Warrington Elizabeth K, Crutch Ebastian J
Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College, London, UK.
Neurocase. 2005 Oct;11(5):351-62. doi: 10.1080/13554790591006375.
We report a patient with semantic dementia who demonstrated a very unusual dyslexia. He had a global loss of conceptual knowledge in the context of a fluent dysphasia and intact syntax. However, he did not have the surface dyslexia which is typical of semantic dementia; rather his reading impairment was characterized by speech production errors resulting in multiple neologisms. In a series of experiments it was established that input phonological and input orthographical processing were intact as was output phonology for naming and propositional speech. We demonstrate that our patient has a task-specific phonological deficit and we argue that reading and propositional speech rely upon dissociable phonological output systems. Thus we corroborate our earlier evidence of task-specific phonological output stores (Crutch and Warrington, 2001). We also document a greater difficulty with comprehending the written than the spoken word. We account for this pattern of performance in terms of our patient's attempting to read by the indirect phonological route, as with other semantic dementia patients, but suggest that this process is overridden by the task-specific speech production deficit.
我们报告了一名患有语义性痴呆的患者,其表现出一种非常不寻常的诵读困难。在流利性失语且句法完整的情况下,他出现了概念知识的全面丧失。然而,他并没有语义性痴呆典型的表层诵读困难;相反,他的阅读障碍表现为言语产生错误,导致出现多个新造词。在一系列实验中发现,输入语音和输入正字法处理完好无损,命名和命题言语的输出语音也是如此。我们证明我们的患者存在特定任务的语音缺陷,并认为阅读和命题言语依赖于可分离的语音输出系统。因此,我们证实了我们早期关于特定任务语音输出存储的证据(克拉奇和沃林顿,2001年)。我们还记录到,患者理解书面文字比理解口头文字更困难。我们根据患者像其他语义性痴呆患者一样试图通过间接语音途径进行阅读来解释这种表现模式,但认为这个过程被特定任务的言语产生缺陷所掩盖。