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Neurocase. 2018 Feb;24(1):31-40. doi: 10.1080/13554794.2018.1428352. Epub 2018 Jan 19.

The neural substrates of improved phonological processing following successful treatment in a case of phonological alexia and agraphia.

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a Department of Speech, Language, and Hearing Sciences , University of Arizona , Tucson , AZ , USA.
b Department of Neurology , University of Arizona , Tucson , AZ , USA.


Phonological deficits are common in aphasia after left-hemisphere stroke, and can have significant functional consequences for spoken and written language. While many individuals improve through treatment, the neural substrates supporting improvements are poorly understood. We measured brain activation during pseudoword reading in an individual through two treatment phases. Improvements were associated with greater activation in residual left dorsal language regions and bilateral regions supporting attention and effort. Gains were maintained, while activation returned to pre-treatment levels. This case demonstrates the neural support for improved phonology after damage to critical regions and that improvements may be maintained without markedly increased effort.


Acquired alexia; acquired agraphia; aphasia; functional MRI; phonological impairment; rehabilitation

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