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Multiple Lesion Sites Associated with Alexia and Agraphia in Speakers of English and Arabic: A Cross-Cultural Study

Poster B5 in Poster Session B, Friday, October 25, 10:00 - 11:30 am, Great Hall 4

Venu, Balasuramanian1, Maha, Aldera2, Morgan, Okula1, Jordan, D'Angelo1; 1Seton Hall University, Nutley, 2Princess Nourah University, Riyad, Saudi Arabia

Introduction. The study of alexia with agraphia (AWA,), in its pure form or in association with aphasia, might offer insights into the neural underpinnings of the interface between reading and writing, as originally suggested by Joseph-Jules DeJerine in 1890. A recent systematic scoping review disclosed several lesion sites (Levy et al, 2023., Kim et al, 2015., Kirschner & Webb, 1982., Purcell et al, 2014) and the symptom complex associated with AWA in speakers of English language (Balasubramanian et al, 2023). An important question to be asked, in this context, is this: Does AWA syndrome look the same across languages/scripts? This issue has implications for both cognitive and neural models of the interface between reading and writing. Hence, a cross-cultural perspective is taken in the current study. The relevance of cross-cultural studies is exemplified in several studies of the past (Bates, et al, 2001; Boerner et al, 2023; Bolger, Perfetti, Schneider, 2005; Chen et al, 2009; Menn, Niemi,] & Ahlsen, 1996; Valaki, et al, 2003). The Problem: What are the lesion sites associated with AWA syndromes in speakers of English and Arabic? What are the distinctive characteristics of AWA syndromes in speakers of English and Arabic? Method: Case-series analyses (Schwartz & Dell, 2010) of AWA syndrome in six Arabic (M:4, F:2) and six English aphasic subjects (M: 2, F: 4) were undertaken. Demographic details of all subjects were gathered. Materials: Experimental tests were chosen from PALPA (Kay, Lesser, & Coltheart, 1992) and Arabic adaptation of these tests were used to identify the central alexia and agraphia. Only lexical level oral reading and writing (to dictation) was targeted. Aphasia diagnosis was completed for all subjects. Results: Multiple lesion sites associated with AWA were seen in both Arabic and English cases, as attested by MRI/CT scan images. AWA syndromes in both linguistic groups were either concordant or discordant types. Conclusions. The results of the current cross-cultural study have yielded similar results in both linguistic groups, despite a few differences in the respective scripts. Both scripts/writing systems are alphabetic in nature. In a cross-cultural study, it seems that writing systems that differ markedly might yield different answers to the research questions. There is a need for more cross-linguistic studies. With regards to the lesion sites associated with AWA syndrome, we need to recognize that recent lesion studies and voxel-based lesion analyses (Baldo, 2018; Kim et al, 2015; Purcell et al, 2015) as well as functional imaging studies of neurologically typical cases (Wilson et al, 2019) point to several different neural structures where reading and writing might converge. These findings reinforce the results of a scoping review of AWA reported earlier (Balasubramanian et al, 2023) Thus, the issue of the neural bases of the convergence of oral reading and writing warrants further investigation. Application of newer approaches to network localization, such as the one proposed by Boes and colleagues (2015), must be considered for further research on the neural underpinnings of AWA.

Topic Areas: Reading, Writing and Spelling

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