Linguistic semantic agraphia: a dissociation of the lexical spelling system from semantics.

Two spelling systems have been described. The phonological system transcodes speech sounds to letters and is thought to be useful for spelling regular words and pronounceable nonwords. Although the second system, the lexical-semantic system, is thought to use visual word images and meaning to spell irregular words, it is not known if this system is dependent on semantic knowledge. We used a homophone spelling test to examine the lexical-semantic system in five patients. The patients were asked to spell individual homophones (doe or dough) using the context of a sentence. Semantically incorrect and correct homophones were spelled equally well, whether they were regular or irregular. These results demonstrate that an irregular word may be spelled without knowledge of the word's meaning. Therefore, the lexical system can be dissociated from semantic influence.