Abstract
Pure alexia is a severe impairment of word reading which is usually accompanied by a right-sided visual field defect. Patients with pure alexia exhibit better preserved writing and a considerable word length effect, claimed to result from a serial letter processing strategy. Two experiments compared the eye movements of four patients with pure alexia to controls with simulated visual field defects (sVFD) when reading single words. Besides differences in response times and differential effects of word length on word reading in both groups, fixation durations and the occurrence of a serial, letter-by-letter fixation strategy were investigated. The analyses revealed quantitative and qualitative differences between pure alexic patients and unimpaired individuals reading with sVFD. The patients with pure alexia read words slower and exhibited more fixations. The serial, letter-by-letter fixation strategy was observed only in the patients but not in the controls with sVFD. It is argued that the VFD does not cause pure alexic reading.
Highlights
Pure alexia is a severe impairment of reading with largely preserved writing and other language skills [1]
The first experiment aimed at a description of eye movements in four patients with pure alexia in comparison to eye movements of controls with simulated visual field defects (sVFD)
It has been reported previously that a sVFD did affect control participant’s eye movements and response times in single word reading but that the resulting pattern were different from pure alexia [12]
Summary
Pure alexia is a severe impairment of reading with largely preserved writing and other language skills [1]. The name implies preserved writing and patients usually exhibit little impairment of spoken language processing, their reading is so impaired that it affects the processing of even short words. Patients resort to a slow, serial letter-by-letter identification strategy which led to the alternative term ‘‘letter-by-letter reading’’. The terms ‘‘pure alexia’’ and ‘‘letter-by-letter reading’’ have often been used interchangeably. The former highlights preservation of writing and other language functions while the latter refers to the compensatory strategy of serial reading, usually found in these patients. Serial processing of letters leading to a mild word length effect may occur in other neurological conditions
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