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Post-stroke Chinese pure alexia: linguistic features and neuropsychological profiles

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Abstract

Purpose

Very few cases of Chinese pure alexia have been reported to date. We aim to summarize the linguistic features and neuropsychological profiles of Chinese pure alexia through a case series study.

Methods

11 consecutive patients with post-stroke Chinese pure alexia and 11 healthy controls were included. The Aphasia Battery of Chinese (ABC) and 68-Chinese character oral reading test (68-character test) were used to evaluate the reading and writing ability. Reading errors were classified based on the performance of 68-character test. Neuropsychological profiles were evaluated with corresponding scales. The possible correlation between the reading ability and the writing ability or neuropsychological performance was analyzed.

Results

The patients had a correct rate of 43.7 ± 23.2% in the 68-character test, significantly lower (P < 0.001) than that of controls. Shape-similar error was the most common type of reading error (101/209, 48.3%). The ABC total writing score rate of the patients ranged from 68.9% to 98.7% (median, 90.5%), significantly lower (P < 0.001) than that of the controls. The patients also showed worse performance in MMSE, auditory verbal learning test, Boston naming test, intersecting pentagons copying and clock-drawing test (all P < 0.05). In the patient group, the correct rate of 68-character test was significantly correlated with the ABC total writing score rate (P = 0.008), the score rate of Boston naming test (P = 0.017), and the clock-drawing test score (P = 0.010).

Conclusion

Shape-similar errors may be a characteristic of Chinese pure alexia. The correlation between visuospatial dysfunction and pure alexia might explain the frequent occurrence of shape-similar errors in Chinese pure alexia.

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Funding

 This work was supported by Shanghai Municipal Health Commission [No.20204Y0425 and No. 20204Y0419] and the National Natural Science Foundation of China [No. 82202799 and No.82271350].

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Author notes

  1. Shen-yi Kuang and Yi Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Huashan Hospital, Fudan University, No.12, Middle Wulumuqi Road, Shanghai, 200040, China

    Shen-yi Kuang, Yi Xu, Zi-gao Wang, Qiang Dong, Xiang Han & Shi-Lin Yang

  2. Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China

    Yi Xu

  3. Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China

    Yu-yuan Wang

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  1. Shen-yi Kuang
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Correspondence to Xiang Han or Shi-Lin Yang.

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Supplementary Information

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Supplementary file 1 (DOCX 17 KB) Table Error types of the clock drawing

13760_2024_2479_MOESM2_ESM.jpg

Supplementary file 2 (JPG 48 KB) Supplementary eFigure 1. Imaging of the patients Brain images showed left temporo-occipital lobe infarction in all patients. 8 of them (patient 1-5,7,8,10) had additional infarction of splenium of the corpus callosum. Supplementary eFigure2. Examples of visual dysgraphia. Some patients exhibited visual dysgraphia, writing a non-existing character that visually resembles the correct character. The expected writing (correct) is shown in the upper row, and the actual writing (incorrect) is shown in the lower row

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Kuang, Sy., Xu, Y., Wang, Yy. et al. Post-stroke Chinese pure alexia: linguistic features and neuropsychological profiles. Acta Neurol Belg 124, 611–620 (2024). https://doi.org/10.1007/s13760-024-02479-z

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