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Sample records for agraphia

  1. 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.)

  2. 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

  3. Acquired agraphia caused by focal brain damage.

    Science.gov (United States)

    Anderson, S W; Saver, J; Tranel, D; Damasio, H

    1993-03-01

    Motor and linguistic aspects of writing were evaluated in 31 subjects with focal damage in 1 of 3 regions of the left hemisphere: (1) dorsolateral frontal lobe sparing primary motor cortex (group FL), (2) parietal lobe (group PL), or (3) temporal lobe (group TL). A standard procedure was used to evaluate writing for grapheme formation, spatial arrangement, spelling, word selection, grammar, and perseveration. It was predicted that agraphia would be observed in all 3 groups, and that the most severe impairments would be associated with frontal lobe damage, particularly in aspects of writing dependent on sequencing (grapheme formation, spelling, and grammar). It was found that agraphia was common in all groups, particularly in the acute epoch, and that all groups showed considerable recovery of writing by the chronic epoch. Few differences were found between groups. However, the FL group was impaired on spelling and grammar relative to the PL group in the acute epoch and impaired on grammar relative to the TL group in the chronic epoch. The findings are consistent with the notion that writing relies on a distributed neuroanatomical network, which acts in concert to link fragments of visuomotor activity with component linguistic elements.

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

    Directory of Open Access Journals (Sweden)

    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. Pure Kana agraphia as a manifestation of graphemic buffer impairment.

    Science.gov (United States)

    Kokubo, K; Suzuki, K; Yamadori, A; Satou, K

    2001-04-01

    We report a left-handed man who demonstrated a pure agraphia limited to words written in Kana characters (syllabograms) following a right putaminal hemorrhage. Writing words in Kanji characters (logograms) was well preserved. His performance in Kana writing was characterized by intact ability to write single syllables, error increase in the second half of words directly proportional to the word length and correct but slow writing of words using kana blocks. Errors were more prominent in Hiragana words than Katakana words which are usually used to transcribe foreign words. Acoustic-grapheme sequencing per se was not impaired as shown by his correct performance in arranging character blocks. These findings suggest selective damage to the graphemic buffer, a module that temporarily maintains the graphemic representation elaborated in previous stages before it is sent to the peripheral systems for its motor realization.

  6. Apraxic agraphia following thalamic damage: Three new cases.

    Science.gov (United States)

    Vandenborre, Dorien; van Dun, Kim; Engelborghs, Sebastiaan; Mariën, Peter

    2015-11-01

    Apraxic agraphia (AA) is a so-called peripheral writing disorder following disruption of the skilled movement plans of writing while the central processes that subserve spelling are intact. It has been observed in a variety of etiologically heterogeneous neurological disorders typically associated with lesions located in the language dominant parietal and frontal region. The condition is characterized by a hesitant, incomplete, imprecise or even illegible graphomotor output. Letter formation cannot be attributed to sensorimotor, extrapyramidal or cerebellar dysfunction affecting the writing limb. Detailed clinical, neurocognitive, neurolinguistic and (functional) neuroimaging characteristics of three unique cases are reported that developed AA following a thalamic stroke. In marked contrast to impaired handwriting, non-handwriting skills, such as oral spelling, were hardly impaired. Quantified Tc-99m ECD SPECT consistently showed a decreased perfusion in the anatomoclinically suspected prefrontal regions. The findings suggest crucial involvement of the anterior (and medial) portion of the left thalamus within the neural network subserving the graphomotor system. Functional neuroimaging findings seem to indicate that AA after focal thalamic damage represents a diaschisis phenomenon. PMID:26460984

  7. [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

  8. Clinico-anatomical correlations of left posterior cerebral artery occlusion. Alexia without agraphia, color anomia, and memory disturbance

    Energy Technology Data Exchange (ETDEWEB)

    Isono, Osamu; Shiota, Junichi; Kawamura, Mitsuru; Hirayama, Keizou; Maki, Toshiyuki.

    1988-11-01

    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.).

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

    Institute of Scientific and Technical Information of China (English)

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

    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 visuoconstructional errors (13.3

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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…

  12. 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.

  13. 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…

  14. Dissociation between distal and proximal left limb agraphia and agraphesthesia in a patient with a callosal disconnection syndrome.

    Science.gov (United States)

    Bachoud-Lévi, A C; Ergis, A M; Cesaro, P; Degos, J D

    2000-06-01

    A few neuropsychological studies have suggested the existence of bilateral hemispheric representations for the proximal parts of the limbs in humans. We report the case of a patient who presented with a callosal disconnection syndrome, which at a later stage of disease became restricted to left agraphia, left agraphesthesia and left auditory extinction. The anomic character of the agraphesthesia was demonstrated. Tactile naming was normal, which allows us to conclude that separate callosal pathways related to the left language areas transmit information for graphesthesia and tactile naming. Agraphia and agraphesthesia were not observed when the proximal part of the left upper limb was utilized. These observations support the conclusion that writing and graphesthesia with the proximal part of the limb can be mediated by the ipsilateral cortex.

  15. 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.

  16. 基底神经节区梗死后失写症的神经心理学分析%The Neuropsychological Analysis of Agraphia After Basal Ganglia Infarction

    Institute of Scientific and Technical Information of China (English)

    金梅; 刘晓加; 陈东; 尹文刚

    2008-01-01

    目的:研究基底神经节(BG)区梗死所致汉语失写症的神经心理学特点.方法:采用汉语失写检查法(CAB)测试40例BG区梗死患者的书写能力,计算各项书写得分和失写指数.对失写组和非失写组头颅CT或MRI进行标准化处理,显示病灶并进行二维平面叠加,直观显示其病灶的集中趋势.结果:在40例患者中,左侧BG区损害21例,失写17例;右侧损害19例,失写4例.神经影像学二维叠加显示,BG区梗死致失写的病灶多位于左侧BG区,包括左侧壳核、尾状核头部和尾状核体;而较少位于右侧壳核和右侧尾状核体.BG区梗死所致失写以失语性失写为主,其特点为构字障碍、字词错写和语法错误.结论:BG区梗死可导致失语性失写症,提示BG参与了书写加工过程,是书写这一高级神经功能的皮质下中枢.%Objective:To investigate the neuropsychological characteristics of Chinese agraphia caused by basal ganglia(BG)infarction.Methods:The writing abilities of 40 patients with BG infarction were detected by Chinese agraphia battery(CAB),and all the writing scores and agraphia quotient were calculated.The head CT/MRI images in agraphia and non-agraphia groups were standardized,the infarction were revealed and the superposition of two-dimensional arrays were performed,so that the central tendency of infarction was visually displayed.Results: Among the 40 patients,21 had left BG infraction,and 17 had agraphia;19 had right BG infraction,and 4 had agraphia.The two-dimensional superimposing neuroimages showed that BG infarctions caused agraphia was mostly in the left BG,including the left putamen,the head and body of the caudate nucleus,but there were fewer infarctions in the right putamen and the body of the candate nucleus.BG infarction caused agraphia was mostly aphasic agraphia,which was characterized by the orthographic disorders,paragraphia,and grammar mistakes.Conclusions: BG infarction may result in aphasic agraphia

  17. 失写症背景下汉字创意课程群的建设%CONSTRUCTION OF THE CURRICULUM CLUSTER OF CHINESE CHARACTERS CREATIONS IN THE BACKGROUND OF AGRAPHIA

    Institute of Scientific and Technical Information of China (English)

    李帆

    2015-01-01

    People have tended to write less because of the long-term use of keyboarding. As a result, the symptoms of agraphia ---- forgetting Chinese characters while writing, may occur. Students generaly are lacking of a good comprehension of the rules of Chinese characters writing, which hinders them from opening mind to design creative Chinese characters. Facing the difficulties in teaching, this paper provides a“three more to one” method to construct the curriculum cluster in Chinese characters creations. Write more, practice more and think more to improve the students’ cultural taste in design and promote the Chinese culture.%由于长期使用键盘输入法,人们写字的机会减少,导致出现“提笔忘字”的失写症症状。学生们对汉字书写规律习惯都理解不够,汉字创意设计思路拓展不开。本文针对目前教学面对的困境,提出“三多对一失”的汉字创意课程群创新建设方法。多写、多练、多思,来提升学生设计作品的文化品位,弘扬汉文化。

  18. Whole-word response scoring underestimates functional spelling ability for some individuals with global agraphia

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    Andrew Tesla Demarco

    2015-05-01

    These data suggest that conventional whole-word scoring may significantly underestimate functional spelling performance. Because by-letter scoring boosted pre-treatment scores to the same extent as post-treatment scores, the magnitude of treatment gains was no greater than estimates from conventional whole-word scoring. Nonetheless, the surprisingly large disparity between conventional whole-word scoring and by-letter scoring suggests that by-letter scoring methods may warrant further investigation. Because by-letter analyses may hold interest to others, we plan to make the software tool used in this study available on-line for use to researchers and clinicians at large.

  19. Neural Mechanism of Apraxia Agraphia%失用性失写的脑机制

    Institute of Scientific and Technical Information of China (English)

    冉光明; 陈旭; 马建苓; 潘彦谷; 胡天强

    2012-01-01

    失用性失写是指人们知道该如何书写,但实际上却不会书写或错误书写的一种现象.失用性失写涉及的神经网络包括皮层与皮层连接、皮层与皮质下连接.其中前者包括额-顶叶相关脑区的连接、顶-枕叶相关脑区的连接以及额-顶-枕相关脑区的连接,这些神经网络分别负责操作空间表征图像、回忆以及检索字母的形状等;后者包括小脑与额-顶叶的连接、左丘脑-大脑皮质的连接以及纹状体-内囊-左额顶叶的连接等,它们分别与图像输出程序、书写运动过程、操作指令的执行过程以及字素形成过程等有关.今后的研究应该集中在完善失用性失写的研究范式、深入探讨失用性失写的心理机制以及推动其康复工作的开展等方面.

  20. 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

  1. Auditory Repetition Priming Is Impaired in Pure Alexic Patients

    Science.gov (United States)

    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.…

  2. De la linguistique a la neurolinguistique: 1930-1976 (From Linguistics to Neurolinguistics: 1930-1976)

    Science.gov (United States)

    Dubois, Jean

    1977-01-01

    A survey of the historical developments of linguistic theories relating to aphasia. Some topics covered are: the breakdown of language as opposed to acquisition of language; functional structuralism basic to neurolinguistics; analysis of language disorders; neurolinguistics--models and typology; aphasia and agraphia. (Text is in French.) (AMH)

  3. The neuropsychological and neuroradiological correlates of slowly progressive visual agnosia.

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    Giovagnoli, Anna Rita; Aresi, Anna; Reati, Fabiola; Riva, Alice; Gobbo, Clara; Bizzi, Alberto

    2009-04-01

    The case of a 64-year-old woman affected by slowly progressive visual agnosia is reported aiming to describe specific cognitive-brain relationships. Longitudinal clinical and neuropsychological assessment, combined with magnetic resonance imaging (MRI), spectroscopy, and positron emission tomography (PET) were used. Sequential neuropsychological evaluations performed during a period of 9 years since disease onset showed the appearance of apperceptive and associative visual agnosia, alexia without agraphia, agraphia, finger agnosia, and prosopoagnosia, but excluded dementia. MRI showed moderate diffuse cortical atrophy, with predominant atrophy in the left posterior cortical areas (temporal, parietal, and lateral occipital cortical gyri). 18FDG-PET showed marked bilateral posterior cortical hypometabolism; proton magnetic resonance spectroscopic imaging disclosed severe focal N-acetyl-aspartate depletion in the left temporoparietal and lateral occipital cortical areas. In conclusion, selective metabolic alterations and neuronal loss in the left temporoparietooccipital cortex may determine progressive visual agnosia in the absence of dementia.

  4. 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 ...

  5. 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...

  6. Behavioral Disorders in Association with Posterior Callosal and Frontal Cerebral Infarction

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    J. P. Lejeune

    1993-01-01

    Full Text Available Behavioral disorders were a prominent clinical feature after the surgical treatment of an anterior communicating artery aneurysm rupture in a 44-year-old man. Callosal apraxia was associated with an alien hand. The latter remained 1 year after surgery while diagonistic apraxia disappeared after 3 months. Other callosal signs included left agraphia, tactile anomia and auditory suppression. MRI revealed posterior callosal infarction and a right frontal infarct. The association of diagonistic apraxia and alien hand is rarely reported.

  7. Crossed Non-Dominant Hemisphere Syndrome in a Right-Hander

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    M. Fujimori

    1994-01-01

    Full Text Available A right-handed patient with a large left temporo-parietal infarction manifested various non-dominant hemisphere signs. He had two left-handed children. On neurobehavioural examinations, he did not show aphasia or ideomotor apraxia, but did show hemispatial neglect, spatial agraphia, constructional apraxia, auditory and tactile extinction, anosodiaphoria and affective changes, all of which are usually observed after right hemispheric damage. We conclude that he has a reversed cerebral laterality of cognitive functions and showed crossed non-dominant hemisphere syndrome.

  8. [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

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

    Science.gov (United States)

    Takaiwa, Akiko; Yamashita, Kenichiro; Nomura, Takuo; Shida, Kenshiro; Taniwaki, Takayuki

    2005-11-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Variability of writing disorders in Wernicke's aphasia underperforming different writing tasks: A single-case study.

    Science.gov (United States)

    Kozintseva, Elena; Skvortsov, Anatoliy

    2016-03-01

    The aim of our study was to evolve views on writing disorders in Wernicke's agraphia by comparing group data and analysis of a single patient. We showed how a single-case study can be useful in obtaining essential results that can be hidden by averaging group data. Analysis of a single patient proved to be important for resolving contradictions of the "holistic" and "elementaristic" paradigms of psychology and for the development of theoretical knowledge with the example of a writing disorder. The implementation of a holistic approach was undertaken by presenting the tasks differing in functions in which writing had been performed since its appearance in human culture (communicative, mnestic, and regulatory). In spite of the identical composition of involved psychological components, these differences were identified when certain types of errors were analyzed in the single subject. The results are discussed in terms of used writing strategy, resulting in a way of operation of involved components that lead to qualitative and quantitative changes of writing errors within the syndrome of Wernicke's agraphia. PMID:27061639

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

    Science.gov (United States)

    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.

  13. [Dual neural circuit model of reading and writing].

    Science.gov (United States)

    Iwata, Makoto

    2011-08-01

    In the hypothetical neural circuit model of reading and writing that was initially proposed by Dejerine and subsequently confirmed by Geschwind, the left angular gyrus was considered as a unique center for processing letters. Japanese investigators, however, have repeatedly pointed out that this angular gyrus model cannot fully explain the disturbances observed in reading and writing Kanji letters in Japanese patients with various types of alexia with or without agraphia. In 1982, I proposed a dual neural circuit model of reading and writing Japanese on the basis of neuropsychological studies on the various types of alexia with or without agraphia without aphasia. This dual neural circuit model proposes that apart from the left angular gyrus which was thought to be a node for phonological processing of letters, the left posterior inferior temporal area, also acts as a node for semantic processing of letters. Further investigations using O15-PET activation on normal subjects revealed that the left middle occipital gyrus (area 19 of Brodmann) and the posterior portion of the left inferior temporal gyrus (area 37 of Brodmann) are the cortical areas responsible for reading Japanese letters; the former serving for phonological reading and the latter for semantic reading. This duality of the neural circuit in processing letters was later applied to explain disturbances in reading English, and was finally accepted as a valid model for other alphabetic letter systems too.

  14. "Apraxic dysgraphia" in a 15-year-old left-handed patient: disruption of the cerebello-cerebral network involved in the planning and execution of graphomotor movements.

    Science.gov (United States)

    Mariën, Peter; de Smet, Eric; de Smet, Hyo Jung; Wackenier, Peggy; Dobbeleir, Andre; Verhoeven, Jo

    2013-02-01

    Apraxic agraphia is a peripheral writing disorder caused by neurological damage. It induces a lack or loss of access to the motor engrams that plan and programme the graphomotor movements necessary to produce written output. The neural network subserving handwriting includes the superior parietal region, the dorsolateral and medial premotor cortex and the thalamus of the dominant hemisphere. Recent studies indicate that the cerebellum may be involved as well. To the best of our knowledge, apraxic agraphia has not been described on a developmental basis. This paper reports the clinical, neurocognitive and (functional) neuroimaging findings of a 15-year-old left-handed patient with an isolated, non-progressive developmental handwriting disorder consistent with a diagnosis of "apraxic dysgraphia". Gross motor coordination problems were objectified as well but no signs of cerebellar, sensorimotor or extrapyramidal dysfunction of the writing limb were found to explain the apraxic phenomena. Brain MRI revealed no supra- and infratentorial damage but quantified Tc-99m-ECD SPECT disclosed decreased perfusion in the anatomoclinically suspected prefrontal and cerebellar brain regions crucially involved in the planning and execution of skilled motor actions. This pattern of functional depression seems to support the hypothesis that "apraxic dysgraphia" might reflect incomplete maturation of the cerebello-cerebral network involved in handwriting. In addition, it is hypothesized that "apraxic dysgraphia" may have to be considered to represent a distinct nosological category within the group of the developmental dyspraxias following dysfunction of the cerebello-cerebral network involved in planned actions.

  15. A new neuropsychology for the XXI century.

    Science.gov (United States)

    Ardila, Alfredo

    2013-12-01

    Regardless of the significant interest in comparing neuropsychological syndromes across cultures, little interest is observed in comparing these syndromes across time. Most of the neuropsychological syndromes were described during the late nineteenth and early twentieth century (e.g., aphasia, alexia, agraphia, acalculia, etc.). However, living conditions have so dramatically changed during the last 100 years that those classical neuropsychological syndromes have to be re-stated and reconsidered; eventually, new syndromes could be proposed. In this paper, an analysis of the impact of the new living conditions in spoken language, written language, numerical abilities, memory, spatial orientation, people recognition, and executive functions is presented. It is concluded that it is time to re-analyze and re-interpret the classical neuropsychological syndromes; and develop new assessment procedures, more in accordance with the twenty-first century living conditions.

  16. Rehabilitation of pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

    2013-01-01

    that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......Acquired reading problems caused by brain injury (alexia) are common, either as a part of an aphasic syndrome, or as an isolated symptom. In pure alexia, reading is impaired while other language functions, including writing, are spared. Being in many ways a simple syndrome, one would think...... in the reviewed studies, have associated deficits like agraphia or aphasia and thus do not strictly conform to the diagnosis. Few studies report clear and generalisable effects of training, none report control data, and in many cases the reported findings are not supported by statistics. We can, however...

  17. A study of dysgraphia of Chinese characters in a patient with semantic dementia%语义性痴呆患者汉语书写障碍的神经心理学分析

    Institute of Scientific and Technical Information of China (English)

    吴小琴; 刘晓加; 王群; 蒋海山; 邓镇

    2012-01-01

    Objective To investigate the clinical features of Chinese dysgraphia and then probe into its mechanisms in a patient with semantic dementia(SD).Methods The patient with SD finished the writing part of the Aphasia Battery of Chinese (Aphasia Battery of Chinese,ABC) and the Chinese agraphia battery (Chinese agraphia battery,CAB ) in addition to a series of other neuropsychological tests.Results ( 1 ) On the Wechsler Adult intelligence scale,the patient performed poorly on information and vocabulary with scores of 6/29 and 8/80,respectively.He spoke out only 11 names totally on the category fluency test within 1 minute,while 25 names or more than were normal.Semantic features test showed he made 37 right answers of 60 questions,with scores of 8/20 on category,7/20 on function and 8/20 on nature features.(2)The writing disorder exhibited Chinese aphasia agraphia with obvious difficulty in forming characters,wrong characters of the same pronunciation or the same form or unrelated errors,and grammatical impairments.Its damage from serious to light occurred in picture writing( 6/40),writing sentences to convey meaning(1/10),dictation(11/40) and automatic writing(35/40).The transcription was relatively preserved (40/40 ). (3)He scored 20 and 19 points on MMSE and MoCA.Executive function was damaged significantly,while recent memory was preserved relatively.Conclusion The patient with SD shows an impoverished store of general knowledge and poor comprehension of single-word.The nature of SD's dysgraphia presents Chinese aphasia agraphia,undoubtedly due to progressive deterioration in semantic memory.More importantly,its error types and distribution show apparent discrepancy from that of alphabetic script.Presumably because Chinese writing system is logographic in nature and the pathway of comprehension concerning syllable-orthography-morphemes mapping,while alphabetic writing system follows a principle of mapping graphemes on-to phonemes and letters themselves dont stand for

  18. The neuropsychological and cortical metabolic changes in two patients with Benson's syndrome%Benson综合征患者两例神经心理特征与皮质代谢异常

    Institute of Scientific and Technical Information of China (English)

    高晶; 郭佳翔; 李方; 冯逢; 朱朝晖; 牛娜; 有慧; 崔丽英; 郭玉璞

    2011-01-01

    Objective Standard neuropsychological assessment plus structural and functional imaging were used in accurate diagnosis of Benson's syndrome (posterior cortical atrophy).Method Serial neuropsychological screening and integrative assessments of visual spatial function, 3D structural MRIimaging and functional FDG-PET imaging were used in two cases of Benson' s syndrome.Results The clinical signs were agnosia, optic ataxia, apraxia, alexia, agraphia and prosopagnosia.MRI imaging revealed bilateral parietal and occipital lobe atrophy.FDG-PET imaging revealed low metabolism in the posterior cortex.The agraphia was constructive: the words were correct but written in the wrong location.Conclusion Standard neuropsychological assessments can recognize the disease nature.When combined with the structural and functional imaging, a correct diagnosis of Benson's syndrome can be made.%目的 应用规范的神经心理评价结合结构影像以及功能影像正确诊断后部皮质萎缩,即Benson综合征.方法 对于综合认知功能评价证实以视空间功能异常为主要改变的2例Benson综合征患者进行系列的视空间功能检查、3D磁共振以及脱氧葡萄糖(FDG)-PET检查.结果 2例以记忆障碍为主诉就诊的患者,其中1例多次就诊于眼科诊断"视力障碍"而无其他异常发现,但经过仔细询问临床过程,规范的神经心理评价,结果证实患者有失认、视觉共济失调、失用、失读、失写(患者书写笔画正确,只是空间位置错误)等症状.2例患者MRI检查示双侧顶枕叶萎缩.FDG-PET反映顶枕皮质代谢减低,符合Benson综合征的诊断.结论 规范的神经心理评价可以正确地认识疾病本质,结构影像和功能影像对鉴别诊断Benson综合征有重要价值.

  19. Right hemisphere dominance for language in a woman with schizophrenia and a porencephalic cyst of the left hemisphere.

    Science.gov (United States)

    de Oliveira-Souza, Ricardo; Monteiro, Myriam; Pacheco, Paula; Tovar-Moll, Fernanda; Mattos, Paulo; Moll, Jorge; Nazar, Bruno Palazzo

    2016-06-01

    A large left hemisphere porencephalic cyst was incidentally found in a 48-year-old woman (MS) with a Diagnostic and Statistical Manual (DSM)-5 diagnosis of schizophrenia. The encephaloclastic characteristics of the cyst indicated that it was acquired between the 22nd and 24th gestational weeks, after the major waves of neuronal migration had tapered off. The cyst destroyed the left temporal and occipital lobes, and the inferior parietal lobule. Surprisingly, MS had no evidence of aphasia, alexia, agraphia, or ideational apraxia; in contrast, cognitive functions dependent on the integrity of the right hemisphere were severely impaired. To test the hypothesis that the development of language in MS took place at the expense of functions that are normally carried out by the right hemisphere, we investigated MS's correlates of oral comprehension with fMRI as a proxy for auditory comprehension and other cognitive functions strongly lateralized to the posterior left hemisphere, such as ideational praxis and reading. Comprehension of spoken language engaged the homologous of Wernicke's area in the right planum temporale. Porencephaly may represent a natural model of neuroplasticity supervening at predictable epochs of prenatal development. PMID:27283036

  20. Words don't come easy

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    of reading, and with the use of functional imaging techniques. Extant evidence for (and against) cerebral specialization for visual word recognition is briefly reviewed and found inconclusive.                       Study I is a case study of a patient with a very selective alexia and agraphia affecting...... reading and writing of letters and words but not numbers. This study raised questions of "where" in the cognitive system such a deficit may arise, and whether it can be attributed to a deficit in a system specialized for reading or letter knowledge. The following studies investigated these questions...... in the visual domain.                       An important account postulates that an area in the mid-fusiform gyrus - The visual word form area - is specialized for reading (in literate adults). Study II is a PET study investigating activity in this area during performance of tasks with pictures and words...

  1. [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

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

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

  4. 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)

  5. 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.

  6. Differing Connectivity of Exner's Area for Numbers and Letters.

    Science.gov (United States)

    Klein, Elise; Willmes, Klaus; Jung, Stefanie; Huber, Stefan; Braga, Lucia W; Moeller, Korbinian

    2016-01-01

    There is a growing body of evidence indicating a crucial role of Exner's area in (hand-) writing symbolic codes such as letters and words. However, a recent study reported a patient with a lesion affecting Broca's and Exner's area, who suffered from severe peripheral agraphia for letters but not for Arabic digits. The authors suggested a speculative account postulating differential connectivity of Exner's area for numbers and letters in order to explain this dissociation. In the present study, we evaluated this account, employing atlas-based tractography for the patient's anatomy, deterministic fiber-tracking as well as an automated toolkit to investigate the connectivity of Exner's area in healthy adults. In particular, fiber pathways connecting Exner's area with areas associated with language processing (e.g., the arcuate fascicle, ventral pathways encompassing the external/extreme capsule system) reached the inferior part of Exner's area, while fronto-parietal fibers (e.g., the superior longitudinal fascicle) connected the upper part of Exner's area with the intraparietal sulcus typically involved in number processing. Our results substantiated the differential connectivity account for Exner's area by identifying the neural connections between fiber tracts and cortex areas of interest. Our data strongly suggest that white matter connectivity should be taken into account when investigating the neural underpinnings of impaired and intact human cognition. PMID:27378882

  7. Long-Term Efficacy of Prism Adaptation on Spatial Neglect: Preliminary Results on Different Spatial Components

    Directory of Open Access Journals (Sweden)

    Maria Luisa Rusconi

    2012-01-01

    Full Text Available This study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA. Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA. Neglect evaluation was performed by means of BIT (conventional and behavioral, Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect.

  8. Long-term efficacy of prism adaptation on spatial neglect: preliminary results on different spatial components.

    Science.gov (United States)

    Rusconi, Maria Luisa; Carelli, Laura

    2012-01-01

    This study describes the long-term effectiveness on spatial neglect recovery of a 2-week treatment based on prism adaptation (PA). Seven right-brain-damaged patients affected by chronic neglect were evaluated before, after two weeks of the PA treatment and at a follow-up (variable between 8 and 30 months after the end of PA). Neglect evaluation was performed by means of BIT (conventional and behavioral), Fluff Test, and Comb and Razor Test. The results highlight an improvement, after the PA training, in both tasks performed using the hand trained in PA treatment and in behavioral tasks not requiring a manual motor response. Such effects extend, even if not significantly, to all BIT subtests. These results support previous findings, showing that PA improves neglect also on imagery tasks with no manual component, and provide further evidence for long-lasting efficacy of PA training. Dissociations have been found with regard to PA efficacy on peripersonal, personal, and representational neglect, visuospatial agraphia and neglect dyslexia. In particular, we found no significant differences between the pre-training and post-training PA session in personal neglect measures, and a poor recovery of neglect dyslexia after PA treatment. The recruitment of a larger sample could help to confirm the effectiveness of the prismatic lenses with regard to the different clinical manifestations of spatial neglect.

  9. 肝豆状核变性患者中文书写时皮质下结构的功能影像研究%The role of the basal ganglia in processing of Chinese writing: evidence from a PET study in Wilson's disease

    Institute of Scientific and Technical Information of China (English)

    陈东; 刘晓加; 吴湖炳; 梁秀龄; 李洵桦

    2009-01-01

    ObjectiveTo investigate the role of basal ganglia in processing of Chinese writing by Wilson' disease(WD). Methods7 WD patients were divided into two groups which were normal writing group and dysgraphia group. They were scanned by 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography respectively while performing two tasks: 1) pseudo-writing,2) Chinese character writing. Data were analyzed with Statistical Parametric Mapping. ResultsCompared with pseudo-writing,patients in normal writing group showed greater activation of bilateral lateral globus pallidus and right putamen,whereas patients in dysgraphia group showed greater activation of right ventral lateral nucleus,claustrum,left putamen and lateral globus pallidus(P<0.01). Conclusions1) The results indicate that Chinese writing of WD patients involves in bilateral subcortical structure. Right basal ganglia plays more important role. 2) Activated areas in bilateral basal ganglia of WD patients with agraphia are different with WD patients with normal writing and right thalamus play a compensatory role when WD patients with agraphia are writing.%目的 通过观察脑型肝豆状核变性患者中文字词书写的皮质下结构激活特点,为基底神经节在书写中的作用机制提供实验数据.方法 将7例脑型肝豆状核变性患者分成正常书写组和书写障碍组,分别进行假写作业、中文字词书写作业的18氟脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)脑功能成像,用统计参数图软件(SPM2)得出基底神经节变化区域.结果 正常书写组的皮质下结构激活区包括双侧苍白球和右侧壳核,书写障碍组包括右侧丘脑腹外侧核、屏状核和左侧壳核、苍白球,均差异有显著性(P<0.01).结论 1)脑型肝豆状核变性患者的中文书写涉及双侧基底神经节,右侧基底神经节可能发挥更重要的作用.2)伴有书写障碍的肝豆状核变性患者双侧基底神经节激活点与正常书写的患

  10. [Professor Hans Otto Lüders].

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    Tsuji, Sadatoshi

    2014-11-01

    Professor Lüders has made significant contributions to Clinical Neurology and particularly to Epilepsy and Clinical Neurophysiology. Some of his most important contributions include the following: 1.He pioneered the use of chronically implanted, large plates of subdural electrodes in the presurgical evaluation of patient who were candidates for epilepsy surgery. These electrodes were used to record epileptic seizures and by electrical stimulation to establish the location of eloquent cortex. Lately he has also advocated the use in the USA of stereotactically implanted depth electrodes for presurgical evaluation of epilepsy patients who had deep seated epileptic foci which were impossible to assess with subdural electrodes. These techniques were imported from Europe. 2.Mapping studies with subdural electrodes led to the discovery of a number of cortical eloquent areas that had not been described before: a. The basal temporal language area located in the dominant fusiform gyrus. b. The "negative motor areas" located in the caudal region of the inferior frontal gyrus (bilaterally) and immediately in mesial frontal pre-SMA region (also bilaterally). He concluded that these "negative motor areas" most likely correspond to praxis regions. c. The dominant posterior fusiform gyrus which plays a crucial role in processing reading material. Stimulation of that area produces "alexia without agraphia". 3.He developed a new classification of epileptic seizures based exclusively on semiological ictal characteristics. With the development of the semiological seizure classification he also defined several new seizure types: a. Dialeptic seizures, b. Hypnopompic seizures, c. Hypomotor seizures. 4.Working with general epilepsy principles, he established the existence of 6 zones that characterize the epilepsies: the epileptogenic zone, the irritative zone, the seizure onset zone, the epileptogenic lesion, the symptomatogenic zone and functional deficit zone. 5.He described the ictal

  11. 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

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    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.

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

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    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

  13. [Writing Kanji without semantics in a case with probable Alzheimer's disease].

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    Hayashi, Atsuko; Suzuki, Kyoko; Ohigashi, Yoshitaka; Takatsuki, Yoko; Nakano, Yoko; Yamadori, Atsushi; Mori, Etsuro

    2002-06-01

    We examined a patient (NM) with probable Alzheimer's disease who showed phonologically plausible errors in kanji (logogram) writing. In semantic tasks, she showed no deficits in pointing or naming but had difficulty in more complex tasks such as proverb comprehension. In reading aloud of kanji words, she could read most kanji words correctly and showed little phonologically plausible reading errors. She performed poorly in lexical decision and on-reading of one-letter kanji (Sino-Japanese pronunciation derived from the Chinese language at the time of borrowing). Writing to dictation demonstrated no mistakes in kana letters and words, but many errors in kanji, which were phonologically equivalent but semantically inappropriate. To explore the relationship between the writing errors in kanji words and comprehension of the word meanings, we selected 33 words that she made phonologically plausible writing errors. We gave her the following five tasks using these words; 1) to ask meanings of the words, 2) to dictate the words, 3) to dictate sentences including these words, 4) to discriminate appropriate target words from distracters including her own erroneous responses, and 5) to write these words again. She showed no consistent errors in these tasks. In some occasions, she could write correct kanji words without understanding word meanings. She also showed phonologically plausible writing errors in spite of describing correct word meanings. In Japanese, word meaning deficits like Gogi aphasia were thought to cause phonologically plausible writing errors. As the impairments of word meanings in NM are comparatively mild, the underpinning of her kanji agraphias might be different from that of phonologically plausible errors in Gogi aphasia. It would be suggested that she frequently wrote phonologically equivalent errors because of her lexical deficits in spite that her phonological processing was preserved. Furthermore, she would not necessarily use the semantics (word

  14. [Associative visual agnosia. The less visible consequences of a cerebral infarction].

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    Diesfeldt, H F A

    2011-02-01

    After a cerebral infarction, some patients acutely demonstrate contralateral hemiplegia, or aphasia. Those are the obvious symptoms of a cerebral infarction. However, less visible but burdensome consequences may go unnoticed without closer investigation. The importance of a thorough clinical examination is exemplified by a single case study of a 72-year-old, right-handed male. Two years before he had suffered from an ischemic stroke in the territory of the left posterior cerebral artery, with right homonymous hemianopia and global alexia (i.e., impairment in letter recognition and profound impairment of reading) without agraphia. Naming was impaired on visual presentation (20%-39% correct), but improved significantly after tactile presentation (87% correct) or verbal definition (89%). Pre-semantic visual processing was normal (correct matching of different views of the same object), as was his access to structural knowledge from vision (he reliably distinguished real objects from non-objects). On a colour decision task he reliably indicated which of two items was coloured correctly. Though he was unable to mime how visually presented objects were used, he more reliably matched pictures of objects with pictures of a mime artist gesturing the use of the object. He obtained normal scores on word definition (WAIS-III), synonym judgment and word-picture matching tasks with perceptual and semantic distractors. He however failed when he had to match physically dissimilar specimens of the same object or when he had to decide which two of five objects were related associatively (Pyramids and Palm Trees Test). The patient thus showed a striking contrast in his intact ability to access knowledge of object shape or colour from vision and impaired functional and associative knowledge. As a result, he could not access a complete semantic representation, required for activating phonological representations to name visually presented objects. The pattern of impairments and

  15. Study of clinical and neuropsychology of Gerstmann syndrome%Gerstmann综合征临床与神经心理学研究

    Institute of Scientific and Technical Information of China (English)

    曹辉; 李华

    2011-01-01

    目的:研究Gerstmann综合征(GS)的临床与神经心理学特点.方法:采用汉语失语症成套测评(ABC)、书写及视空间检查,对259例经CT或MRI检查确诊为脑卒中或脑损伤的患者进行评价.结果:(1)259例患者中有19例患有Gerstmann综合征(GS),其中9例有GS四主征、10例有GS的核心症状、命名性失语(AA)5例、经皮质运动性失语(TCM)2例、经皮质感觉性失语(TCS)4例、Wernicke失语3例、构音障碍2例、无失语5例;(2)病变部位:左顶枕、左侧颞顶、左侧颞顶枕、左侧额顶枕和左侧基底节共17例,右侧基底节、顶叶损害2例.结论:(1)Gerstmann综合征不是一个独立的综合征;(2)其病变部位不仅仅限于优势半球顶叶.%Objective To study clinical and neuropsychology features of patients with Gerstmann syndrome (GS). Methods 259 patients with stroke diagnosed by CT or MRI were detected by the Aphasia Battery of Chinese( ABC) .Writing Test and the Visual Space Test. Results (1)19 patients of the 259 cases had Gerstmann syndrome(GS) ,and 9 patients of the 19 cases had agraphia, acalculia, the tetrad of GS-finger agnosia and left-right disorientation, and 10 cases of GS with core symptoms. 5 cases showed anomic aphasia ( AA) , 2 showed transcortical motor aphasia ( TCM ) , 4 showed transcortical sensory aphasia (TCS) ,3 with Wemicke aphasia ( WA) ,2 with dysarthria, and no aphasia was in 5 Cases. (2)The lesion site was as follows: 17 cases localized to left parietal occipital lesion,left temporoparietal,left temporoparietal occipital,left occipital and left basal ganglia;2 cases localized to right basal ganglia,parietal lobe damage. Conclusion Gerstmann syndrome is not a single disorder;The site of cerebral impairment can be seen not only in dominant lobus pari-etalis.

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

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    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

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

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    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