Neural Substrates of Improvement Following Treatment in a Case of Phonological Agraphia/Alexia

Tesla DeMarco, Andrew and Rising, Kindle and Rapcsak, Steve Z. and Wilson, Stephen M. and Pélagie, Beeson M. (2013) Neural Substrates of Improvement Following Treatment in a Case of Phonological Agraphia/Alexia. [Clinical Aphasiology Paper]

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Abstract

Damage to left perisylvian regions often results in phonological alexia/agraphia syndromes, which are characterized by disproportionate difficulty reading or spelling novel sequences of phonemes or graphemes (pseudowords) compared to real words. A relatively small literature has documented that a sequence of behavioral treatments directed toward phonological skills and phonology-orthography relations can improve reading and spelling performance on pseudowords, with additional functional benefits for written language skills overall (e.g. Beeson et al., 2010). However, the neural substrates supporting these improvements remain to be elucidated. Because phonological processing is a strongly left-lateralized skill in most literate adults, we hypothesized that neural support for improvement is likely to remain in the left hemisphere. To examine this hypothesis, we conducted pre and post treatment fMRI with an individual with acquired phonological alexia/agraphia due to left hemisphere stroke before and after administration of treatment sequence to improve phonological skills.

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