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Handbook of Clinical Neurology 2021Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In...
Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In neuropsychology, a distinction is made between central alexia (commonly seen in aphasia) and peripheral alexia (a perceptual or attentional deficit). The prototypical peripheral alexia is alexia without agraphia (pure alexia), where patients can write but are impaired in reading words and letters. Pure alexia is associated with damage to the left ventral occipitotemporal cortex (vOT) or its connections. Hemianopic alexia is associated with less extensive occipital damage and is caused by a visual field defect, which creates problems reading longer words and passages of text. Reading impairment can also arise due to attentional deficits, most commonly following right hemisphere or bilateral lesions. Studying patients with alexia, along with functional imaging studies of normal readers, has improved our understanding of the neurobiological processes involved in reading. A key question is whether an area in the left ventral occipitotemporal cortex is specialized for or selectively involved in word processing, or whether reading relies on tuning of more general purpose perceptual areas. Reading deficits may also be observed in dementia and traumatic brain injury, but often with less consistent deficit patterns than in patients with focal lesions.
Topics: Cerebral Cortex; Dyslexia; Humans; Stroke
PubMed: 33832678
DOI: 10.1016/B978-0-12-821377-3.00010-6 -
Handbook of Clinical Neurology 2022This chapter gives a broad overview of the description and theorizing of a wide range of language disorders resulting from brain damage, commonly classified under the... (Review)
Review
This chapter gives a broad overview of the description and theorizing of a wide range of language disorders resulting from brain damage, commonly classified under the umbrella term "aphasia." It covers works written in Antiquity up to the 20th century. Moreover, it looks at disturbances in various language modalities such as speech, language comprehension, reading, writing, and sign language. In addition, also forms of the more recently discovered primary progressive aphasia are discussed. Finally, important developments in the history of assessment and rehabilitation of language disorders are described. To properly characterize disorders of language, these developments are discussed from the perspectives of neurology, psychology, and linguistics.
Topics: Agraphia; Aphasia; Humans; Language; Reading; Speech
PubMed: 35078608
DOI: 10.1016/B978-0-12-823384-9.00017-7 -
International Journal of Language &... Nov 2020Every language has certain specific idiosyncrasies in its writing system. Cross-linguistic analyses of alexias and agraphias are fundamental to understand commonalities...
BACKGROUND
Every language has certain specific idiosyncrasies in its writing system. Cross-linguistic analyses of alexias and agraphias are fundamental to understand commonalities and differences in the brain organization of written language. Few reports of alexias and agraphias in the Spanish language are currently available.
AIMS
To analyse the clinical manifestations of alexias and agraphias in Spanish, and the effect of demographic variables.
METHODS & PROCEDURES
Spanish versions of the Western Aphasia Battery (WAB) and Boston Diagnostic Aphasia Examination (BDAE) were used for language assessment. Lesion localization was obtained by using computed axial tomography and magnetic resonance imaging. The final sample included 200 patients: 195 (97.5%) right-handed and five (2.5%) left-handed; 119 men and 81 women with a mean age of 57.37 years (SD = 15.56), education of 13.52 years (SD = 4.08), and mean time post-onset of 6.58 months (SD = 12.94). Using the WAB, four quotients were calculated: aphasia quotient (AQ), reading-writing quotient (RWQ), language quotient (LQ) and cortical quotient (CQ).
OUTCOMES & RESULTS
The types of aphasia were: global = 11 patients (5.5%), Broca = 31 (15.5%), Wernicke = 30 (15.0%), conduction = 22 (11.0%), transcortical sensory = 17 (8.5%), transcortical motor = 3 (1.5%), amnesic or anomic = 54 (27.0%) and mixed non-fluent = 32 (16.0%). The degree of oral and written language impairment differed across the various aphasia types. Most severe reading and writing difficulties were found in global, mixed non-fluent and transcortical motor aphasia; fewer difficulties were observed in amnesic, Broca and conduction aphasia. The severity of the written language impairments paralleled the severity of the oral language disturbances. Age negatively, while schooling positively, correlated with the scores in reading and writing tests. No effect of sex and time since onset was found.
CONCLUSIONS & IMPLICATIONS
In Spanish-speaking aphasia patients, difficulties in reading and writing are similar to oral language difficulties. This similarity of performance is mostly based on severity rather than the participants' patterns of errors. What this paper adds What is already known on the subject There is limited information about alexia and agraphia in Spanish. What this paper adds to existing knowledge An extensive study with a large sample of patients. What are the potential or actual clinical implications of this work? The study contributes to the clinical management of patients with reading and writing disturbances.
Topics: Agraphia; Brain; Chile; Databases, Factual; Dyslexia, Acquired; Female; Humans; Language; Language Tests; Linguistics; Male; Middle Aged; Reading; Tomography, X-Ray Computed
PubMed: 32735061
DOI: 10.1111/1460-6984.12566 -
American Family Physician Nov 2019Academic underachievement, such as failing a class and the threat of being held back because of academic issues, is common. Family physicians can provide support and... (Review)
Review
Academic underachievement, such as failing a class and the threat of being held back because of academic issues, is common. Family physicians can provide support and guidance for families as they approach their child's unique academic challenges. Specific learning disabilities are a group of learning disorders (e.g., dyscalculia, dysgraphia, dyslexia) that impede a child's ability to learn. Understanding standard educational terms; looking for medical, family, and social risk factors associated with academic underachievement; and investigating the medical differential for academic underachievement can help direct the family to appropriate care. The physician can provide medical documentation to support an individualized education program evaluation and address risk factors that schools may not be aware of or cannot assess. The family physician can support children and families by understanding the connection between risk factors, medical and educational evaluations, and educational resources.
Topics: Child; Family Relations; Humans; Learning Disabilities; Physician's Role; Physicians, Family; Risk Factors; Schools
PubMed: 31730315
DOI: No ID Found -
Scientific Reports Dec 2020Dysgraphia, a disorder affecting the written expression of symbols and words, negatively impacts the academic results of pupils as well as their overall well-being. The...
Dysgraphia, a disorder affecting the written expression of symbols and words, negatively impacts the academic results of pupils as well as their overall well-being. The use of automated procedures can make dysgraphia testing available to larger populations, thereby facilitating early intervention for those who need it. In this paper, we employed a machine learning approach to identify handwriting deteriorated by dysgraphia. To achieve this goal, we collected a new handwriting dataset consisting of several handwriting tasks and extracted a broad range of features to capture different aspects of handwriting. These were fed to a machine learning algorithm to predict whether handwriting is affected by dysgraphia. We compared several machine learning algorithms and discovered that the best results were achieved by the adaptive boosting (AdaBoost) algorithm. The results show that machine learning can be used to detect dysgraphia with almost 80% accuracy, even when dealing with a heterogeneous set of subjects differing in age, sex and handedness.
Topics: Adolescent; Agraphia; Algorithms; Case-Control Studies; Child; Data Accuracy; Female; Handwriting; Humans; Machine Learning; Male
PubMed: 33299092
DOI: 10.1038/s41598-020-78611-9 -
Journal of Alzheimer's Disease : JAD 2021Agraphia is a typical feature in the clinical course of Alzheimer's disease (AD).
BACKGROUND
Agraphia is a typical feature in the clinical course of Alzheimer's disease (AD).
OBJECTIVE
Assess the differences between AD and normal aging as regards kinematographic features of handwriting and elucidate writing deficits in AD.
METHODS
The study included 23 patients with AD (78.09 years/SD = 7.12; MMSE 21.39/SD = 3.61) and 34 healthy controls (75.56 years/SD = 5.85; MMSE 29.06/SD = 0.78). Both groups performed alphabetical and non-alphabetical writing tasks. The kinematographic assessment included the average number of inversions per stroke (NIV; number of peaks in the velocity profile in a single up or down stroke), percentage of automated segments, frequency (average number of strokes per second), writing pressure, and writing velocity on paper.
RESULTS
A total of 14 patients showed overt writing difficulties reflected by omissions or substitutions of letters. AD patients showed less automated movements (as measured by NIV), lower writing velocity, and lower frequency of up-and-down strokes in non-alphabetical as well as in alphabetical writing. In the patient group, Spearman correlation analysis between overt writing performance and NIV was significant. That means patients who had less errors in writing a sentence showed a higher automaticity in handwriting. The correctness of alphabetical writing and some kinematographic measures in writing non-alphabetical material reached excellent diagnostic values in ROC analyses. There was no difference in the application of pressure on the pen between patients and controls.
CONCLUSION
Writing disorders are multi-componential in AD and not strictly limited to one processing level. The slow and poorly automated execution of motor programs is not bound to alphabetical material.
Topics: Aged; Agraphia; Alzheimer Disease; Automatism; Female; Handwriting; Humans; Language Tests; Male; Neuropsychological Tests; ROC Curve; Task Performance and Analysis
PubMed: 34057089
DOI: 10.3233/JAD-210279 -
PloS One 2020Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their...
Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their handwriting. This can bring anxiety and can negatively impact education. 280 children were recruited in schools and specialized clinics to perform the Concise Evaluation Scale for Children's Handwriting (BHK) on digital tablets. Within this dataset, we identified children with dysgraphia. Twelve digital features describing handwriting through different aspects (static, kinematic, pressure and tilt) were extracted and used to create linear models to investigate handwriting acquisition throughout education. K-means clustering was performed to define a new classification of dysgraphia. Linear models show that three features only (two kinematic and one static) showed a significant association to predict change of handwriting quality in control children. Most kinematic and statics features interacted with age. Results suggest that children with dysgraphia do not simply differ from ones without dysgraphia by quantitative differences on the BHK scale but present a different development in terms of static, kinematic, pressure and tilt features. The K-means clustering yielded 3 clusters (Ci). Children in C1 presented mild dysgraphia usually not detected in schools whereas children in C2 and C3 exhibited severe dysgraphia. Notably, C2 contained individuals displaying abnormalities in term of kinematics and pressure whilst C3 regrouped children showing mainly tilt problems. The current results open new opportunities for automatic detection of children with dysgraphia in classroom. We also believe that the training of pressure and tilt may open new therapeutic opportunities through serious games.
Topics: Agraphia; Biomechanical Phenomena; Child; Female; Handwriting; Humans; Male; Motor Skills
PubMed: 32915793
DOI: 10.1371/journal.pone.0237575 -
Children (Basel, Switzerland) Sep 2022Knowledge is limited about dysgraphia in adolescence and its association with daily motor-related daily performance and health-related quality of life (HRQOL). This...
Knowledge is limited about dysgraphia in adolescence and its association with daily motor-related daily performance and health-related quality of life (HRQOL). This study aimed to (1) compare and (2) examine correlations between handwriting measures, motor-related daily performance, and HRQOL of adolescents with and without dysgraphia and (3) examine the contribution of motor-related daily performance and handwriting measures to predict their physical HRQOL. There were eighty adolescents (13-18 yr): half with dysgraphia and half matched controls without dysgraphia per the Handwriting Proficiency Screening Questionnaire and Handwriting Legibility Scale participated. They copied a paragraph script onto a paper attached to the Computerized Penmanship Evaluation Tool digitizer and completed the World Health Organization Quality of Life Questionnaire-brief version and the Adult Developmental Coordination Disorder Checklist (ADC). We found significant between-group differences in motor-related daily performance, handwriting measures, and HRQOL and significant correlations between HRQOL and handwriting process measures and motor-coordination ability. Handwriting measures predicted 25%, and the ADC A and C subscales 45.6%, of the research group's physical QOL domain score variability. Notably, the control group's current perceptions of their motor-coordination performance (ADC-C) predicted 36.5% of the variance in physical QOL. Dysgraphia's negative effects during childhood and adolescence may reduce adolescents' HRQOL now and into adulthood.
PubMed: 36291371
DOI: 10.3390/children9101437 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022FTD is a group of neurodegenerative diseases with progressive deterioration of behavioral and speech disorders, morphologically associated with pathology of the frontal... (Review)
Review
FTD is a group of neurodegenerative diseases with progressive deterioration of behavioral and speech disorders, morphologically associated with pathology of the frontal or temporal lobes. International clinical trials have made it possible to define modern diagnostic criteria for various subtypes of clinically «possible/probable» FTD. Our article is devoted to one of the rare subtypes of frontotemporal dementia (FTD), corticobasal syndrome (CBD), in which we presented a review of current data with a demonstration of clinical observation. A clinical case of a patient with a patient with speech disorders and memory impairment is presented. A 60-year-old man at the time of the outpatient visit had been complaining of speech impairment for two years, a slight decrease in memory for current events. Neurological and neuropsychological studies revealed two leading clinical syndromes in the patient: «frontal» syndrome with impaired higher cortical functions in the form of efferent motor aphasia, impaired writing and reading with visual-spatial agnosia and dysgraphia, «frontal» signs (positive «palm-mouth «and» grasping «reflexes); «Corticobasal syndrome» with pronounced dynamic, optic-kinesthetic dyspraxia, dermolexia, apraxia of closing the eyes, «alien» hand syndrome with symptoms of levitation and intermanual conflict. MRI diagnostics revealed changes characteristic of neurodegeneration of the frontotemporal type (atrophy of the frontal and temporal lobes prevails). Taking into account complaints, anamnesis of the disease, identified clinical syndromes and structural changes according to MRI data, the patient was diagnosed with a clinically «probable» FTD. Determination and accurate diagnosis of FTD subtypes will help the neurologist in managing these patients with the appointment of the correct pharmacologic treatment. In FTD, in contrast to AD patients, the administration of cholinesterase inhibitors does not lead to a positive therapeutic effect a positive therapeutic effect and, therefore, is not advisable. The standards of patient therapy should include recommendations for antipsychotic therapy, the use of antidepressants (SSRIs) and anxiolytics with nootropic effects for the correction of affective and behavioral disorders.
Topics: Frontotemporal Dementia; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurodegenerative Diseases; Syndrome; Temporal Lobe
PubMed: 35271245
DOI: 10.17116/jnevro2022122021107