Ingles Janet L, Fisk John D, Fleetwood Ian, Burrell Steven, Darvesh Sultan
*School of Human Communication Disorders Departments of †Psychology and Neuroscience ‡Medicine §Psychiatry ∥Surgery ¶Diagnostic Radiology #Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Cogn Behav Neurol. 2014 Mar;27(1):31-47. doi: 10.1097/WNN.0000000000000022.
Clinical analyses of patients with acquired dysgraphia provide unique opportunities to understand the cognitive and neural organization of written language production. We report J.B., a 50-year-old woman with peripheral dysgraphia who had prominent dissociations in her ability to write in lowercase versus uppercase and print versus cursive. We gave J.B. a series of tasks that evaluated her skills at writing uppercase and lowercase print and cursive, spelling aloud and in writing, writing numbers and symbols, and visual letter recognition and imagery. She was impaired in printing letters, with lowercase more affected than uppercase, but her cursive writing was relatively intact. This pattern was consistent across letter, word, and nonword writing tasks. She was unimpaired on tasks assessing her visual recognition and imagery of lowercase and uppercase letters. Her writing of numbers was preserved. J.B.'s handwriting disorder was accompanied by a central phonological dysgraphia. Our findings indicate functional independence of graphomotor programs for print and cursive letter styles and for letters and numbers. We discuss the relationship between peripheral and central writing disorders.
对后天性书写障碍患者的临床分析为理解书面语言生成的认知和神经组织提供了独特的机会。我们报告了J.B.，一名50岁患有外周性书写障碍的女性，她在小写与大写书写以及印刷体与草书书写能力上存在明显的分离。我们给J.B.进行了一系列任务，评估她书写大写和小写印刷体及草书的技能、出声拼写和书写拼写、书写数字和符号，以及视觉字母识别和想象。她在印刷字母方面存在障碍，小写字母比大写字母受影响更大，但她的草书书写相对完好。这种模式在字母、单词和非单词书写任务中是一致的。在评估她对小写和大写字母的视觉识别和想象的任务中，她没有受损。她书写数字的能力得以保留。J.B.的书写障碍伴有中枢性语音书写障碍。我们的研究结果表明，印刷体和草体字母样式以及字母和数字的书写运动程序具有功能独立性。我们讨论了外周性和中枢性书写障碍之间的关系。
