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Alexia
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Alexia is defined as a condition where a person loses the ability to read due to brain damage, and the word literally means “without reading.” The word alexia may remind you of a similar word: dyslexia, which means “impaired reading.” Technically, the term “acquired dyslexia” is also sometimes used to refer to cases of brain damage that result in reading difficulties, and there is an overlap (Coslett, 2003). For simplicity's sake, this chapter always uses the word alexia. The name of the disorder will become complicated enough once we consider the different subtypes.
Cortical Visual Loss
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
This is a reduction in reading proficiency that cannot be attributed to more elementary visual, ocular motor, attentional or language problems. Writing is said to be spared, but patients with pure alexia may show difficulty writing words with irregular spelling (e.g., colonel, isle), which cannot be written from their sound alone using spelling rules, and require access to an internal dictionary (268, 269). The severity of their alexia can range from an inability to read even single letters, a “global alexia” (270) that may also affect the ability to read numbers and other abstract symbols such as numbers (271), musical notation and map symbols (272, 273), to a milder version in which reading is slow and contains errors, “spelling dyslexia” or “letter-by-letter reading” (267). A key diagnostic feature is an increased word-length effect: the more letters in the word, the longer it takes for the patient to read it (274, 275). The number of letters in a word is a perceptual variable, in that it indexes the amount of perceptual work involved, as opposed to linguistic characteristics such as the frequency of a word in a language or the part of speech. While the word length effect in normal readers is only about 10–20 msec per letter, in alexic subjects it can range from a few hundred msec to a few seconds per letter (276).
Rehabilitation and management of visual dysfunction following traumatic brain injury
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
An important part of text recognition is the decoding of visual percepts into language. Interruption of visual pathways at the left angular gyrus172 or splenium173 prevent this decoding process from occurring, resulting in acquired alexia or inability to read. Most case reports of this dysfunction show some residual reading function. Treatment of alexia using integration strategies and based on the patient’s residual reading skills has been successful. Often, a letter-by-letter reading strategy can be employed by these patients, although it severely slows reading. Motor rehearsal, in terms of copying or tracing letters and words, as well as flash card techniques pairing the written with the spoken word have been applied with some success.
Stroke self-efficacy questionnaire – Denmark (SSEQ-DK): test–retest of the Danish version
Published in Topics in Stroke Rehabilitation, 2023
Sedsel Kristine Stage Pedersen, Hanne Pallesen
Although serious attempts were made to include people with stroke regardless of the degree of the severity of their stroke and the effect it had on their ADL and participation, some participants found it difficult to understand the written instructions or needed assistance to answer them and were therefore excluded. This may have reduced the generalizability of the present findings which may not apply to stroke individuals with alexia or severe cognitive impairment. However, such individuals could constitute an especially vulnerable group for whom rehabilitation is particularly important. As nobody declined the invitation to participate, an inherent selection bias may exist as we may have included participants who were motivated to participate because they had a friendly relationship to the clinicians in charge of the rehabilitation and/or felt grateful for the rehabilitation they received. We chose to recruit both in- and outpatients for convenience. However, the stroke duration made the two groups quite different in terms of spontaneous recovery. Furthermore, the small sample sizes in both groups decreased the power of the non-pooled estimates why these findings should be interpreted with caution.
Diagnosing and managing post-stroke aphasia
Published in Expert Review of Neurotherapeutics, 2021
Shannon M. Sheppard, Rajani Sebastian
In addition to broad language comprehension and production deficits, stroke can also cause reading and writing deficits. Alexia refers to reading deficits and agraphia refers to writing deficits. In cases of pure alexia, patients demonstrate reading impairments in the absence of any other deficits [34,35]. Pure alexia is associated with simultaneous damage to 1) left occipital cortex, which causes right homonymous hemianopsia where visual information is initially processed in the right occipital cortex, and 2) splenium of the corpus callosum, which then prevents visual information in the right hemisphere from crossing over to the left hemisphere, where language is processed [36]. Pure agraphia refers to cases where writing impairments are present in the absence of other difficulties [35]. Spelling deficits are associated with damage to left inferior parietal cortex and left occipitotemporal cortex [37].
Attention Process Training-3 to improve reading comprehension in mild aphasia: A single-case experimental design study
Published in Neuropsychological Rehabilitation, 2020
Jaime B. Lee, McKay Moore Sohlberg, Beth Harn, Robert Horner, Leora R. Cherney
An alternative approach to treating alexia is to directly address the cognitive deficits that underlie the reading process. Direct attention training (DAT) has been administered as an aphasia intervention in a handful of studies (e.g., Coelho, 2005; Helm-Estabrooks, Connor, & Albert, 2000; Murray, Keeton, & Karcher, 2006). DAT is based on the notion that attentional abilities can be improved by activating and stimulating the impaired attention system through repetitive drills, which promotes recovery of damaged neural circuits and improves attentional processing (Sohlberg & Mateer, 2001). While labelled “attention training,” intervention programmes that have been evaluated in the neurogenic literature target a broad range of attention, working memory and executive control processes (Butler et al., 2008; Duval, Coyette, & Seron, 2008; Sohlberg, 2000). Preliminary evidence indicates that DAT can improve attentional processing in individuals with aphasia (Barker-Collo et al., 2009; Sturm & Willmes, 1991; Sturm, Willmes, Orgass, & Hartje, 1997).