Meyer Aaron M, Snider Sarah F, Faria Andreia V, Tippett Donna C, Saloma Ryan, Turkeltaub Peter E, Hillis Argye E, Friedman Rhonda B
Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, USA.
Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center, USA.
Neuropsychologia. 2025 Jan 29;207:109066. doi: 10.1016/j.neuropsychologia.2025.109066. Epub 2025 Jan 3.
The underlying causes of reading impairment in neurodegenerative disease are not well understood. The current study seeks to determine the causes of surface alexia and phonological alexia in primary progressive aphasia (PPA) and typical (amnestic) Alzheimer's disease (AD). Participants included 24 with the logopenic variant (lvPPA), 17 with the nonfluent/agrammatic variant (nfvPPA), 12 with the semantic variant (svPPA), 19 with unclassifiable PPA (uPPA), and 16 with AD. Measures of Surface Alexia and Phonological Alexia were computed by subtracting control-condition word reading accuracy from irregular word reading and pseudoword reading accuracy, respectively. Cases of Surface Alexia were common in svPPA, lvPPA, uPPA, and AD, but not in nfvPPA. At the subgroup level, average Surface Alexia was significantly higher in svPPA, lvPPA, and uPPA, compared to unimpaired age-matched controls. Cases of Phonological Alexia were common in nfvPPA, lvPPA, and uPPA, and average Phonological Alexia was significantly higher in these subgroups, compared to unimpaired age-matched controls. Behavioral regression results indicated that Surface Alexia can be predicted by impairment in the lexical-semantic processing of nouns, suggesting that a lexical-semantic deficit is required for the development of surface alexia, while cortical volume regression results indicated that Surface Alexia can be predicted by reduced volume in the left Superior Temporal Pole, which has been associated with conceptual-semantic processing. Behavioral regression results indicated that Phonological Alexia can be predicted by impairment on Pseudoword Repetition, suggesting that this type of reading difficulty may be due to impaired phonological processing. The cortical volume regression results suggested that Phonological Alexia can be predicted by reduced volume within the left Inferior Temporal Gyrus and the left Angular Gyrus, areas that are associated with lexical-semantic processing and phonological processing, respectively.
神经退行性疾病中阅读障碍的潜在原因尚未完全明确。当前研究旨在确定原发性进行性失语（PPA）和典型（遗忘型）阿尔茨海默病（AD）中表层失读症和语音性失读症的病因。参与者包括24名患有言语流畅性变异型（lvPPA）、17名患有非流畅/语法缺失变异型（nfvPPA）、12名患有语义变异型（svPPA）、19名患有无法分类的PPA（uPPA）以及16名患有AD的患者。表层失读症和语音性失读症的测量分别通过从不规则词阅读和假词阅读准确性中减去对照条件下的单词阅读准确性来计算。表层失读症病例在svPPA、lvPPA、uPPA和AD中较为常见，但在nfvPPA中不常见。在亚组水平上，与年龄匹配的未受损对照组相比，svPPA、lvPPA和uPPA中的平均表层失读症显著更高。语音性失读症病例在nfvPPA、lvPPA和uPPA中较为常见，与年龄匹配的未受损对照组相比，这些亚组中的平均语音性失读症显著更高。行为回归结果表明，名词的词汇语义加工受损可预测表层失读症，这表明表层失读症的发展需要词汇语义缺陷，而皮质体积回归结果表明，左侧颞上极体积减小可预测表层失读症，该区域与概念语义加工有关。行为回归结果表明，假词重复受损可预测语音性失读症，这表明这种类型的阅读困难可能是由于语音加工受损所致。皮质体积回归结果表明，左侧颞下回和左侧角回体积减小可预测语音性失读症，这两个区域分别与词汇语义加工和语音加工有关。
