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Writing from dictation in adults with focal brain lesions: Implications for the neural models of writing

Poster E6 in Poster Session E, Saturday, October 8, 3:15 - 5:00 pm EDT, Millennium Hall

Venugopal Balasuramanian¹, Akshita Garg, Tarunya Mayilvahanan, Jayashree Balaraman; ¹Seton Hall University, ²Middlesex county Academy of Allied Health and Biomedical Sciences, ³Rensselaer Polytechnic Institute

Linguistic-motor models of writing are rooted in lesion studies (Chen et al, 2019., Margolin, 1984., Roeltgen 1995, Roeltgen & Hellman, 1984, 1985) and more recently, in stimulation studies (Roux et al, 2013). Recent brain stimulation studies (Roux et al, 2013)have claimed that the neural underpinnings of writing from dictation is the left temporoparietal cortex, whereas the lesion-based models have recognized a wide-spread neural network including the left and right hemispheres (Davous & Boller, 1994., Ardila & Roselli, 1993., Rothi et al, 1987., Ogden, 1996., Weekes, 1995), subcortical structures ( Poncet, Habib, & Robillard, 1987), and the right cerebellum ( Dunn et al, 2016 ). This situation warrants further studies to expand our understanding of the neural underpinnings of writing. The primary objective of this study is to present lesion data and characteristics of agraphia from aphasics to discuss the neural underpinnings of agraphia. Using a case-series analysis, the current study presents lesion data from six adults (f = 5, m = 1) with aphasia and central agraphia. All six aphasics (JL, PP, CBH, LK, SE, and SA) were native speaker of English, except one (SA). Subjects were tested on Boston Diagnostic Aphasia Examination. In addition, two experimental tests were also administered: PALPA and JHUDB. The task was to write words on dictation. Results. Lesion analyses: SA a 48-year-old female with a history multiple strokes and the resulting infarction of the left lateral temporal and precentral gyrus and encephalomalacia of bilateral corona radiata and basal ganglia. SA was diagnosed with Jargon aphasia. PP, a 65-year- old female with symptoms of mild conduction aphasia and stroke induced lesions showed left parietal including supramarginal gyrus and angular gyrus and mesial posterior temporal lobe. JL, a 66-year-old white female with the symptoms of conduction aphasia had left parietal lobe lesion including supramarginal and angular gyrus and posterior temporal lobe. CBH, a 59-year-old, right-handed female with anomic fluent aphasia had a medical history of bilateral parietal lobe lesion. LK, a 45-year-old male, with stroke-induced infarcts involving the left temporal region extending up to a portion of the left frontal lobe and left basal ganglia. SE, a 69-year-old right-handed female had lesions in right frontal lobe under the anterior horn of the lateral ventricle and the head of caudate and putamen due to hemorrhagic cerebrovascular accident. The left hemisphere was spared. Dysgraphia Profiles: Both LK and CBH had features of Phonological/surface dysgraphia. SA’s writing was characterized by jargon agraphia. SE’s writing had features of phonological agraphia. PP had buffer dysgraphia whereas JL’s writing performance was indicative of impaired lexical-semantic and POC mechanisms. The limited data reported in the current study warrants further research. The left temporo-parietal lobe function underpinning writing to dictation finds some support. However, right hemisphere lesion in SE does not offer support to this position. Recent research supports the view of widely distributed network supporting writing from dictation (Chen et al, 2019). Another factor that could explain the wide-spread lesion sites associated with central agraphia is the gradient nature of laterality for writing.

Topic Areas: Writing and Spelling, Disorders: Acquired