Brain MRI Lesions in Alexia Without Agraphia: A Case-Control Study.

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Jeremy N Shapiro, Aseem Sharma, Jonathan D Trobe, Ryan D Walsh, Sangeeta Khanna
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引用次数: 0

Abstract

Background: Alexia without agraphia (AWA) is an acquired reading disturbance associated with left posterior cerebral artery (PCA) infarction. Based on autopsy and neuroimaging, there are two explanations for its pathogenesis: a visual cortex-language cortex disconnection and a visual word-form agnosia. Our goal was to discover if more refined brain imaging in a case-control study would provide further imaging support for either of these hypotheses.

Methods: A neuroradiologist masked to the presence of AWA reviewed diffusion-weighted and fluid-attenuated inversion recovery brain MRIs in patients who had left PCA infarctions with AWA (9 patients) or without AWA (18 patients) to characterize lesions in the splenium, left forceps major, and left fusiform gyrus.

Results: Patients with AWA had various combinations of lesions in the splenium, left forceps major, and left fusiform gyrus. One of these regions was involved in 3 patients, 2 were involved in 3 patients, and 3 were involved in 3 patients. Most (89%) patients without AWA lacked involvement of any of these 3 regions.

Conclusions: Our data provide imaging evidence for the two existing hypotheses of AWA. Involvement of any of these lesions on MRI imaging should encourage clinicians to obtain further neuropsychological testing.

无书写障碍的亚历克西娅的脑磁共振成像病变:病例对照研究
背景:无阅读障碍症(AWA)是一种与左侧大脑后动脉(PCA)梗塞有关的后天性阅读障碍。根据尸检和神经影像学检查,对其发病机制有两种解释:视觉皮层-语言皮层断裂和视觉词形失认症。我们的目标是在病例对照研究中发现更精细的脑成像能否为这两种假说提供进一步的成像支持:方法:一名神经放射科医生在不知道患者是否患有 AWA 的情况下,对伴有 AWA 的左侧 PCA 梗死患者(9 例)或不伴有 AWA 的患者(18 例)进行弥散加权和液体衰减反转恢复脑 MRI 检查,以确定脾脏、左侧大肌和左侧纺锤形回病变的特征:结果:AWA 患者的脾脏、左侧大鱼际和左侧蝶状回有不同的病变组合。3名患者的病变涉及其中一个区域,3名患者的病变涉及两个区域,3名患者的病变涉及三个区域。大多数(89%)无 AWA 的患者的上述 3 个区域均未受累:我们的数据为现有的两种 AWA 假设提供了影像学证据。MRI 成像中任何一个病灶受累都应鼓励临床医生进行进一步的神经心理测试。
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来源期刊
Journal of Neuro-Ophthalmology
Journal of Neuro-Ophthalmology 医学-临床神经学
CiteScore
2.80
自引率
13.80%
发文量
593
审稿时长
6-12 weeks
期刊介绍: The Journal of Neuro-Ophthalmology (JNO) is the official journal of the North American Neuro-Ophthalmology Society (NANOS). It is a quarterly, peer-reviewed journal that publishes original and commissioned articles related to neuro-ophthalmology.
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