior part of the trunk of the corpus callosum on admission. MRI (inversion recovery technique) on the 60th hospital day showed a low intensity area extending for about 2 cm posteriorly from the center of the trunk. Sequential neuropsychological examinations for the callosal disconnection syndrome were performed. The patient showed ideo-motor apraxia and agraphia in her left hand only. Her response to verbal commands were all parapraxic except for correct use of a comb and a tooth brush. Her writings with her left hand were those of scrawls due to apraxia. These apraxia and agraphia of the left hand were transient and recovered completely within 80 days of onset. Transient impairement of bimanual coordination movement was also observed. Ataxie optique, callosal pseudoneglect, left hand tactile anomia, difficulty of somesthetic transfer or diagonistic dyspraxia was not observed. Based on the neuropsychological and the MRI findings we suggest that the lesion in the posterior part of the trunk of the corpus callosum is important for causing ideo-motor apraxia and agraphia of the left hand.

  12. MRI in callosal apraxia and agraphia due to a traumatic lesion in the posterior trunk of the corpus callosum

    International Nuclear Information System (INIS)

    We discussed functional topography of the corpus callosum in a case with ideo-motor apraxia and agraphia of the left hand due to a traumatic callosal hematoma confirmed by MRI. The patient was a 35-year-old right-handed woman with head injury in a traffic accident. On admission she was semi-comatose with left oculomotor palsy and her left upper limb showed a decorticate rigidity by noxious stimuli, however, she became alert within 14 days. X-ray CT showed an abnormal high density area in the posterior part of the trunk of the corpus callosum on admission. MRI (inversion recovery technique) on the 60th hospital day showed a low intensity area extending for about 2 cm posteriorly from the center of the trunk. Sequential neuropsychological examinations for the callosal disconnection syndrome were performed. The patient showed ideo-motor apraxia and agraphia in her left hand only. Her response to verbal commands were all parapraxic except for correct use of a comb and a tooth brush. Her writings with her left hand were those of scrawls due to apraxia. These apraxia and agraphia of the left hand were transient and recovered completely within 80 days of onset. Transient impairement of bimanual coordination movement was also observed. Ataxie optique, callosal pseudoneglect, left hand tactile anomia, difficulty of somesthetic transfer or diagonistic dyspraxia was not observed. Based on the neuropsychological and the MRI findings we suggest that the lesion in the posterior part of the trunk of the corpus callosum is important for causing ideo-motor apraxia and agraphia of the left hand. (author)

  13. What letters can "learn" from Arabic digits--fMRI-controlled single case therapy study of peripheral agraphia.

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    Jung, Stefanie; Halm, Katja; Huber, Walter; Willmes, Klaus; Klein, Elise

    2015-10-01

    Research on (hand-)writing has revealed that Exner's area subserves transferring linguistic impulses into writing programmes. We report on a patient with a lesion affecting Broca's and Exner's area suffering from severe peripheral agraphia for letters but not for Arabic digits. Analogous to semantic (magnitude) information in numbers, we developed a specifically tailored writing training: additional mental imagery based semantic information was attached to letters. The training resulted in significant improvements. Imaging data revealed stronger fronto-parietal network activity including perilesional activation around Exner's area and precuneus for writing letters to dictation than for writing letters corresponding to their mental image expressions. Follow-up testing showed not only stable training effects but also an activation shift into the left angular gyrus. Results document neuronal correlates of a successful intervention by attaching additional meanings to letters in order to retrieve their grapho-motor patterns. These findings contribute to understanding the impact of Exner's area. PMID:26186229

  14. Neurolinguistic analysis of the language abilities of a patient with a "double disconnection syndrome": a case of subangular alexia in the presence of mixed transcortical aphasia.

    OpenAIRE

    Pirozzolo, F J; Kerr, K L; Obrzut, J E; Morley, G K; Haxby, J V; Lundgren, S.

    1981-01-01

    In contrast to the classic form of alexia without agraphia, subangular alexia results from a single lesion located deep in the white matter of the left parietal lobe. In the present report, a patient with subangular alexia and features of mixed transcortical aphasia is described. Neurolinguistic findings include: alexia without agraphia, paucity of spontaneous speech, moderate auditory comprehension difficulty, excellent repetition, echopraxia, colour agnosia, and naming disorder. Neurolingui...

  15. POST-STROKE WRITING AND READING DISORDERS

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    Sinanović Osman

    2013-01-01

    Full Text Available The writing and reading disorders in stroke patients (alexias, agraphias and acalculias are more frequent than verified in routine exam, not only in the less developed but also in large neurological departments. Alexia is an acquired type of sensory aphasia where damage to the brain causes a patient to lose the ability to read. It is also called word blindness, text blindness orvisual aphasia. Alexia refers to an acquired inability to read caused by brain damage and must be distinguished from dyslexia, a developmental abnormality in which the individual is unable to learn to read, and from illiteracy, which reflects a poor educational back-ground. Most aphasics are also alexic, but alexia may occur in the absence of aphasia and may occasionally be the soledisability resulting from specific brain lesions. There are different classifications of alexias. Traditionally, the alexias are divided into three categories: pure alexia with agraphia, pure alexia without agraphia, and alexia associated with aphasia (“aphasic alexia”. Agraphia is defined as the disruption of previously intact writing skills by brain damage. Writing involves several elements—language processing, spelling, visual perception, visual-spatial orientation for graphic symbols, motor planning, and motor control of writing. A disturbance of any of these processes can impair writing. Agraphia may occur by itself or as association with aphasias, alexia, agnosia and apraxia. Agraphia can also result from “peripheral” involvement of the motor act of writing. Like alexia, agraphia must be distinguished from illiteracy, where writing skills were never developed. Acalculia is a clinical syndrome of acquired deficits in mathematical calculation, either mentally or with paper and pencil. This language disturbances can be classified differently, but there are three principal types of acalculia: acalculia associated with language disturbances, including number paraphasia, number

  16. Clinico-anatomical correlations of left posterior cerebral artery occlusion

    International Nuclear Information System (INIS)

    The relation between neurological signs and symptoms and computed tomography (CT) and magnetic resonance imaging (MRI) was examined in 11 cases of occlusion of the left posterior cerebral artery. All the patients were righthanded. Right homonimous hemianopia was noted in 8 cases, right upper quadrantanopia in 2 cases, and right lower quadrantanopia in 1 case. Of the 11 cases, alexia without agraphia was noted in 9 cases, all 9 of which showed lesions of inferior occipital cortex (lingual and fusiform gyri) and subjacent white matter. Lesions of splenium were found in only 5 of the cases of alexia without agraphia. In 2 cases with neither alexia nor agraphia, lesions were seen in the medial occipital cortex and the subjacent white matter but not in the inferior occipital lobe. Three patients had color anomia which was accompanied by memory disturbances and alexia without agraphia. In 2 of these 3, lesions were widespread in the region of the left posterior cerebral artery. Memory disturbances were observed in 6 cases, all of which also showed alexia without agraphia. The lesions extended not only of the inferior surface of the occipital lobe and along the interhemispheric fissure, but also of hippocampal and parahippocampal gyri. In 3 cases of alexia without agraphia in which no memory distrubance was found, the symptoms of alexia were slight and disappeared at an early stage. (J.P.N.)

  17. Posterior cortical dementia with alexia: neurobehavioural, MRI, and PET findings.

    OpenAIRE

    Freedman, L; Selchen, D H; Black, S E; Kaplan, R; Garnett, E. S.; Nahmias, C

    1991-01-01

    A progressive disorder of relatively focal but asymmetric biposterior dysfunction is described in a 54 year old right handed male. Initial clinical features included letter-by-letter alexia, visual anomia, acalculia, mild agraphia, constructional apraxia, and visuospatial compromise. Serial testing demonstrated relentless deterioration with additional development of transcortical sensory aphasia, Gerstmann's tetrad, and severe visuoperceptual impairment. Amnesia was not an early clinical feat...

  18. Auditory Repetition Priming Is Impaired in Pure Alexic Patients

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    Swick, Diane; Miller, Kimberly M.; Larsen, Jary

    2004-01-01

    Alexia without agraphia, or ''pure'' alexia, is an acquired impairment in reading that leaves writing skills intact. Repetition priming for visually presented words is diminished in pure alexia. However, it is not possible to verify whether this priming deficit is modality-specific or modality independent because reading abilities are compromised.…

  19. Maurice Ravel's illness: a tragedy of lost creativity

    OpenAIRE

    Henson, R A

    1988-01-01

    Maurice Ravel had been subject to psychiatric disorder for many years when signs of organic brain disease appeared at the age of 52. Aphasia, apraxia, agraphia, and alexia became established some five years later. Musical creativity was lost. Alajouanine diagnosed cerebral atrophy with bilateral ventricular enlargement. Though Ravel's condition deteriorated progressively, generalised dementia was not apparent. He died in December 1937, after a craniotomy performed by Clovis Vincent, possibly ...

  20. Acute parietal lobe infarction presenting as Gerstmann’s syndrome and cognitive decline mimicking senile dementia

    OpenAIRE

    Chen, Tien-Yu; Chen, Chun-Yen; Yen, Che-Hung; Kuo, Shin-Chang; Yeh, Yi-Wei; Chang, Serena; Huang, San-Yuan

    2013-01-01

    Gerstmann’s syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elderly man with a history of several cardiovascular diseases was initially brought to the psychiatric outpatient department by his family because of worsening of recent memory, executive function, and mixed anxious-depressive mood. Gerstmann’s syndrome without obvious motor function impairment and dementia-like features could be observed at first. Emergent brain computed tomograph...

  1. POST-STROKE WRITING AND READING DISORDERS

    OpenAIRE

    Sinanović Osman; Mrkonjić Zamir

    2013-01-01

    The writing and reading disorders in stroke patients (alexias, agraphias and acalculias) are more frequent than verified in routine exam, not only in the less developed but also in large neurological departments. Alexia is an acquired type of sensory aphasia where damage to the brain causes a patient to lose the ability to read. It is also called word blindness, text blindness orvisual aphasia. Alexia refers to an acquired inability to read caused by brain damage and must be distinguished fro...

  2. Acute parietal lobe infarction presenting as Gerstmann’s syndrome and cognitive decline mimicking senile dementia

    OpenAIRE

    Chen TY; Chen CY; Yen CH; Kuo SC; Yeh YW; Chang S; Huang SY

    2013-01-01

    Tien-Yu Chen,1 Chun-Yen Chen,1,3 Che-Hung Yen,2,3 Shin-Chang Kuo,1,3 Yi-Wei Yeh,1,3 Serena Chang,1 San-Yuan Huang1,31Department of Psychiatry, 2Department of Neurology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, 3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of ChinaAbstract: Gerstmann’s syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. An elderly m...

  3. A case of carbon monoxide poisoning by explosion of coal mine presenting as visual agnosia: re-evaluation after 40 years

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    Takaiwa, A.; Yamashita, K.; Nomura, T.; Shida, K.; Taniwaki, T. [Kyushu University, Fukuoka (Japan). Department of Neurology, Graduate School of Medical Science

    2005-11-15

    We re-evaluated a case of carbon monoxide poisoning presenting as visual agnosia who had been injured by explosion of Miike-Mikawa coal mine 40 years ago. In an early stage, his main neuropsychological symptoms were visual agnosia, severe anterograde amnesia, alexia, agraphia, constructional apraxia, left hemispatial neglect and psychic paralysis of gaze, in addition to pyramidal and extra pyramidal signs. At the time of re-evaluation after 40 years, he still showed visual agnosia associated with agraphia and constructional apraxia. Concerning visual agnosia, recognition of the real object was preserved, while recognition of object photographs and picture was impaired. Thus, this case was considered to have picture agnosia as he could not recognize the object by pictorial cues on the second dimensional space. MRI examination revealed low signal intensity lesions and cortical atrophy in the bilateral parieto-occipital lobes on T1-weighted images. Therefore, the bilateral parieto-occipital lesions are likely to be responsible for his picture agnosia.

  4. [Case of callosal disconnection syndrome with a chief complaint of right-hand disability, despite presence of left-hand diagonistic dyspraxia].

    Science.gov (United States)

    Okamoto, Yoko; Saida, Hisako; Yamamoto, Toru

    2009-04-01

    e report the case of 48-year-old right-handed male patient with an infarction affecting most part of the body and the splenium of the left half of the corpus callosum. Neuropsychological examination revealed typical signs of callosal disconnection including left-sided apraxia, diagonistic dyspraxia, left-sided agraphia, left-hand tactile anomia, left hemialexia, and right-sided constructional disability. Moreover, he complained of impairment in activities involving the right hand disability and agraphia. He could not stop behaving with his right hand when he had a vague idea. For example, he involuntarily picked up a tea bottle with his right hand when he had a desire to drink, although the action was not appropriate to that occasion. The imitation and utilization behavior did not imply this case, because his right hand behaviors were not exaggerated in response to external stimuli, such as the gestures of the examiner or the subjects in front of the patient. Unexpectedly, he complained about impairment of the activity of his right hand and was unaware of left hand apraxia or diagonistic dyspraxia; this trend continued for 6 months, at the time of this writing. We argue that the patient may have been subconsciouly aware of the symptoms of his left hand but had not verbalized them. PMID:19378819

  5. Association of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study.

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    Motomura, Kazuya; Fujii, Masazumi; Maesawa, Satoshi; Kuramitsu, Shunichiro; Natsume, Atsushi; Wakabayashi, Toshihiko

    2014-07-01

    Alexia and agraphia are disorders common to the left inferior parietal lobule, including the angular and supramarginal gyri. However, it is still unclear how these cortical regions interact with other cortical sites and what the most important white matter tracts are in relation to reading and writing processes. Here, the authors present the case of a patient who underwent an awake craniotomy for a left inferior parietal lobule glioma using direct cortical and subcortical electrostimulation. The use of subcortical stimulation allowed identification of the specific white matter tracts associated with reading and writing. These tracts were found as portions of the dorsal inferior frontooccipital fasciculus (IFOF) fibers in the deep parietal lobe that are responsible for connecting the frontal lobe to the superior parietal lobule. These findings are consistent with previous diffusion tensor imaging tractography and functional MRI studies, which suggest that the IFOF may play a role in the reading and writing processes. This is the first report of transient alexia and agraphia elicited through intraoperative direct subcortical electrostimulation, and the findings support the crucial role of the IFOF in reading and writing. PMID:24655122

  6. Optic aphasia, optic apraxia, and loss of dreaming.

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    Peña-Casanova, J; Roig-Rovira, T; Bermudez, A; Tolosa-Sarro, E

    1985-09-01

    A 47-year-old man with a left temporo-occipital infarct in the area of the posterior cerebral artery is presented. The neuropsychological examination did not reveal aphasia or gross mental deficits. The patient presented with alexia without agraphia, color agnosia, but few visual perceptual deficits. The main impairment was in confrontation naming; he was incapable of naming objects and pictures, not from lack of recognition (excluding visual agnosia) but from lack of access to the appropriate word (optic aphasia). The patient also exhibited a deficit in the evocation of gesture from the visual presentation of an object (optic apraxia) and a difficulty in "conjuring up" visual images of objects (impaired visual imagery) and loss of dreams. The fundamental deficit of this patient is tentatively explained in terms of visuoverbal and visuogestural disconnection and a deficit of mental imagery. PMID:2413956

  7. sup 123 I-IMP-SPECT in vascular dementia

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    Namura, Yasuhiro; Miyoshi, Toshihiko; Shio, Hideo; Yamaguchi, Shinya; Kimura, Jun (Kyoto Univ. (Japan). Hospital)

    1990-12-01

    Cerebral blood flow (CBF) was studied by N-isopropyl-p-{sup 123}I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author).

  8. Positron emission tomography scans on kanji and kana

    International Nuclear Information System (INIS)

    We reanalyzed our positron emission tomography (PET) study on reading of Japanese kanji (morphogram) words, kana (phonogram) words and kana nonwords, using Statistical Parametric Mapping (SPM). The basal occipital and occipito-temporal areas were activated in common, among which activity was most pronounced in the fusiform/inferior temporal gyri with kanji and in the inferior occipital gyrus with kana. The results were consistent with the clinical observations that damage to the posterior inferior temporal cortex including the fusiform/inferior temporal gyri causes alexia with agraphia for kanji, whereas damage to the posterior occipital area including the inferior occipital gyrus causes pure alexia for kana. Bases on the present results and the lesion studies, a dual-route hypothesis that modifies Iwata's model of reading about the Japanese language was proposed. That is, the middle occipital gyrus, deep perisylvian temporoparietal cortex and posterior temporal gyrus constitute a dorsal route for reading and process phonology for words, whereas the inferior occipital, fusiform and posterior inferior temporal gyri constitute a ventral route for reading and process orthography and lexico-semantics for words. The ventral route may gain dominance in reading, according as a word is repeatedly presented. (author)

  9. [A case of diagnostic dyspraxia without ideomotor apraxia by callosal lesion].

    Science.gov (United States)

    Tei, H; Soma, Y; Uchiyama, S; Maruyama, S

    1993-05-01

    A case of diagnostic dyspraxia was reported. A 57-year-old right handed male had been suffering from the lack of cooperation between his right and left hands for six months. Except for decreased deep tendon reflexes in all extremities, there were no abnormal findings on neurological examination. On neuropsychological examination, he was attentive, well orientated and his spontaneous speech, comprehension, naming, repetition and reading were intact. There was peculiar dissociative behavior between his right and left hands. For instance, he put a cigarette or coin in the pocket with his right hand then his left hand took out and replaced them, and he buttoned his shirts with his right hand but then unbuttoned with his left hand. These left hand oppositional behavior to his right hand were triggered by voluntary activities of his right hand. Left unilateral agraphia was also revealed but ideomotor apraxia, compulsive manipulation of tools and grasp reflex were not demonstrated. T1-weighted MRI demonstrated irregular low signal intensity areas extending from the genu to the body of the corpus callosum. No definite lesion was detected in the medial aspect of the frontal lobe. Only small numbers of diagnostic dyspraxia have been reported and such cases without ideomotor apraxia or medial frontal lesion are even rare. MRI is very useful for detecting the lesion of the corpus callosum. PMID:8365065

  10. [A case of multiple sclerosis with alien hand (diagonistic dyspraxia)].

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    Konagaya, Masaaki; Sakai, Motoko

    2007-05-01

    In this paper, we describe a case of mutiple sclerosis (MS) with diagonistic dyspraxia and the callosal lesions in MRI. The patient was a 54-year-old woman with 12 year-history of suffering from MS. Her clinical symptoms were left alien hand, mild euphoria, right blindness, left visual deficit (0.06), mild weakness of right upper limb, complete paraplegia of lower limbs, total sensory deficit below middle sternal level and neurogenic bladder. She was right-handed person and her alien hand was such a manner; when she intended to use spoon with right hand, her left hand aimlessly began to hold and release a cup or dish. Then, she was diagnosed as diagnostic dyspraxia. Neuropsychological examinations disclosed left hemispheric dysfunction including left hand agraphia and disconnection of the callosum. MRI showed patchy lesions in the callosum, right optic radiation, both side thalamus (left > right), left cerebral peduncle, and spinal cord of cervical to the thoracal portion. Although the functional disorders and the radiological atrophy of the callosum, the clinical manifestation of the callosal disconnection in MS cases has been scarcely reported, and this case seems to be a quite rare condition to be described. PMID:17533980

  11. Neural substrates of reading and writing

    International Nuclear Information System (INIS)

    Functional MRI has made a great advance in the neurological field because of its low invasion, easiness to collect data to be analyzed by such a globally standardizable software as SPM (statistical parametric mapping), and appearance of academic journals specified for neuroimaging. This chapter of the review describes the activating regions and functions in reading and writing, the essential ability of language belonging to the cerebral highest function, as evidenced by the fMRI and positron emission tomography (PET) images including those under disease states (alexia and agraphia), in the following order; Correspondence of Japanese kanji/kana-words to English ones for studies on activation, Cognitive psychological model of reading, Studies on the activation of reading words, and Studies on the activation of writing words. In this paper, regions are mainly documented in accordance with the coordinate of Montreal Neurological Institute. The third section above mentions the concerned regions in the fusiform gyrus and posterior inferior temporal cortex; lateral occipital gyrus subcortex; temporal plane, superior temporal gyrus and middle temporal gyrus; posterior middle temporal, angular and supramarginal gyri; and inferior frontal gyrus, insular gyri, and supplementary motor area. The fourth section for writing words says the regions in the fusiform gyrus, posterior inferior temporal gyrus and posterior inferior temporal cortex; intraparietal sulcus pericortex, superior parietal lobule and lateral occipital gyrus; and sensorimotor area, posterior middle temporal gyrus and posterior inferior frontal gyrus. (R.T.)

  12. Positron emission tomography scans on kanji and kana

    Energy Technology Data Exchange (ETDEWEB)

    Sakurai, Yasuhisa [Mitsui Memorial Hospital, Tokyo (Japan)

    2002-12-01

    We reanalyzed our positron emission tomography (PET) study on reading of Japanese kanji (morphogram) words, kana (phonogram) words and kana nonwords, using Statistical Parametric Mapping (SPM). The basal occipital and occipito-temporal areas were activated in common, among which activity was most pronounced in the fusiform/inferior temporal gyri with kanji and in the inferior occipital gyrus with kana. The results were consistent with the clinical observations that damage to the posterior inferior temporal cortex including the fusiform/inferior temporal gyri causes alexia with agraphia for kanji, whereas damage to the posterior occipital area including the inferior occipital gyrus causes pure alexia for kana. Bases on the present results and the lesion studies, a dual-route hypothesis that modifies Iwata's model of reading about the Japanese language was proposed. That is, the middle occipital gyrus, deep perisylvian temporoparietal cortex and posterior temporal gyrus constitute a dorsal route for reading and process phonology for words, whereas the inferior occipital, fusiform and posterior inferior temporal gyri constitute a ventral route for reading and process orthography and lexico-semantics for words. The ventral route may gain dominance in reading, according as a word is repeatedly presented. (author)

  13. Letter-By-Letter Reading: Natural Recovery and Response to Treatment

    Directory of Open Access Journals (Sweden)

    Pélagie M. Beeson

    2005-01-01

    Full Text Available The present investigation provides a longitudinal study of an individual (RB with acquired alexia following left posterior cerebral artery stroke. At initial testing, RB exhibited acquired alexia characterized by letter-by-letter (LBL reading, mild anomic aphasia, and acquired agraphia. Repeated measures of reading accuracy and rate were collected for single words and text over the course of one year, along with probes of naming and spelling abilities. Improvements associated with natural recovery (i.e., without treatment were documented up to the fourth month post onset, when text reading appeared to be relatively stable. Multiple oral reading (MOR treatment was initiated at 22 weeks post-stroke, and additional improvements in reading rate and accuracy for text were documented that were greater than those expected on the basis of spontaneous recovery alone. Over the course of one year, reading reaction times for single words improved, and the word-length effect that is the hallmark of LBL reading diminished. RB's response to treatment supports the therapeutic value of MOR treatment to in LBL readers. His residual impairment of reading and spelling one-year post stroke raised the question as to whether further progress was impeded by degraded orthographic knowledge.

  14. 123I-IMP-SPECT in vascular dementia

    International Nuclear Information System (INIS)

    Cerebral blood flow (CBF) was studied by N-isopropyl-p-123I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author)

  15. Síndrome de gerstmann de desenvolvimento associada a neoplasia cerebelar: relato de um caso e revisão da literatura Developmental Gerstmann syndrome associated with cerebellar neoplasm: a case report with review of litterature

    Directory of Open Access Journals (Sweden)

    Lineu César Werneck

    1975-03-01

    Full Text Available É relatado um caso de síndrome de Gerstmann de Desenvolvimento, que apresentava acalculia, agrafía, confusão direita-esquerda, agnosia de dedos e apraxia construcional, em um menino de 7 anos. O tratamento inicial com metilfenidato determinou bons resultados no que concerne à hiperatividade, à atenção e à apraxia construcional. Durante o curso clínico, o paciente apresentou sintomatologia cerebelar, hipertensão intracraniana, tendo sido feita intervenção cirúrgica na fossa posterior, sendo excisado um meduloblastoma de cerebelo. O autor acredita que é esta a primeira descrição na literatura da concomitância da síndrome de Gerstmann de Desenvolvimento e neoplasia de fossa posterior. São feitos comentários focalizando cada um dos aspectos clínicos, fatores etiológicos e topográficos.A Developmental Gerstmann syndrome in a 7 years-old-boy with hyperactivity, short attention span, acalculia, agraphia, right-left confusion, finger agnosia and constructional apraxia is reported. An initial trial with methylphenidate was done with good improvement regarding hyperactivity, attention span and constructional apraxia. In the clinical course developed a cerebellar syndrome and intracranial hypertension. Surgical exploration of the cerebellum discovered a medulloblastoma. The author believes that this is the first described association of Developmental Gerstmann syndrome and cerebellar neoplasia. The clinical findings, the etiology and the topography of the Gerstmann syndrome are discussed.

  16. An autopsied case of corticobasal degeneration showing severe cerebral atrophy over a protracted disease course of 16 years.

    Science.gov (United States)

    Kondo, Daizo; Hino, Hiroaki; Shibuya, Katsuhiko; Fujisawa, Koshiro; Kosaka, Kenji; Hirayasu, Yoshio; Yamamoto, Ryoko; Kasanuki, Koji; Minegishi, Michiko; Sato, Kiyoshi; Hosokawa, Masato; Arai, Tetsuaki; Arai, Heii; Iseki, Eizo

    2015-06-01

    The patient was a 72-year-old Japanese woman. At the age of 57, she started having difficulty performing daily work and developed agraphia. She also exhibited restlessness and loss of interest, and began to speak less. Thereafter, stereotypical behavior, gait disturbance and dysphagia were noted. CT scan demonstrated left-dominant frontal and temporal lobe atrophy. She died at the age of 72, about 16 years after the onset of symptoms. Neuropathologically, the brain weighed 867 g, and showed remarkable cerebral atrophy with degeneration of the white matter, predominantly in the left dorsal frontal lobe and anterior temporal lobe. Microscopically, severe neuronal loss and gliosis with rarefaction were found in the cerebral cortex, and severe destruction of myelin and axons was observed in the cerebral white matter. Moderate neuronal loss with gliosis was also found in the pallidum and substantia nigra. Gallyas-Braak staining and tau immunostaining revealed pretangle neurons, NFTs, ballooned neurons and astrocytic plaques in the cerebral cortex, subcortical nuclei and brainstem, and argyrophilic threads and coiled bodies in the subcortical white matter. Tau isoform-specific immunostaining revealed that most tau-immunoreactive structures were positive for 4-repeat (4R) tau, but some of the NFTs were positive for 3-repeat (3R) tau in the cerebral neocortex. Immunoblotting demonstrated an accumulation of 4R tau in the cerebral cortex and subcortical white matter. The patient was pathologically diagnosed as having corticobasal degeneration. Her long survival course likely accounts for the severe white matter degeneration and accumulation of 3R tau in NFTs. PMID:25516199

  17. [Motor amusia following a right temporal lobe hemorrhage--a case report].

    Science.gov (United States)

    Takeda, K; Bandou, M; Nishimura, Y

    1990-01-01

    A 65-year-old female was admitted to our hospital because of left hemiparesis with sudden onset one week before. She was congenitally right-handed. She had been a teacher of Japanese string instrument (samisen) playing and been able to sing Japanese traditional songs well. A tape on which she had recorded her songs one year before the admission also proved her to be a good singer. Neurological examination on admission revealed almost normal findings except for minimal weakness in her left hand fingers. Right temporal lobe hemorrhage was revealed by CT scan. One month after the admission, she complained that she was unable to sing her songs and to play samisen as she used to do. Her intelligence was normal (WAIS VIQ116, PIQ108) and there were no abnormal findings as follows: aprosodia, aphasia, agraphia, memory disturbance, agnosia and ideational, ideomotor, constructional or limb-kinetic apraxia. She could point out her errors while singing. However, musical receptive function was slightly disturbed with tonal memory in Seashore test. When she was asked to sing a song without any instrumental support, she hummed a melody occasionally with wrong pitch, but rhythmically. After hearing a song she knew well, she reproduced it with slight improvement. With the vocal or the instrumental accompaniment, she could sing fairly well. She had some mistakes of pitch while playing a samisen. MRI was performed one year and a half after the brain hemorrhage. It displayed a thin linear of hematoma in the white matter of the right upper temporal and transverse gyrus. It was proved in our case that motor amusia with minimal musical receptive dysfunction could appear following a cerebral lesion and musical function might be independent of intelligence or verbal function. PMID:2184966

  18. A 58-year-old female with blurred vision and apraxia

    Directory of Open Access Journals (Sweden)

    Zhi-hong SHI

    2014-07-01

    Full Text Available A 58-year-old right handed woman, with 12 years of formal education, had a five-year history of slowly progressive blurred vision and apraxia. Five years before the examination she gradually became blurred vision and had difficulties identifying static objects within the visual field. Then she went to an ophthalmologist and received cataract surgery. However, the symptoms were not improved after surgery. Two years later, she had difficulty doing household chores and was unable to dress herself. She developed an anxiety disorder in the absence of prominent language or memory deficits. Five years after onset, she showed global cognitive decline and abilities of daily life decline. On neurological examination she was alert. Neuropsychological testing revealed a mini-mental state examination (MMSE score of 20/30 with anomia, agraphia, alexia and partial impairment on time orientation. Biochemical investigations for disorders involving thyroid function, vitamin B12, and folate were unremarkable. A brain MRI showed diffuse cortical atrophy and hippocampus atrophy. An 18F-FDG PET scan showed bilateral hypometabolism at the frontal lobes, tempoparietooccipital adjunction, posterior cingulate cortices and precuneus, insular lobes, caudate nuclei and right thalamus. An 11C-PIB PET scan showed bilateral amyloid deposits at bilateral frontal lobes and occipital lobes, left temporal lobe and insular, basal ganglia, bilateral cingulate cortices and precuneus. No PSEN1, PSEN2 or APP mutations were identified. This early-onset patient had an unusual cognitive complaint, including visual agnosia and apraxia. The clinical features, structural and functional imaging findings of this case were compatible with the diagnosis of Posterior Cortical Atrophy (PCA. PCA is a neurodegenerative condition characterized by a progressive, often dramatic and relatively selective decline in visual processing skills and other functions subserved by parietal, occipital and

  19. Preserved processing of musical syntax in a person with agrammatic aphasia

    Directory of Open Access Journals (Sweden)

    Sadhvi Saxena

    2014-04-01

    Full Text Available A growing body of work suggests that processing hierarchical structure in language and in music rely on shared systems (review: Slevc, 2012, however this conclusion is tempered by neuropsychological dissociations between linguistic and musical processing (i.e., aphasia and amusia; review: Peretz, 2006. An influential reconciliation comes from Patel’s (2003 shared syntactic integration resource hypothesis (SSIRH, which suggests that evidence for shared processes reflect reliance on shared syntactic integration processes whereas dissociations result from damage to domain-specific syntactic representations. The SSIRH thus predicts that patients with deficits in the processing of linguistic syntax–such as agrammatic aphasics–should show parallel deficits in musical structural (harmonic processing. This prediction is countered by findings of impaired harmonic processing in patients with (apparently spared linguistic syntactic processing (e.g., Sammler et al., 2011, however evidence for the opposite dissociation–preserved harmonic processing in agrammatic aphasia–is lacking. While there are reports of preserved musical abilities despite global aphasia (Basso & Capitani, 1985 or severe Wernicke’s aphasia (Luria, Tsvetkova, & Futer, 1965, of preserved reading and writing of music in the face of alexia and agraphia (Signoret et al., 1987, and of preserved musical sound naming in the face of severe anomia (Tzortzis et al., 2000, no study (to our knowledge has demonstrated preserved musical structural processing in an agrammatic patient. In addition, at least one group of agrammatic aphasics did not show normal effects of harmonic priming, and showed a relationship between accuracy on acceptability judgments in language and in music (Patel et al., 2008. Here, we report a detailed analysis of structural processing in language and in music in HV, a 63 year-old native English-speaking female musician who sustained a left peri-Sylvian stroke. She