Subcortical aphasia with deep dyslexia: A case study of a Japanese patient

The reading performance of a Japanese Broca-type aphasic patient on a single-word reading test was investigated. The result indicated that the subject fits the symptom complex of deep dyslexia in more than one aspect. Unique characteristics of this subject included (1) the isolated subcortical site of the lesion, which apparently produced deep dyslexia, and (2) double dissociations between kanji and kana processing and between oral reading and reading comprehension. The performance of this subject was compared with that of another Japanese deep dyslexic subject in S. Sasanuma (1980, In M. Coltheart, K. Patterson, & J. C. Marshall (Eds.), Deep dyslexia, London: Routledge & Kegan Paul). A theoretical implication was attempted based on a dual coding process scheme by S. Sasanuma and O. Fujimura (1978, Cortex, 7, 1-18).     

Developmental and acquired dyslexia: A comparison

Jorm (1979a) has drawn attention to similarities between developmental dyslexia and acquired deep dyslexia, an analogy which has been criticized by A. W. Ellis (1979). A series of three experiments compared the two syndromes, using the techniques applied by Patterson and Marcel (1977) to adult deep dyslexics, to study a group of 15 boys suffering from developmental dyslexia. Patterson and Marcel's patients were able to perform a lexical decision task but showed no evidence of phonemic encoding of nonwords; our dyslexic children performed this task very slowly and with reduced accuracy but showed clear evidence of phonemic coding of the nonword items. Patterson and Marcel observed that their patients could not read out orthographically regular nonwords; our dyslexic children were able to do this task, although more slowly and somewhat less accurately than their chronological age or reading age controls. Finally, Patterson and Marcel observed that highly imageable words were more likely to be read correctly than words of equal frequency but low imageability; we observed a similar effect in both our dyslexic group and in their reading age controls. This implies that the imageability effect may not be peculiar to dyslexics but may be characteristic of normal reading under certain conditions. It is concluded that developmental dyslexics differ from the patients studied by Patterson and Marcel in demonstrating a pattern of reading which, though slow, is qualitatively similar to the reading of normal readers of a younger age. As such, our results do not support Jorm's position.     

Acquired dyslexia in Spanish: a review and some observations on a new case of deep dyslexia

Readers and writers of Spanish use an orthography that is highly transparent. It has been proposed that readers of Spanish can rely on grapheme-phoneme correspondences, alone, to access meaning or phonology from print. In recent years, a number of case studies have yielded evidence inconsistent with this idea. We review these studies with particular focus on those that report evidence for reading based on direct lexical mappings between print, orthographic representations, and meaning or phonology. We report a new case of acquired literacy impairment in Spanish, MJ, who presents a pattern of preserved abilities and deficits symptomatic of deep dyslexia. The patient is unable to read nonwords, but can read a substantial number of words. Her reading is characterized by the production of semantic, visual, and derivational errors. We argue that MJ has a deficit in her lexical selection ability, common to both her reading and her naming problems. We propose that MJ, and the other cases we review, demonstrate that lexical reading is adopted by skilled readers even in a transparent language.     

Right-hemisphere reading in a case of developmental deep dyslexia

The right-hemisphere hypothesis of deep dyslexia has received support from functional imaging studies of acquired deep dyslexia following damage to the left cerebral hemisphere, but no imaging studies of cases of developmental deep dyslexia, in which brain damage is not suspected, have been reported. In this paper, we report the first evidence of right hyperactivation in an adult case of developmental deep dyslexia. Hyperactivation was observed in the right inferior frontal cortex during functional magnetic resonance imaging (fMRI) of the oral reading of imageable content words and nonwords to which imageable lexical responses were frequently made. No evidence of right hyperactivation was observed in the oral reading of function words, nor during the naming of imageable words in response to pictured objects. The results reveal strategic and selective use of right-hemisphere functions for particular types of written stimuli. We propose that children with developmental deep dyslexia compensate for their lack of phonological skills by accessing right-hemisphere imageable associations that provide a mnemonic for linking written forms to spoken names.     

Right-hemisphere reading in a case of developmental deep dyslexia

The right-hemisphere hypothesis of deep dyslexia has received support from functional imaging studies of acquired deep dyslexia following damage to the left cerebral hemisphere, but no imaging studies of cases of developmental deep dyslexia, in which brain damage is not suspected, have been reported. In this paper, we report the first evidence of right hyperactivation in an adult case of developmental deep dyslexia. Hyperactivation was observed in the right inferior frontal cortex during functional magnetic resonance imaging (fMRI) of the oral reading of imageable content words and nonwords to which imageable lexical responses were frequently made. No evidence of right hyperactivation was observed in the oral reading of function words, nor during the naming of imageable words in response to pictured objects. The results reveal strategic and selective use of right-hemisphere functions for particular types of written stimuli. We propose that children with developmental deep dyslexia compensate for their lack of phonological skills by accessing right-hemisphere imageable associations that provide a mnemonic for linking written forms to spoken names.     

The analysis of morphological errors in a case of acquired dyslexia

An issue that is persistently raised in studies of subjects who produce morphological errors in reading and other tasks is whether these errors are the consequence of a morphological processing deficit, or whether they in any way reflect morphological principles of organization in the lexicon. We discuss the performance of one such subject on a number of tasks and evaluate standard arguments for attributing aspects of his performance to a morphological processing deficit. Although there are several features of his performance that are suggestive in this regard; we argue that, when these issues are addressed in the context of a sufficiently elaborated theory of lexical processing, a morphological processing deficit cannot be demonstrated. We also survey a number of recent reports that purport to provide evidence for a morphological processing deficit and argue that, in most cases, they fail to support such claims for similar reasons. An important moral to be drawn from a critique of these studies is that in order to make valid inferences concerning the role of morphology in organizing the lexicon, we must consider these errors in the context of theories of the lexicon that take seriously the effects of converging lexical factors in processing.     

An analysis of writing in a case of deep dyslexia

In tests of her ability to produce written and spoken language, this deep dyslexic patient produced semantic, visual, and derivational errors, including functor substitutions, and exhibited part-of-speech and abstractness effects in oral reading, oral and written naming, and writing to dictation, but not in repetition of single words and copying from memory. This patient therefore provides confirmation of the hypothesis presented in Nolan and Caramazza (1982) that the defining symptoms of deep dyslexia will be observed in responses to any task which requires lexical mediation. The patient's written responses in all tasks but direct copying were characterized by spelling errors which included transpositions, omissions, substitutions, and additions of letters. A model of writing is proposed which explains these errors in terms of a disruption of a phoneme-grapheme conversion process which normally functions to prevent decay of information from a Graphemic Buffer.     

Lesioning an attractor network: investigations of acquired dyslexia

A recurrent connectionist network was trained to output semantic feature vectors when presented with letter strings. When damaged, the network exhibited characteristics that resembled several of the phenomena found in deep dyslexia and semantic-access dyslexia. Damaged networks sometimes settled to the semantic vectors for semantically similar but visually dissimilar words. With severe damage, a forced-choice decision between categories was possible even when the choice of the particular semantic vector within the category was not possible. The damaged networks typically exhibited many mixed visual and semantic errors in which the output corresponded to a word that was both visually and semantically similar. Surprisingly, damage near the output sometimes caused pure visual errors. Indeed, the characteristic error pattern of deep dyslexia occurred with damage to virtually any part of the network.     

Simultaneous activation of reading mechanisms: evidence from a case of deep dyslexia

We report the performance of LC, a deep dyslexic. We investigated extensively her errors according to serial cognitive neuropsychological models of oral reading. Initial evaluation of her reading suggested impaired access to the phonological output lexicon (POL). Impaired grapheme-to-phoneme conversion (GPC) and semantic errors in reading suggested that LC read via an impoverished semantic route. However, a serial model of oral reading could not explain error differences in reading, picture naming, spontaneous speech, and repetition. Neologisms occurred in oral reading but not in spontaneous speech and repetition. Semantic errors in naming exceeded those in oral reading. To account for these different error patterns we propose that the semantic route, the direct route from the orthographic input lexicon to the POL, and GPC activate simultaneously during reading, converging at the POL to constrain phonological selection. These routes are modular but not functionally encapsulated. For LC, the POL receives ambiguous information due to degradation of all routes, causing reading errors.     

Right hemisphere contribution to lexical access in an aphasic with deep dyslexia

Three hemifield tachistoscopic studies of a right-handed patient with acquired Broca's aphasia and deep dyslexia, but with intact visual fields, are presented to support the hypothesis of right hemisphere (RH) participation in deep dyslexic reading. A systematic comparison of this deep dyslexic with the disconnected RHs of two patients with complete cerebral commissurotomy disclosed a similar, but not identical, pattern of abilities. The results demonstrate partial reliance on the RH for accessing the meaning of single words, but not for phonological encoding in this patient.     

Morphological errors in acquired dyslexia: A case of mistaken identity

Morphological errors in oral reading have been used to support theories of lexical access in which root morphemes and affixes are independently represented in the orthographic lexicon. No support for such theories was found in this study, which examined the morphological errors made by two patients with different patterns of acquired dyslexia. Instead, it was shown that the probability of making a morphological error depended upon the absolute levels of imageability and word frequency of the affixed word and the relative levels of its root morpheme. These properties also affected the oral reading of words without affixes. It was concluded that so-called “morphological” errors reflect the properties of the reading system which influence lexical orthographic access for both affixed and unaffixed words and further reflect the functional level of the lexical pathways available to the patient.     

Letter-by-letter acquired dyslexia is due to the serial encoding of letters

Letter-by-letter acquired dyslexia (pure alexia) is assumed to be related to the serial encoding of letters, but the evidence for this assumption is somewhat indirect. Here, we demonstrate that the deficit is indeed due to serial encoding by comparing the performance of a letter-by-letter dyslexic reader with the performance of normal readers who were forced to read letter by letter; the data patterns are remarkably similar.     

Stimulus-specific neglect in a deep dyslexic patient

We report a patient (B.V.) who appears to suffer from two dyslexic disorders. First, B.V. showed a severe impairment in reading aloud nonwords (e.g., reading TREST as TREE), in addition to making several semantic errors when reading aloud words (e.g., reading ILL as SICK) and in picture naming (e.g., responding KNIFE to a picture of a FORK). These results suggest that B.V. suffers from deep dyslexia. Second, B.V. showed an impairment in reading the final letters of both words and nonwords (e.g., reading SHOWN as SHORT and reading PROGE as PROOF). Thus, it appears that B.V. also suffers from neglect dyslexia. We discuss how these two forms of dyslexia could be interacting to account for B.V.'s pattern of errors in reading aloud words and nonwords and in picture naming.     

Acquired dyslexia in three writing systems: study of a Portuguese-Japanese bilingual aphasic patient

The Japanese language is represented by two different codes: syllabic and logographic while Portuguese employs an alphabetic writing system. Studies on bilingual Portuguese-Japanese individuals with acquired dyslexia therefore allow an investigation of the interaction between reading strategies and characteristics of three different writing codes. The aim of this study was to examine the differential impact of an acquired brain lesion on the reading of the logographic, syllabic and alphabetic writing systems of a bilingual Portuguese-Japanese aphasic patient (PF). Results showed impaired reading in the logographic system and when reading irregularly spelled Portuguese words but no effects on reading regular words and nonwords in syllabic and alphabetic writing systems. These dissociations are interpreted according to a multi-route cognitive model of reading assuming selective damage in the lexical route can result in acquired dyslexia across at least three different writing codes.     

Morphological units in the Arabic mental lexicon: evidence from an individual with deep dyslexia

An ongoing debate in Arabic morphology concerns the nature of the smallest unit governing lexical organization and representation in this language. A standard model maintains that Arabic words are typically analyzable into a three-consonantal root morpheme carrying the core meaning of words and a prosodic template responsible mostly for grammatical information. This view has been largely supported by research in both theoretical linguistics and psycholinguistics. An alternative theory holds that the meaning of words in Arabic is, rather, encoded in the 'etymon' comprising two unordered consonants of the root only. Results from a recent priming experiment have shown that the etymon induces strong morphological priming effects, supporting its morphological/lexical status. In this paper we present data from a patient with deep dyslexia questioning the role of the etymon as a psychologically real representational unit in Arabic and arguing, instead, for the central role of the root in both morphological and lexical representation in this language.     

Deep dysphasia: An analog of deep dyslexia in the auditory modality

A right-handed patient, with two left hemisphere lesions, a small one in the prefrontal lobe and a larger one in the temporal, presents an unusual syndrome: a massive deficit for oral language (expression and comprehension) contrasting with a fairly good preservation of written language (expression and comprehension). The processing of isolated words and sentences has been extensively tested with repetition and dictation tasks. The patient performs rather well with nouns, verbs, and adjectives, poorly with adverbs and function words, and completely fails with nonsense words. A remarkable feature of his repetition is the frequency of semantic paraphasias. Thus, this patient exhibits a behavior rather similar to deep dyslexia, hence the possible label "deep dysphasia." The paper presents a "preunderstanding" hypothesis to account for such behaviors.     

诊断中的异化与异化的诊断——1例误诊病例的反思

随着诊断技术的日新月异,极大地拓展了临床医师对疾病的认识,但同时也限制了医师的临床思维,形成诊断过程中的"异化"现象。本文以1例患者的误诊过程为例,说明诊断中的异化现象及其对诊断的影响。为减少误诊,医师必须回到"人"的位置,避免成为医疗技术的"奴隶"。     

Whole-word phonological representations of disyllabic words in the Chinese lexicon: data from acquired dyslexia

This study addresses the issue of the existence of whole-word phonological representations of disyllabic and multisyllabic words in the Chinese mental lexicon. A Cantonese brain-injured dyslexic individual with semantic deficits, YKM, was assessed on his abilities to read aloud and to comprehend disyllabic words containing homographic heterophonous characters, the pronunciation of which can only be disambiguated in word context. Superior performance on reading to comprehension was found. YKM could produce the target phonological forms without understanding the words. The dissociation is taken as evidence for whole-word representations for these words at the phonological level. The claim is consistent with previous account for discrepancy of the frequencies of tonal errors between reading aloud and object naming in Cantonese reported of another case study of similar deficits. Theoretical arguments for whole-word form representations for all multisyllabic Chinese words are also discussed.