Acalculia, alexia, & agraphia

Question 1

Alexia with hemianopsia & achromotopsia suggests a lesion in the

Answer 1

Dominant occipital-temporal area

Question 1

Neuroanatomical correlate of phonological agraphia

Answer 1

Supramarginal gyrus or insula (assoc. w/ alexia) Perisylvian region (assoc. w/ aphasia)

Question 1

Exner’s area

Answer 1

Area just superior to Broca’s believed to be associated with agraphia

Question 2

What are the two general nosologies of agraphia?

Answer 2

Clinical neurology classification (aphasic & nonaphasic agraphias) Cognitive neuropsychological classification (phonological & lexical agraphia)

Question 3

Derivational error

Answer 3

Reading, writing, or speaking error at the single word level in which the correct morpheme root is retained but differs in part of speech (e.g., ‘confuse’ for ‘confusion’)

Question 4

Neuroanatomical correlate of alexia with agraphia

Answer 4

Dominant angular gyrus in the inferior parietal lobe

Question 4

Spatial agraphia

Answer 4

Writing impairment due to spatial deficits that affect nonlinguistic aspects of writing

Question 4

Attentional alexia

Answer 4

Characterized by relative preservation of single-word reading in context of gross disruption of reading when words are presented as text or in the presence of other words or letters

Question 5

Alexia without agraphia is associated with what other conditions?

Answer 5

R HH, color naming disturbance

Question 5

Visual-spatial agraphia (constructional agraphia) is characterized by

Answer 5

Reiteration of strokes Inability to complete a straight horizontal line Insertion of spaces between graphemes

Question 6

Surface alexia is associated with lesions in the

Answer 6

L temporal lobe

Question 8

Hans Berger’s primary acalculia

Answer 8

Disturbance in performing calculations specifically

Question 9

Allographic aphasia

Answer 9

Writing impairment associated with poor written production characterized by frequent omission errors w/ well-formed letter production (may reflect wrong letter); copying & oral spelling are spared

Question 10

Neuroanatomical correlate of surface/lexical agraphia

Answer 10

Posterior angular gyrus & parieto-occipital lobule (assoc. w/ aphasia)

Question 10

What other conditions are often associated with acalculia assoc. w/ alexia & agraphia for numbers?

Answer 10

Aphasia, verbal alexia, ideational & ideomotor apraxia, constructional deficits, somatognosia

Question 11

Literal alexia is associated with a lesion in the

Answer 11

left frontal area

Question 12

Phonological agraphia

Answer 12

Reflects impairment of sound-to-letter correspondences (nonlexical spelling route); markedly impaired spelling of nonwords & unfamiliar words but can spell words with which they are familiar

Question 12

Peripheral vs. central dyslexias (Shallice & Warrington)

Answer 12

Peripheral - characterized by deficit in processing of visual aspects of stimulus, which prevents pt from reliably matching familiar word to stored form (e.g. alexia without agraphia) Central - impairment to deeper or higher reading functions by which visual word forms mediate access to meaning or speech production mechanisms

Question 13

Semantic agraphia

Answer 13

Impaired ability to spell & write with meaning; may produce semantic jargon, spell semantically incorrect but correctly spelled dictated homophones; common finding in AD & semantic dementia

Question 14

Hecaen’s classifications (1961) of acalculia

Answer 14

1) Acalculia assoc. w/ alexia & agraphia for numbers 2) Acalculia of the spatial type 3) Anarithmetria

Question 16

Neuroanatomical correlate of anarithmetria

Answer 16

Left-sided & bilateral brain disease; RH only if parietal lobe is involved

Question 16

What other conditions are often associated with anarithmetria?

Answer 16

Aphasia, visuoconstructive deficits, general cognitive deterioration, verbal alexia, visual field defects

Question 17

Alexia without agraphia is also known as

Answer 17

Posterior alexia

Question 18

Hemi-alexia

Answer 18

Individual can read adequately in one visual field but not other; often seen when posterior CC is severed but both visual sensory areas remain intact

Question 20

Alexia for arithmetical signs with preserved reading of #s is associated with what type of lesion?

Answer 20

Focal LH lesion in parietal or temporal-occipital areas

Question 21

The origin of our current concept of alexia stems from case reports by \_\_\_\_\_\_\_

Answer 21

Dejerine

Question 23

Inability to read or write #s is associated with a lesion in the

Answer 23

L parietal lobe

Question 24

Ideational agraphia

Answer 24

Not apraxia agraphia because can hold pen, but difficulties with all the motor steps needed to write

Question 24

Brain abnormalities associated with reading disorders

Answer 24

Symmetrical planum temporale, cortical malformations in frontal & temporal areas, reduced insular & frontal lobe volumes

Question 25

Neuroanatomical correlate of alexia without agraphia

Answer 25

Dominant occipital lobe, involves white matter of posterior corpus callosum

Question 26

Alexia with agraphia is also known as

Answer 26

Central alexia

Question 27

Who coined the term 'akalkulia' in 1919?

Answer 27

Henschen

Question 28

Phonological agraphia is often associated with what other disorders?

Answer 28

Aphasia, phonological alexia

Question 29

What is the difference between alexia & dyslexia?

Answer 29

Alexia - acquired Dyslexia - congenital/early life

Question 30

Agraphia in isolation is assocaited with a lesion in

Answer 30

Dominant superior or inferior parietal lobe or second frontal gyrus

Question 32

Reiterative agraphia

Answer 32

Abnormal repetition of phrases, words, letters, etc. often seen with frontal lobe dementia

Question 33

Hans Berger's secondary acalculia

Answer 33

Problems with calculations due to more general disturbances in memory, language, attention, etc.

Question 33

Who was the first to publish a detailed report of a calculation disorder resulting from focal brain damage?

Answer 33

Stadelman (1908); the patient also had R HH

Question 35

Alexia with agraphia is often accompanied by

Answer 35

Fluent aphasia, Gerstmann's syndrome, hemisensory loss, R visual field defect

Question 37

Neuroanatomical correlate of acalculia of the spatial type

Answer 37

Post-Rolandic lesion of the RH

Question 39

Neuroanatomical correlate of deep agraphia

Answer 39

Supramarginal gyrus or insula, far extending

Question 40

Acalculia of the spatial type

Answer 40

Impaired spatial organization results in calculation problems due to misalignment of numbers, reversal of digits, inversions, & reversal errors

Question 41

McCloskey & Caramazza's subclassification of number processing skills

Answer 41

Lexical processing - ability to read or write individual numbers Syntactic processing - ability to combine numbers into correct form & quantity

Question 42

The origin of the concept of alexia is from case reports by

Answer 42

Dejerine (1890s)

Question 44

Paralexia

Answer 44

Substitutions made when reading aloud

Question 45

Phonological alexia (dyslexia)

Answer 45

An inability to make spelling-to-sound correspondence rules; results in visual paralexias - real words misread as visually similar words ('cat' for 'car'); better reading of high frequency words

Question 47

Literal alexia

Answer 47

AKA frontal or anterior alexia; can read whole words but not recognize individual letters; associated with severe agraphia, poor copy with omissions, agrammatism, poor spelling

Question 47

Dual-route model for spelling

Answer 47

Lexical: processes words holistically; cannot process unfamiliar or non-words Non-lexical: processes words on subword level, fragmenting them into phonological components; cannot correctly process irregular words

Question 48

Deep agraphia

Answer 48

Trouble spelling nonwords, more trouble spelling function words than nouns, semantic paragraphic errors ("flight" instead of "propeller")

Question 49

Alexia without agraphia (posterior alexia) is considered a disconnection syndrome because it disconnects ______ from \_\_\_\_\_\_\_

Answer 49

Visual info; language cortex

Question 50

Anarithmetria

Answer 50

Deficits in performing the calculation itself

Question 50

Mental graphia

Answer 50

Metaphorical term for the inability to put thoughts into written phrases

Question 52

Surface alexia (dyslexia)

Answer 52

Grapheme-to-phoneme conversion disorder; can't read words with irregular orthography (e.g., 'tough' read as 'tug')

Question 53

According to Neilson's model, what are the 3 forms of agraphia?

Answer 53

Aphasic, apretic (basically apraxic), isolated

Question 55

Deep alexia (dyslexia)

Answer 55

Reading errors based on semantic (real word) substitutions for target words (semantic paralexias); substituted word may be paralexia, totally incorrect, or neologism; syntactic (functional) words are almost totally omitted

Question 56

Optic agraphia

Answer 56

Inability to copy written or printed words while being capable of writing from dictation; associated with lesions in the posterior language-dominant hemisphere

Question 57

Lexical agraphia is often associated with what other disorders?

Answer 57

Aphasia, alexia, Gerstmann syndrome

Question 58

Lexical agraphia

Answer 58

Selective impairment of lexical (whole-word) spelling route that results in overreliance on spelling by sound-to-letter correspondence; inability to spell irregular words ('feign' becomes 'fane')

Question 59

Alexia with agraphia is associated with a lesion in the

Answer 59

Inferior parietal lobe of LH, centering on angular gyrus

Question 60

Primary acalculia is associated with lesions in

Answer 60

Dominant angular gyrus/inferior parietal lobe, dominant or nondominant perisylvian lesion

Question 61

Gerstmann's syndrome

Answer 61

Agraphia, finger agnosia, L/R disorientation, alcalculia

Question 62

Global alexia

Answer 62

Term used to indicate total loss of the ability to understand written or printed language; synonymous with central alexia but indicates total loss

Question 63

Literal alexia is associated with what other conditions?

Answer 63

R HP, nonfluent aphasia, unilateral sensory/visual field neglect