Intact reading in patients with profound early visual dysfunction.

Despite substantial neuroscientific evidence for a region of visual cortex dedicated to the processing of written words, many studies continue to reject explanations of letter-by-letter (LBL) reading in terms of impaired word form representations or parallel letter processing in favour of more gener...

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Published in:Cortex: A Journal Devoted to the Study of the Nervous System & Behavior Vol. 49; no. 9; pp. 2294 - 2307
Main Authors: Yong, Keir X X, Warren, Jason D, Warrington, Elizabeth K, Crutch, Sebastian J
Format: research Journal Article
Published: Masson SPA 2013 Oct
Online Access:View this record in EBSCOhost
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      dt: 2013 Oct
      vid: 49
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      pub: Masson SPA
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        10.1016/j.cortex.2013.01.009
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        atl: Intact reading in patients with profound early visual dysfunction.
      aug:
        au:
          Yong, Keir X X
          Warren, Jason D
          Warrington, Elizabeth K
          Crutch, Sebastian J
        affil: Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, University College London, UK. Electronic address: yong@drc.ion.ucl.ac.uk.
      sug:
        subj:
          Visual Perception Physiology
          Reading
          Occipital Lobe Physiopathology
          Aged
          Aged, 80 and Over
          Atrophy Pathology
          Dyslexia Physiopathology
          Female
          Human
          Middle Age
          Neuropsychological Tests
          Reaction Time Physiology
          Occipital Lobe Physiology
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
      ab: Despite substantial neuroscientific evidence for a region of visual cortex dedicated to the processing of written words, many studies continue to reject explanations of letter-by-letter (LBL) reading in terms of impaired word form representations or parallel letter processing in favour of more general deficits of visual function. In the current paper, we demonstrate that whilst LBL reading is often associated with general visual deficits, these deficits are not necessarily sufficient to cause reading impairment and have led to accounts of LBL reading which are based largely on evidence of association rather than causation. We describe two patients with posterior cortical atrophy (PCA) who exhibit remarkably preserved whole word and letter reading despite profound visual dysfunction. Relative to controls, both patients demonstrated impaired performance on tests of early visual, visuoperceptual and visuospatial processing; visual acuity was the only skill preserved in both individuals. By contrast, both patients were able to read aloud words with perfect to near-perfect accuracy. Reading performance was also rapid with no overall significant difference in response latencies relative to age- and education-matched controls. Furthermore, the patients violated a key prediction of general visual accounts of LBL reading - that pre-lexical impairments should result in prominent word length effects; in the two reported patients, evidence for abnormal word length effects was equivocal or absent, and certainly an order of magnitude different to that reported for LBL readers. We argue that general visual accounts cannot explain the pattern of reading data reported, and attribute the preserved reading performance to preserved direct access to intact word form representations and/or parallel letter processing mechanisms. The current data emphasise the need for much clearer evidence of causality when attempting to draw connections between specific aspects of visual processing and different types of acquired peripheral dyslexia.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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